Insurance fraud solutions

Detect and investigate insurance fraud with the power of advanced analytics and machine learning.

Enable risk-based decision making through streamlined systems and processes.

Without a unified tech-enabled approach to fraud management, risk decision making can be daunting.

The solution? Finding powerful technology that can help you identify suspicious circumstances with advanced analytic algorithms and machine learning so you can standardize industry leading practices, metrics, KPIs, analytics and more across all your geographies and lines of business.

How to help future-proof risk management in an era of disruption

Five key takeaways and technology considerations to help future-proof risk management in an era of disruption.

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Our approach

Designed to comply with the most stringent insurance fraud regulations, PwC’s technology and related services are tailored with insurance carriers’ needs in mind.

Automate fraud detection

Identify potential fraud early in the claim life cycle, allowing you to catch potential fraud before incurring costs of claims. Leverage advanced analytics and enriched data to identify signs of potential financial distress, previous criminal activity, aliases, and potential networks to help mitigate exposure to illegitimate claims.

Improve operational efficiency

Apply multilayered analytics to claim, policy and third party data to help find potential complex fraud faster and reduce false positives. Automate investigative activities to reduce the cycle time to assemble data, check related cases and make investigated assignments.

Enhance customer experience

Clear legitimate claims for settlement early in the claim process enabling straight-through processing by digitizing fraud detection early in the claim process. Automate the detection of potential provider fraud, waste and abuse to protect policyholders from inappropriate cost and services.

Insurance fraud products


Risk Detect

Faster analytics and more intelligent testing with the power of advanced analytics. Risk Detect uses artificial intelligence to flag high-risk activity, potentially reducing both the frequency and impact of potential insurance fraud.

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Ready Assess

Fraud maturity assessments at start-up speed. Ready Assess helps streamline your business’ total risk assessments onto a single platform—making the overall process visual, interactive, trackable and actionable.

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Insights you need to help detect insurance fraud

How technology can enable proactive risk management

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Request a demo of our insurance fraud solutions

Discover how Risk Detect and Ready Assess can help solve your business challenges.

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