Detect, prevent and manage insurance claims fraud across all lines of business

Fraud Decisioning for Claims highlight

SAS Fraud Decisioning for Claims

Don't accept insurance claims fraud as a cost of doing business.



Key features

Data management

Includes an insurance-specific claims fraud data model that consolidates data from internal and external sources – claims systems, watch lists, third parties, unstructured text and others – and seamlessly integrates into existing solutions.

Advanced analytics & embedded AI

Provides a broad set of advanced analytic and AI techniques, including modern statistical, machine learning, deep learning and text analytics algorithms in a single environment.

Rule & analytic model management

Includes prepackaged insurance-specific rules, anomaly detection and predictive models, with the ability to create and logically manage business rules, analytic models, alerts and watch lists.

Detection & alert generation

Scores claims for fraud at first submission and rescores at each processing stage as new claims data is captured.

Alert management

Combines alerts from multiple monitoring systems and associates them with individuals for a more complete view of the individual’s and group’s risk.

Social network analysis

Goes beyond transaction and detailed claims views to show the network of related activities and relationships.

Search & discovery

Lets you perform free-text, field-based or geospatial searches across all internal and external claims data, and refine using interactive filters.

Case & intelligence management

Streamlines operations with a configurable workflow for systematic, repeatable claims fraud investigations, and captures and displays all pertinent case information.

Flexible deployment options

Turn your insurance claims fraud detection over to SAS in a hosted managed cloud service deployment on Microsoft Azure infrastructure; let SAS remotely manage deployment while you keep the data in your preferred cloud; or choose a combination of the two. SAS managed cloud services deliver fast time to value and high availability. Or deploy on-site if you want to manage and maintain your own environment. Regardless of how you deploy, you get a SAS solution tailored to your organization’s specific requirements.


Recommended resources for SAS Fraud Decisioning for Claims

Solution Brief

Insurance Claims Fraud: Make better payment decisions by quickly detecting and managing fraud

White Paper

Celent Insurance Fraud Detection Solutions: Property and Casualty Insurance, 2022 Edition

White Paper

Simplifying Fraud Analytics: 10 Steps to Detect and Prevent Insurance Fraud


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