Recent research from Gallagher Bassett highlights an interesting challenge for Australian insurers. In its 2026 claims study, 74% of respondents said claims complexity had increased, while 76% reported difficulty finding qualified candidates. Four in five also said workforce constraints were affecting their ability to grow and manage claims efficiently.
For fraud teams, those findings are worth considering together. Fraud detection has become increasingly sophisticated, giving insurers more ways to identify claims that warrant a closer look. But identifying a potentially suspicious claim is only the start of the process. Someone still has to investigate it, and as cases become more complex, that can place very different demands on the people involved.
An investigator managing 20 relatively straightforward cases may have a very different workload from someone with the same number involving multiple parties, conflicting evidence, linked claims or suspected organised activity. Case numbers alone therefore don’t necessarily give an accurate picture of capacity. Complexity, the type of investigation required and the experience needed to progress it all have an impact on how much resource a case consumes.
Making better use of the skills already in the team
This becomes particularly important when experienced investigators are difficult to recruit. The next available person isn’t always the best person for a particular case. Investigators build knowledge in different areas and some cases will benefit from specific experience, whether that’s a particular fraud type, product area or method of investigation.
For fraud leaders, this makes allocation more than a question of who has the fewest cases. Understanding the likely demands of a new referral, the skills it may require and the genuine workload of the people available can help teams use existing resource more effectively. In a busy operation, however, making those decisions manually becomes increasingly difficult, particularly when new referrals are arriving throughout the day and priorities are constantly changing.
Capacity also isn’t just about how many investigators are available. It’s about how their time is being used. Administration will always form part of an investigation, but searching across systems, gathering information and repeating manual tasks can take experienced people away from work that actually requires their judgement.
This is where technology can make a practical difference. Not by attempting to automate every investigative decision, but by reducing some of the work around the investigation itself. Bringing relevant information together, removing unnecessary manual steps and helping teams allocate cases according to workload and experience can give investigators more time to focus on progressing the cases that need their attention.
Looking beyond headcount
The Gallagher Bassett findings relate to the wider Australian claims workforce rather than fraud investigation teams specifically, so we shouldn’t assume every fraud operation is experiencing the same pressures. They do, however, raise a useful question for fraud leaders. If claims are becoming more complex while experienced insurance professionals are becoming harder to recruit, is headcount still the best way to think about investigation capacity?
Looking more closely at where investigator time is being spent, how work is distributed and whether specialist skills are being used effectively may provide a much better picture. It can also help identify where relatively small changes to processes or technology could release capacity without simply adding more people.
At kbs Intelligence, we see this as an important part of the fraud management process. Good detection matters, but so does what happens once a claim has been referred. How quickly it reaches the right person, how easily they can access the information they need and how much time they can spend actually investigating all influence the eventual outcome.
With claims complexity increasing and skilled people difficult to find, adding more investigative resource won’t always be the easiest option. Making better use of the resource already available may prove just as important.
Source: Gallagher Bassett, The Road Ahead: 2026 Claims Insights – Australia
