In response to evolving fraud challenges, the Insurance Regulatory and Development Authority of India (IRDAI) has released a draft of new guidelines aimed at creating a robust insurance fraud monitoring framework. This framework, a revised version of the 2013 guidelines, intends to fortify the insurance sector against fraud risks through advanced detection, prevention, and data-driven strategies.
Key Highlights:
- New Fraud Monitoring Framework: The updated framework, known as the Insurance Fraud Monitoring Framework Guidelines, 2024, draws on international best practices and introduces enhanced fraud prevention measures.
- Focus on Data Analytics: Emphasizing data analytics, IRDAI proposes a Fraud Monitoring Technological Framework to utilize comprehensive data for effective fraud prevention across all insurance lines.
- Role of the Insurance Information Bureau (IIB): The IIB will manage a centralized database of suspected fraudulent activities, facilitating real-time threat intelligence and risk mitigation across the industry.
- Unique Identifier Proposal: To streamline fraud detection, a unique identifier for policyholders is suggested to ensure accurate identification across insurers.
- Repository for Blacklisted Entities: IIB will maintain a database of blacklisted agents, hospitals, TPAs, and other entities to protect the integrity of the insurance industry.
Stakeholders and the public are encouraged to submit their feedback on these draft guidelines by 13 November.
