Pulling off health insurance fraud used to take time and skill.
Until a few years ago, criminals couldn’t fabricate health records without knowing medical terminology and billing codes.
If the scheme involved fooling a call center worker, the fraudster would have to pick up the phone and pose as a patient or doctor.
With artificial intelligence, these barriers have melted away. A simple prompt in a large language model like ChatGPT can generate documentation of a procedure that never happened. AI agents can be told to call an insurance company thousands of times in a single day without human involvement.
“We believed (AI) was something that was going to be leveraged against us as an insurance industry for fraud, and now we’re starting to see that,” said
Kurt Spear, vice president of financial investigation and provider review at Highmark.
The rapid proliferation of artificial…
THE BHI TRUST PONZI SCHEME (SOUTH AFRICA)
Date: Ongoing updates through February 2026 Perpetrator: Craig Warriner (Principal), with alleged co-conspirators
Case Description: The BHI Trust scandal remains one of South Africa’s most devastating financial crimes, involving the loss of between R1.9 billion and R3 billion. Craig Warriner, the “genius trader” behind the trust, turned himself in during late 2023, but the legal and recovery battles reached a fever pitch in 2025 and 2026. Warriner operated the trust as a textbook Ponzi scheme, utilizing “Old Boy” networks and high-profile brokers to lure in pensioners and high-net-worth individuals with promises of 20% annual returns.
In early 2025, the National Prosecuting Authority (NPA) faced heavy criticism for “provisionally withdrawing” charges against alleged co-conspirators Michael Haldane and Sona Pillay. However, civil recovery efforts by joint trustees have continued into 2026, aiming to claw back hundreds of millions in “fictitious profits” from early investors to redistribute to those who lost everything. The case is a masterclass in the failure of fiduciary duty; the FSCA eventually banned several advisors for up to 30 years for peddling the unlicensed scheme despite clear red flags, such as the lack of a website, the absence of regulated financial reports, and a fee structure that was triple the industry average.
Link to Original: Moneyweb – BHI Trust Scandal Deep Dive