In 2026, Équité Association is placing a heightened focus on the impacts of artificial intelligence on insurance crime and fraud. Throughout 2025, our investigators and members began noticing an emerging pattern of criminals leveraging artificial intelligence (AI) to commit insurance crime. As organized insurance crime evolves, the mechanics of fraud are no longer constrained by human capacity or the number of hours in a day. What was once small, local crime rings have expanded into coordinated and sophisticated criminal operations, enabled by technology.

Digital tools, such as AI, have become so easily accessible that criminal organizations are now operating like professional enterprises. Organized crime treats insurance fraud as a reliable, repeatable revenue stream: staging accidents, fabricating claims, and using AI-generated documents and false identities to secure payouts. These schemes no longer stop at a single claim with a single insurer. We have seen a shift from physical crimes like vehicle theft to digital fraud carried out anonymously, remotely, and on a global scale, using stolen data, fake images, and coordinated networks to exploit systems.

These crimes exploiting advanced technologies have concerning public safety implications for Canadians. Insurance fraud sustains a much broader and more dangerous criminal ecosystem, funding other serious crimes such as guns, drugs and human trafficking. For every new technology that makes our lives easier, there is a criminal trying to use it to commit fraud. This is why Équité has invested in the knowledge, infrastructure, and talent to ensure this technology works for crime prevention.

ÉQ Insights: Harnessing the Power of Artificial Intelligence to Fight Insurance Crime

ÉQ Insights, the first ever national P&C insurance fraud detection platform in Canada, leverages ground-breaking AI and machine learning with consortium data to uncover fraudulent networks across multiple insurers. Our advanced analytics and expert data analysts generate reliable, actionable insights.

By developing learning algorithms that can identify and prevent fraud before it enters the system, we are changing how fraud detection happens. Types of advanced technologies ÉQ Insights already uses:

• Machine Learning and Rules-Based AI: ÉQ Insights is leveraging gradient boosted decision trees and other machine learning models trained on historical fraud cases to generate fraud risk scores alerting for new claims.
• Anomaly Detection: Advanced algorithms are used to detect unusual claim patterns and identify potential cross-insurer fraud.
• Graph AI/Network Analysis: Used to detect and visualize complex networks of linked individuals and entities using addresses, phone numbers, and emails to uncover large-scale fraud rings and collusion across thousands of claims and policies spanning multiple insurers.

The fight against insurance fraud, particularly in an era shaped by organized crime and AI, is not the responsibility of any one organization or one tool. It demands a collective response that harnesses human expertise and advanced technology, sharing intelligence across insurers, and strengthening our collaboration with law enforcement and regulators.

Future of AI Use in Insurance Fraud Detection

The future of AI in fraud detection is being shaped by emerging trends that transform innovation and intelligence into insurance crime defense. Our AI fraud detection models are continuously improved to reveal fraudulent networks between claims, policies, people, vehicles, and businesses across multiple insurers. The collaboration between investigative teams, data scientists and our AI-driven platform create a system that’s faster, smarter, and far more resilient.

Advanced technologies that may support insurance crime detection and prevention:

• Large Language Models (LLMs) can analyze language and behavior in claim notes, adjuster comments, and customer statements to identify linguistic patterns that suggest coordination, duplication or intent.
• Computer Vision, Machine Learning, and Image Forensics AI can help us close that gap by spotting reused or fake images that might otherwise go undetected. This technology examines patterns, object details, and overall scene composition to verify authenticity.
• Agentic AI can automatically correlate patterns, detect irregularities across multiple data sources, and prioritize cases for human investigation to automate fraud detection tasks, improving accuracy and enabling investigators to focus on complex cases. While the expanded uses of ‘Agentic AI’ may be in the early stages, these capabilities are being rapidly designed to take on the heavy lifting of tasks, such as automatically gathering, sorting, and interpreting information across multiple data sources.

Integrating AI into Well-established Frameworks

Insurance fraud is deeply complex and requires specialized investigative knowledge and expertise. Équité is leading in intelligence sharing, anticipating trends to mitigate risk and innovating with technology. ÉQ Insights provides participating insurers with the advantages of aggregated data, including fraud data modeling and enhanced reporting. This is complemented by the hands-on expertise of seasoned investigators who lead large cross-insurer fraud cases.

Our analysts specialize in uncovering fraudulent patterns and our investigators – most with extensive backgrounds in law enforcement – work in partnership with our industry members. We use this specialized expertise to identify, predict and prevent fraud.

Through rigorous forensic identification conducted by experts with decades of experience in the field, Équité detects emerging trends in theft and fraud, enables the identification of security vulnerabilities exploited by criminal networks, and provides real-time recommendations to industry stakeholders.

Leveraging the capabilities of AI, Équité is supporting the industry to better detect, understand and respond to emerging insurance crime. Driving collaboration amongst members, law enforcement, government and other stakeholders, Équité is committed to strengthening fraud deterrence efforts to protect Canadians against insurance crime.

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