InsureThink

Insurers need to stop treating fraud and CX as separate problems

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Fraud in insurance is no longer confined to claims. Some of the most damaging activity I see today starts much earlier in the customer journey. From quoting to login to policy setup, fraudsters are exploiting weaknesses in digital experiences long before they ever try to submit anything suspicious. They are using real customer data, manipulating automated systems, and slipping past tools that were designed to catch a different kind of fraud.

That is because most prevention programs still focus on structured data like IDs, forms, and documents. But fraud is no longer only about what someone enters into a field. It is increasingly about how they behave inside the digital experience.

In my work with insurers, I have seen how vulnerable these early touchpoints can be. I have also seen how much risk gets missed when teams lack visibility into what users are doing during a session. Traditional systems were never built to detect behavioral anomalies, but that is where many of today's fraud signals actually live.

Fraud is moving upstream

Today's fraud does not always begin with a claim. It begins with a quote request. It begins with a password reset or an account signup. I have seen fraudsters use synthetic identities, real credentials, and automated quote-tweaking tactics to quietly test what they can get away with.

These signals rarely show up in paperwork. They appear in how someone moves through the process. The quote flow, the sign-in journey, the session behavior itself. This is where intent becomes visible.

Why behavior matters

Behavioral intelligence is about recognizing when something feels out of step with how real customers interact, not only about watching users.

Legitimate users tend to follow a fairly predictable path. They move through tasks at a normal pace, make minor corrections, and proceed logically. Fraudsters behave differently: skipping steps, jumping between screens, hesitating at strange moments, and repeating actions that seem designed to probe for weaknesses. These are deliberate moves to test the system.

These behavioral cues can be tracked without collecting personal information. But they need to be interpreted in real time and with context to be useful.

One tactic I see often is quote manipulation. A user submits quote requests back-to-back, changing just one detail each time. Maybe the ZIP code or the birthdate. The goal is not to get coverage. It is to game the pricing logic. When seen individually, each request looks legitimate. But viewed together, the pattern tells a different story.

Another red flag involves switching devices mid-session. A journey might start on a mobile browser and resume a few minutes later on a desktop in a different location. That does not reflect how most customers behave. It may be innocent, but more often it signals synthetic activity or account takeover attempts.

I also look closely at session flow. Real users tend to move forward in a straight line: quote, register, confirm. In contrast, I have seen suspicious sessions bounce between login, help pages, and account creation multiple times in a row – someone looking for weak points.

On their own, these signals might not prove anything. But together, they form a pattern that can guide smarter decisions.

Why this matters now

Insurers are under pressure to improve digital experience while also reducing fraud. Customers expect easy, seamless journeys, especially on mobile. But minimizing risk often involves adding friction, and that tradeoff can drive people away.

Behavioral data offers a better path. It allows insurers to adapt based on real-time behavior. Users who follow expected patterns can move quickly. Others who raise behavioral red flags can be asked for additional verification. This risk-based approach protects both the business and the customer experience.

It also helps reduce false positives, a major pain point in many fraud systems. Blocking the wrong user creates frustration and damages trust. Behavioral insight helps avoid that.

What comes next

Fraud prevention and customer experience are too closely linked to be managed in isolation. To reduce risk without harming legitimate users, insurers need to understand how real customers behave and learn to act on those signals early.

The companies I see making the most progress are the ones interpreting behavior as soon as a digital session begins. That is where the next generation of fraud prevention is headed. Not at the claims desk, but at the very first click.

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Customer experience Fraud Customer data Claims
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