Claims Fraud Detection

Key Stats.

97

%+

Claims risk assessed throughout life cycle

30

%+

Increase in retention rate for claims identified as high risk

80

%

Conversion rate for fast tracked claims


Detecting these types of fraudulent behaviour requires a comprehensive approach before any claim is paid. Our fraud detection modules are designed to continuously enhance your ability to identify fraud risks and minimise wasteful false positives.

We employ an array of targeted techniques in our automated fraud prediction process. These include models trained on your data using the latest machine learning methodologies, text mining, fraud profiles, anomaly detection, and geospatial enrichment. Additionally, any risks highlighted by our Fraud Intelligence and Link Analysis applications are seamlessly integrated into the process.


Our rules engine is flexible, allowing you to incorporate your own model outputs and internal referrals, or build rules based on your knowledge and expertise. Either way, we ensure you have all the information you need at your fingertips with our visualisation and business intelligence modules. Our simulation module also lets you compare current results with candidate rule sets, ensuring you have the optimal setup for your needs.


Like all our applications, our case management modules can be deployed independently or as an integrated part of our broader solution, providing flexibility and scalability to meet your needs.

Key Benefits

Utilise machine learning, text mining, anomaly detection, and more to stay ahead of evolving fraud tactics.

Incorporate your own models and referrals, or build custom rules to suit your expertise and specific needs.

Access all necessary information quickly and easily through our advanced visualization and business intelligence modules.

Use our simulation module to test and compare rule sets, ensuring your fraud detection system is always optimised.

Ready to Take Control?

Discover our world class software to help you improve your fraud systems