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Jubilee busts Sh400m fictitious insurance claims on AI use
From left: Jubilee Holdings Limited Group's CEO Dr Julius Kipngetich, Chairman Zul Abdul and Deputy Group CEO Juan Cazcarra pose for a picture after the release of the company's 2024 Full Year Financial Results at their offices in Upper Hill, Nairobi on April 3, 2025.
Jubilee Holdings foiled fictitious insurance claims worth Sh400 million in the financial year ended December 2024, highlighting the gains of enriching their digital systems with artificial intelligence (AI) capabilities.
The insurer, which operates in Kenya, Uganda, Tanzania and Burundi, said it deployed a fraud detection tool that is supported by AI, which helped it identify and act on 536 suspicious cases and resulted in saving the Sh400 million.
The cases from last year marked a 286 percent increase from the previous year, with 16 cases being escalated to the Insurance Fraud Investigations Unit of the Directorate of Criminal Investigations.
The majority of the cases were addressed through internal mechanisms such as staff disciplinary actions, claim rejections, declined business and enhanced risk assessments, according to the firm.
Jubilee Holdings chairman Zul Abdul said in an interview on Friday that the first-line detection capability has enabled the group to map fraud trends and patterns, facilitating timely and efficient allocation of anti-fraud resources.
“When the economic environment gets difficult, the level of fraud increases and insurance business is particularly fraught with fraud. We have now applied AI to make sure we control fraud,” said Mr Abdul.
“In medical insurance, if one has a common cold and gets a prescription from the doctor but tries to use that prescription to get an aftershave, AI will flag that invoice because it is trained to match diseases with a range of prescriptions.”
Jubilee Holdings deputy CEO Juan Cazcarra said the installation of the system was part of the five-year Sh2.25 billion digital investment that started in 2022, dubbed ‘Changamk@.’
“Today, we are authorising more than 4,000 claims daily without human intervention. This helps us to avoid fraud and overbilling. When these claims were being authorised manually, a lot of fraud cases were going undetected,” said Mr Cazcarra.
He added that data analytics capabilities have helped Jubilee to capture claims whose size and frequency are outside the usual pattern, enabling them to act first.
With industry estimates putting fraud prevalence at 20 percent of total claims, Jubilee Holdings CEO Julius Kipngétich said that cutting the fraud levels would allow underwriters like Jubilee to discount their products, drive affordability and lift insurance penetration from the current under three percent in markets like Kenya.
“We are investing in reviewing our products and enriching them with technology to drive up convenience for customers so that we have the right products on the right platforms so as to change people’s mindset about risk management,” said Mr Kipngétich.
On Friday, Jubilee held its annual general meeting during which shareholders approved a Sh978.39 million dividend made up of Sh144.95 million interim distribution that had been made in October last year and a final payout of Sh833.44 million that was made after the meeting.
Jubilee posted an 82.5 percent jump in net profit to Sh4.72 billion in the financial year ended December 2024, helped by growth in underwriting business and investment income.
