Saudi Arabia’s Tawuniya Launches AI-Based Medical Underwriting System to Reduce Claims Leakage

The Company for Cooperative Insurance (Tawuniya), Saudi Arabia’s largest insurer, has introduced an AI-based medical underwriting system designed to significantly reduce claims leakage and improve premium accuracy across its healthcare portfolio.

The new platform analyzes millions of anonymized medical records, treatment histories, and hospital billing patterns to detect fraud, overcharging, and duplicate claims. Tawuniya executives say the system could reduce medical claims expenses by up to 14 percent within two years.

The AI engine was developed in collaboration with South Korea’s Lotte Data Communication and Singapore’s Synapxe, both of which specialize in healthcare data analytics. Tawuniya will deploy the system across employer-sponsored medical plans covering more than five million beneficiaries.

Hospitals in Riyadh, Jeddah, and Dammam have been integrated into the new network. The system flags anomalies such as repeated diagnostics, inflated procedure costs, or unusually high medication billing.

Saudi Arabia’s medical insurance market has grown rapidly due to workforce expansion, attracting attention from global insurers. Analysts say Tawuniya’s move sets a new benchmark in regional medical insurance technology.

The insurer plans to expand the AI system to dental, maternity, and chronic-disease coverage as part of its multi-year digital transformation strategy.