The Market Dynamics of Claims Fraud Detection

Deal, Functionality, and Technology Trends
by Nicolas Michellod, April 8, 2013
Industry Trends
Global

Abstract

Claims fraud detection is a crucial topic for insurance companies. The current economic environment makes it difficult for firms to generate underwriting profits. In this context, identifying and fighting fraudulent claims represents a key lever to improve loss ratios.

In the report The Market Dynamics of Claims Fraud Detection: Deal, Functionality, and Technology Trends, Celent provides an overview of the market for claims fraud detection systems. The report describes the anticipated evolution of claims fraud detection system deals and looks at how vendors will try to improve their solutions in terms of both functionality and technology.

“Claims fraud detection is an area where insurance companies will drastically increase their investments in the next three to five years.” says Nicolas Michellod, Senior Analyst with Celent’s Insurance Group and author of the report. “The pace of insurers’ investments in claims fraud detection systems will depend on their understanding of the importance of analyzing data using modern technologies.”

Celent profiled IT vendors active in the claims fraud detection area in November 2012. This report examines trends in the market. Additionally, the report is informed by the findings of a survey launched in the beginning of 2013 regarding insurers’ views on the role and importance of data.

This 22-page report contains 11 figures and 4 tables.

Celent is a research and advisory firm dedicated to helping financial institutions formulate comprehensive business and technology strategies. Celent publishes reports identifying trends and best practices in financial services technology and conducts consulting engagements for financial institutions looking to use technology to enhance existing business processes or launch new business strategies. With a team of internationally based analysts, Celent is uniquely positioned to offer strategic advice and market insights on a global basis. Celent is a member of the Oliver Wyman Group, which is a wholly-owned operating unit of Marsh & McLennan Companies [NYSE: MMC].

Media Contacts

North America
Michele Pace
mpace@celent.com
Tel: +1 212 345 1366

Europe (London)
Chris Williams
cwilliams@celent.com
Tel: +44 (0)782 448 3336

Asia (Tokyo)
Yumi Nagaoka
ynagaoka@celent.com
Tel.: +81 3 3500 3023

Table of Contents

Executive Summary

1

Introduction

2

Market Participants

3

 

A Market with Multiple Facets

3

Deal Trends

5

 

Recent History

5

 

Investment in Claims Fraud Detection Technologies

6

 

Deal Trends

8

Functionality Trends

10

 

The Functionality Elements

10

 

The Celent View on Functionality Trends

11

Technology Trends

14

 

Delivery and Service Approaches

14

 

Celent View on Technology Trends

14

Final Thoughts

18

 

People to Look at Data

18

 

Tools to Look at Data

18

Leveraging Celent’s Expertise

20

 

Support for Financial Institutions

20

 

Support for Vendors

20

Related Celent Research

21

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