Insurance Fraud Detection Solutions: Property and Casualty Insurance, 2022 Edition

A claims fraud-detection system helps insurance carriers identify fraudulent claims, at both the individual and organizational levels. It is typically used by claims teams and in special investigative units (SIU). There are a variety of business benefits that can be achieved from claims fraud-detection solutions, but two of the primary goals are:

•  Improving the carrier’s loss ratio by identifying illegitimate claims.

• Enhancing the overall customer experience by giving carriers the confidence to quickly indemnify claims that are deemed valid.

This report provides an overview of fraud-detection solutions for property-casualty insurance carriers. The report profiles 11 claims fraud-detection solutions providing an overview of their functionality, customer base, technology, SaaS capabilities, implementation, pricing, and support. Celent asked firms that provide claims fraud-detection solution for property-casualty insurers to enter information about their company and products into Celent’s free digital catalog, VendorMatch (https://www.celent.com/vendormatch). This report presents certain extracts of that information. Additional details about each product are available in VendorMatch, subject to VendorMatch’s terms of use. The goal of this report is to help property-casualty insurers to define their claims fraud-detection solution requirements if they are looking to select a partner. It can be used as the first step toward creating a short list of vendors for evaluation. Insurers continue to have a broad spectrum of systems and vendors to consider when looking for a solution to fit their needs. Insurers can leverage their access to the authors through analyst access calls to learn more about the vendors.