Insurance Fraud Detection Market Size Worth $9.7 Billion By 2025

The global insurance fraud detection market size is expected to reach USD 9.7 billion by 2025, registering a CAGR of 13.7% over the forecast period, according to a new report by Grand View Research, Inc. Detecting and preventing fraudulent activities is a global challenge for insurers. However, the emergence of advanced solutions such as the use of automated business rules, self-learning models, text mining, predictive analytics, image screening, network analysis, and device identification is expected to deliver actionable insights to improve claims processes. As a result, insurance organizations are adopting fraud detection solutions that not only recognize the genuine claims process but also reduce the number of false positives.

The prevention and detection of fraud capabilities are increasing with the growing awareness of perpetrators and sophisticated crimes. Global concerns about the ever-increasing cases of insurance frauds coupled with sophisticated organized crime, have signaled a need for coherent action by all insurance companies. As per a research conducted by the Federal Bureau of Investigation (FBI), the total estimated cost of insurance fraud in the U.S. is expected to be more than USD 40 billion per year. As a result, in the U.S., it has led to an increased premium of approximately USD 420 to 700 per year for the average earning family. Similarly, according to the Association of British Insurers in the U.K., insurer unearthed more than 113,000 fraudulent claims and 449,000 dishonest insurance applications, valued at USD 1.3 billion. Thus, to curb fraudulent claims coupled with the various stringent regulations set by the government, enterprises are expected to adopt these solutions in the near future. These solutions are expected to enable an enterprise to identify fraudulent activities with higher speed and accuracy, thereby improving the consumer experience by realizing fast payouts.

In the insurance sector, fraudulent activities are primarily categorized as criminal and cultural. In criminal type, professional perpetrators habitually try to identify a weak system to attack. While in cultural type, a genuine claimant is opportunistic by exaggerating a claim. With the help of data analytics, insurance companies can analyze and detect the possibility of fraudulent activities. The user can enter data, and claim applications are automatically given a score to indicate the likelihood that scam has occurred. Thus, the use of predictive modeling can potentially produce a quantified score that helps a company to understand the propensity of a scam. Monitoring the arrived score through the use of advanced solutions is expected to show more accurate and effective results than that of traditional fraud detection methods. However, relying solely on technology for suspecting the fraudulent activities to be flagged is expected to be a key challenge for the insurers. Thus, to overcome such challenges, analysts are required to initiate immediate action and follow appropriate measures to help the company reduce losses.

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Further key findings from the report suggest:

  • Solutions segment held the leading market share in 2018 and is expected to continue leading over the forecast period
  • Managed services segment is anticipated to exhibit the fastest CAGR of 15.6% over the forecast period
  • Large enterprise segment dominated the market with highest revenue share in 2018
  • The Asia Pacific region is anticipated to witness the fastest CAGR over the forecast period

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