Press Information Bureau (2022) Government website / press release

Anti-fraud system for India's National Health Insurance Scheme (AB-PMJAY)

PIB, Ministry of Health and Family Welfare

Ref: SRC-001-IND-006

https://pib.gov.in/PressReleseDetailm.aspx?PRID=1847423

Accessed: 10/31/2025

Summary

Government press release confirming NHA uses AI and ML for a comprehensive fraud analytics solution. Details NAFU/SAFU structure, Aadhaar-based biometric verification at private hospitals, zero-tolerance approach to fraud. Reports 0.18% of authorised admissions confirmed as fraudulent since inception.

View Harvard reference

Press Information Bureau (2022) 'Anti-fraud system for India's National Health Insurance Scheme (AB-PMJAY)'. New Delhi: PIB, Ministry of Health and Family Welfare, 2 August. Available at: https://pib.gov.in/PressReleseDetailm.aspx?PRID=1847423 (Accessed: 31 October 2025).

Linked Cases (1)

IND-006 IND Full Production Deployment

AI-Enabled Fraud Detection and Analytics for India's National Health Insurance Scheme (AB PM-JAY)

Social insurance Hybrid