Claims Fraud Detection Systems: 2012 IT Vendor Spectrum

by Nicolas Michellod, November 30, 2012
Vendor Reviews
Global

Abstract

The insurance industry is going through difficult times. Getting the insurance business basics right is a major preoccupation for insurance companies worldwide.

In the report, Claims Fraud Detection Systems: 2012 IT Vendor Spectrum, Celent provides a detailed description of IT vendors and their offerings in the claims fraud detection area.

Profiled Vendors

Vendor

Solution

Headquarters

BearingPoint

HyperCube

Amsterdam, The Netherlands

CSC

Fraud Analytics Suite

Falls Church, VA, USA

Detica NetReveal

Detica NetReveal for Insurance

Guildford, United Kingdom

FICO

FICO Claims Fraud Solution

Minneapolis, MN, USA

Friss Fraud & Risk Solutions

FRISS

Utrecht, The Netherlands

IBM

Fraud and Abuse Management Solution

Armonk, NY, USA

Innovation Group

Insurer Analytics

Whiteley, United Kingdom

LexisNexis

ClaimFocus

Alpharetta, GA, USA

Panopticon Software AB

Panopticon

Stockholm, Sweden

SAP

SAP Fraud Management for Insurance

Walldorf, Germany

SAS, Inc.

SAS Fraud Framework for Insurance (SFFI)

Cary, NC, USA

SynerScope B. V.

SynerScope

Eindhoven, The Netherlands

Valen Technologies, Inc.

ClaimsRight

Denver, CO, USA

“Fighting claims fraud represents a key element of insurers’ strategy, and we think claims fraud mitigation will trigger more investment in the near future,” says Nicolas Michellod, Senior Analyst with Celent’s Insurance Group and coauthor of the report.

“There are differences among vendors, most notably in terms of data sources, service, and delivery options,” he adds. “We recommend that insurers carefully assess what options best fit their requirements.”

Each vendor and system described in this report is profiled using the same structure, starting with a synoptic table presenting the company and its claims fraud detection solution. Celent describes the solutions’ data sources and delivery options, functionality, and technology as well as implementation and costs.

This 59-page report contains 57 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 part of Marsh & McLennan Companies [NYSE: MMC].

Media Contacts

North America (Boston)
Tylor Tourville
ttourville@celent.com
Tel.: +1 617 424 3284

Europe (London)
Chris Williams
cwilliams@celent.com
Tel: +44 (0)208 870 7875

Asia (Tokyo)
Yumi Nagaoka
ynagaoka@celent.com
Tel.: +81.3.3500.3023

Table of Contents

Executive Summary

1

An Overview of the IT Vendor Spectrum

2

BearingPoint HyperCube

6

CSC: Fraud Analytics Suite

10

Detica NetReveal: Detica NetReveal for Insurance

14

FICO: FiCO Claims Fraud Solution

19

Friss Fraud & Risk Solutions: FRISS

23

IBM: Fraud and Abuse Management Solution

28

Innovation Group: Insurer Analytics

32

LexisNexis Risk Solutions: ClaimFocus

36

Panopticon Software AB: Panopticon

40

SAP: SAP Fraud Management for Insurance

44

SAS, INC.:SAS Fraud Framework for Insurance (SFFI)

48

SynerScope B.V.: SynerScope

52

Valen Technologies Inc.: ClaimsRight

57

Leveraging Celent’s Expertise

62

Related Celent Research

63

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