Insurance Fraud in a Borderless World

Insurance fraud is one of the most complex and consequential threats facing the global insurance industry not because it is new, but because it is no longer constrained by borders, jurisdictions, or traditional controls. Addressing this reality requires more than individual company initiatives or isolated enforcement actions. It requires a coordinated, global response built on trust, intelligence sharing, and sustained collaboration.

The Global Insurance Fraud Summit was founded in 2019 to provide that unifying forum. Established as an independent, non-profit organization, GIFS was created with a clear vision: to foster global collaboration in the fight against insurance fraud by bringing together insurers, regulators, law enforcement, and industry leaders from around the world. The objective being not simply to raise awareness, but to formalize a united front against insurance fraud through shared knowledge, best practices, and innovative strategies that deter, detect, and mitigate transnational fraud impacting insurers and policyholders worldwide.

The mission of GIFS reflects this focus to provide a forum for recognized anti-fraud leaders to appropriately share information, data, and methods to combat global insurance fraud, while facilitating stronger communication and coordination across public and private sectors. From the outset, the Summit has been designed to break down geographic and institutional barriers that fraudsters routinely exploit, replacing fragmented efforts with strategic alignment and practical action.

Guided by its Board of Directors, comprised of experienced and diverse antifraud leaders, the Summit is focused on advancing a coordinated global strategy that reflects the evolving nature of fraud risk and public/private collaboration. As transnational fraud becomes increasingly organized and systemic, the Board’s emphasis remains on deliverables that produce measurable outcomes and strengthen the resilience of the insurance ecosystem as a whole.

Now in its eighth year, the Global Insurance Fraud Summit has convened participants from nearly 40 countries, hosting Summits in Spain, Portugal, Scotland, Singapore and Canada, with Panama announced as the host location for 2026. While global in scope, the Summit’s focus remains highly practical, supporting both domestic and internationally operating insurers by improving awareness of emerging fraud trends, regulatory expectations, intelligence sharing, and enforcement realities that increasingly influence financial and operational risk.

From Opportunistic Activity to Transnational
Organized Crime

Once viewed as opportunistic and localized, insurance fraud has matured into a borderless enterprise, frequently driven by transnational organized criminal networks that exploit regulatory fragmentation, digital platforms, and periods of economic or geopolitical stress. High transaction volumes, complex processes, inconsistent oversight across jurisdictions, and limited consequences when fraud is detected make insurance a repeatable and reliable source of illicit revenue.

Modern schemes often involve coordinated actors across multiple countries, combining identity theft, staged losses, provider collusion, cybercrime, and money laundering into a single operating model. While the economic cost of fraud is well understood, the more consequential issue is persistence. Fraud is no longer episodic; it is embedded. For insurers, this creates sustained pressure on loss ratios, operational expenses, investigative capacity, and ultimately long-term financial stability.

Technology as Both Enabler and Countermeasure

Insurers continue to accelerate investment in advanced analytics, artificial intelligence, and automation to detect fraud earlier in the policy and claims lifecycle. When properly governed, these capabilities reduce leakage while improving consistency, speed, and transparency.

At the same time, criminal networks are adopting many of the same tools. Generative AI is increasingly used to create synthetic identities, falsified documentation, manipulated images, and convincing digital artifacts. Deepfake audio and automated claim submissions are no longer theoretical concerns; they are operational realities.

This dynamic presents a defining leadership challenge: how to scale technology-driven detection while preserving governance, explainability, and human judgment. Organizations that strike this balance demonstrate a level of operational maturity that extends well beyond fraud prevention alone.

The Dark Web and the Industrialization of Fraud

The continued expansion of dark web marketplaces has further globalized insurance fraud. Stolen personal data, compromised credentials, and step-by-step fraud methodologies are readily available, enabling specialization among criminal actors. Some groups focus exclusively on data acquisition; others on claim execution; and others on laundering proceeds through international financial channels.

This specialization increases resilience within criminal networks and introduces aggregation risk for insurers. What appears as isolated activity locally may reflect coordinated, repeatable behavior across multiple markets and jurisdictions, particularly for carriers supporting regional or national portfolios.

Geopolitical Instability and Event-Driven Exposure

Geopolitical instability and climate-driven catastrophes continue to amplify fraud risk. Armed conflict, economic sanctions, mass displacement, and supply-chain disruption weaken oversight and strain claims operations, creating environments where both opportunistic and organized fraud can flourish.

Natural catastrophes, in particular, generate predictable surges in inflated or fabricated claims. Insurers must respond quickly and compassionately while maintaining disciplined controls, an increasingly complex task as events occur with greater frequency and severity.

Why Fraud Risk Now Signals Financial Strength

Taken together, these trends reinforce a critical reality: insurance fraud is no longer a peripheral operational concern. It intersects directly with governance effectiveness, cyber resilience, enterprise risk management, and long-term financial sustainability.

From a financial strength perspective, several questions are becoming increasingly relevant:

• Is global fraud risk clearly understood and owned at the executive and board level?

• Are analytics and controls embedded across the value chain, or limited to reactive post-loss review?

• Does the organization actively participate in intelligence sharing and collaboration with industry peers, regulators, and law enforcement?

• Are systems, data, and people equipped to evolve as fraud tactics change?

Insurers that address these questions proactively are better positioned to withstand volatility and protect long-term market confidence.

Looking Ahead

The insurance industry’s ability to manage transnational fraud risk will increasingly depend on executive-level engagement and collective leadership. As fraud schemes grow more organized, technology-enabled, and globally coordinated, fragmented responses will prove insufficient. Forums such as the Global Insurance Fraud Summit play a critical role in enabling senior leaders to align strategy, share intelligence, and engage directly with regulators and law enforcement across jurisdictions. Meaningful progress against transnational insurance fraud will require sustained commitment from boards and executive teams treating fraud not as a localized operational issue, but as a strategic, enterprise-level risk that demands coordinated global action to protect financial strength, policyholders, and market confidence.

To find out more about the Global Insurance Fraud Summit Inc. go to: www.globalinsurancefraudsummit.org.

Matthew J. Smith Esq. is the executive director of the Global Insurance Fraud Summit. He previously served in the same role with the Coalition Against Insurance Fraud, and as an advisor and consumer representative to the National Association of Insurance Commissioners. For more than 30 years he represented insurance carriers across the U.S. in matters involving insurance fraud and bad faith. Smith now also serves as a consultant and expert witness on insurance law matters in the U.S. He may be reached at: director@globalfraud.org.

Dennis Toomey is the president and founder of the Global Insurance Fraud Summit and a director in PwC’s Insurance Fraud and Financial Crimes practice. He is widely recognized as an international subject matter expert in counter-fraud, with deep experience across the property and casualty, life, and disability insurance sectors. With more than 30 years of industry experience, Toomey has worked with insurers globally to design and operationalize advanced fraud, compliance and analytics programs. His background spans law enforcement, industry leadership as head of fraud at a top five insurance carrier, and senior roles in product management and data analytics at global professional services firms. Toomey is a frequent author and speaker on fraud, analytics and transnational organized crime. He may be reached at: President@GlobalFraud.org