Insurance Fraud Detection & Claims Analytics
Navigating Complex Challenges with Innovative Solutions
Insurance fraud is the second most common type of fraud globally, just behind tax fraud — costing the industry up to $80 billion every year (Coalition Against Insurance Fraud). From falsified claims to inflated damages, fraud touches every branch of insurance.
With claims representing the largest single expense for insurers, fraudsters see them as a prime target. As the insurance market grows, so does its appeal for criminal activity — impacting not only company profits but also honest customers, whose premiums rise to cover the losses.
The Challenge for Modern Insurers
-
Up to 10% of all claims involve some form of fraud, detected or undetected.
-
Fraud costs the industry an estimated €80 billion annually.
-
Fraud leakage can reduce insurer profits by 10–12%.
-
85% of insurers have dedicated fraud investigation teams — yet these teams face enormous volumes of structured and unstructured data.
​​
Traditional detection methods are often too slow, incomplete, or dependent on limited sampling. This creates a risk of missed anomalies, lower efficiency, and higher operational costs.
RAALS – The Advanced Fraud Prevention Platform for Insurance
RAALS is an AI-powered, big-data-driven platform designed to detect, prevent, and investigate fraud across the entire insurance claims process.
​
It helps insurers:
​
-
Identify red flags with Key Fraud Indicators (KFIs) and Key Risk Indicators (KRIs).
-
Analyze 100% of claims data in real time — no sampling limitations.
-
Use predictive models to anticipate suspicious activity before it escalates.
-
Automate workflows for faster, more consistent investigations.
-
Ensure compliance with data security and regulatory requirements.
Proven Results in Fraud Detection
RAALS is already saving millions annually for leading insurers worldwide. By combining statistical analysis, machine learning models, and user-friendly interfaces, RAALS delivers:
​
-
Up to 50% reduction in fraudulent claim payouts.
-
Over 6% improvement in loss ratios.
-
Measurable ROI through cost savings and operational efficiency.
-
Intangible benefits such as improved policyholder satisfaction and reduced disputes.
More Than Fraud Detection – A Strategic Advantage
By enhancing the accuracy, speed, and reach of fraud investigations, RAALS transforms the fraud management department from a cost center into a key driver of profitability in a competitive market.
​
Discover RAALS for Insurance – Protect your resources, strengthen customer trust, and stay ahead of evolving fraud threats.
