Insurance fraud costs 308 billion dollars annually. Traditional methods detect only 10-20 per cent.

Insurance fraud represents 5-10 per cent of all claims paid. SIU investigators spend 50-60 per cent of their time on false positives generated by static rules. Organised fraud rings are increasingly sophisticated: coordinated repair shops, staged accidents, and inflation of genuine damage. Rule-based methods catch known patterns but are blind to new typologies. The cost of not detecting far exceeds the cost of investigating.

Coalition Against Insurance Fraud, Shift Technology 2024