Top 10 Best Insurance Fraud Detection Software of 2026

FRISS is an AI-powered fraud detection and prevention platform tailored for the insurance industry, utilizing machine learning, behavioral analytics, and network analysis to identify fraud risks in real-time across claims, underwriting, and policies. It delivers actionable insights through a unified score that integrates data from multiple sources, reducing false positives and accelerating straight-through processing for legitimate cases. By automating fraud workflows and providing explainable AI decisions, FRISS helps insurers minimize losses, improve compliance, and optimize operational efficiency.

Shift Technology is an AI-powered platform designed specifically for insurance fraud detection and claims automation, leveraging machine learning to analyze claims data in real-time and identify suspicious patterns across auto, health, and property insurance. It integrates seamlessly with existing insurer systems to triage claims, prioritize investigations, and prevent fraudulent payouts. The solution draws from a vast network of anonymized data from global insurers, enhancing detection accuracy over time.

LexisNexis Risk Solutions offers advanced fraud detection software tailored for the insurance industry, utilizing a massive global data network including claims history, public records, and entity linkages to identify suspicious patterns. It employs AI, machine learning, and predictive analytics to score claims in real-time, detect organized fraud rings, and prevent losses across auto, property, health, and other lines of insurance. The platform integrates with core insurance systems for seamless workflow enhancement and compliance with regulatory standards.

SAS Fraud Management is a comprehensive analytics platform tailored for detecting insurance fraud, including claims, application, and premium leakage fraud. It employs advanced machine learning, AI-driven anomaly detection, and social network analysis to identify fraudulent patterns across vast datasets in real-time. The solution integrates with SAS Viya for scalable deployment and provides customizable rules engines and entity resolution for precise investigations.

FICO Falcon Fraud Manager is an enterprise-grade fraud detection platform leveraging advanced machine learning, analytics, and a massive consortium network to identify and prevent insurance fraud in real-time. It analyzes claims data, policyholder behavior, and external signals to score risks and automate decisioning, reducing false positives while adapting to evolving fraud tactics. Widely used in financial services, it extends effectively to insurance for claims, underwriting, and provider fraud detection.

Verisk Fraud Solutions provides comprehensive insurance fraud detection tools powered by advanced analytics, AI, and machine learning, helping insurers identify fraudulent claims across property & casualty, health, and other lines. It leverages massive consortium databases like ClaimSearch, which aggregates billions of claims data points, to uncover patterns, links, and anomalies in real-time. The platform supports predictive scoring, social network analysis, and workflow integration to reduce fraud losses and optimize investigations.

Cotality is an AI-driven platform specializing in insurance fraud detection, leveraging machine learning to analyze claims data, policyholder behavior, and external sources for anomaly detection. It provides real-time alerts, risk scoring, and investigative tools to help insurers minimize fraudulent claims efficiently. The software integrates with core insurance systems to automate workflows and reduce manual reviews.

Featurespace offers the ARIC Risk Hub, an AI-driven platform specializing in adaptive behavioral analytics for real-time fraud detection across industries, including insurance. It uses unsupervised machine learning to model individual customer behaviors, identifying anomalies in claims, policy applications, and transactions without relying on static rules. This approach enables insurers to combat sophisticated fraud rings while reducing false positives and operational costs.

Guidewire FraudManager is an advanced fraud detection solution integrated within the Guidewire InsuranceSuite, primarily targeting property and casualty insurers. It employs machine learning models, configurable business rules, and network analysis to score claims for fraud risk in real-time and post-submission. The platform equips investigators with tools like link charts, case management, and predictive analytics to uncover fraud rings and suspicious patterns effectively.

Feedzai is an AI-powered risk management platform specializing in real-time fraud detection, including insurance claims fraud, policyholder risk scoring, and suspicious activity monitoring. It uses advanced machine learning models to analyze vast datasets from transactions, behaviors, and external sources for precise risk assessment. The solution offers orchestration tools, explainable AI, and continuous adaptation to emerging fraud tactics, making it suitable for high-volume insurance operations.