Resumo

CHUMMUN, BZ. How can Artificial Intelligence reduce fraud in the inclusive cover niche: A case of developing African countries. JCMAN [online]. 2018, vol.15, n.spe, pp.1-17. ISSN 1815-7440.

The article seeks to investigate the relationship between artificial intelligence and fraudulent claims in the inclusive insurance sector in developing countries. Although low-income cover has been classified as an important tool to combat poverty, fraudulent claims continue to escalate and is more a serious threat to the low-income cover market sustainability as fraudsters seem to be a step ahead of the game. Through a review of literature that has flagged to be scarce, the author advances the hypothesis that artificial intelligence is more likely to be successful where the increased use of online purchases of inclusive cover(micro-insurance), high cost of identifying claims fraud, lack of data and resources experienced by the providers of inclusive cover amongst others, are available. The study's drive is predicated on the argument that although with the advances of computing techniques and technology, artificial intelligence systems can be employed to reduce the frequency and severity of fraudulent claims. Despite some identified challenges, the findings reveal that leveraging use of artificial intelligent systems in the low-income cover market could promote the effective sustainability of the inclusive cover niche market as it is an uncertain profit business by nature of its low premium income and high transaction cost compared to the regular insurance market. Finally, the author points to some possible ways for combatting fraudulent claims occurrences through the effective use of artificial intelligence systems in the midst of Industry 4.0.

Palavras-chave : Artificial intelligence; fraudulent claims; fraudulent-combatting measures; inclusive insurance and low-income households.

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