INNOVATION LAB
ClaimFraud Shield
Life Insurance Claims Fraud Intelligence
Under Development
Global TAM: $12BLife Insurance
The Problem
- Life and health insurance fraud costs $80B+ annually globally across all markets
- Hospital billing fraud including upcoding, unbundling, and phantom billing drains insurer reserves
- Provider kickback schemes and collusion networks are growing in sophistication and scale
- Identity-based claims fraud exploits gaps in cross-insurer data sharing and verification
How ClaimFraud Shield Works
Hospital Billing Pattern Analysis
Detects upcoding, unbundling, and phantom billing by comparing provider billing patterns against peer benchmarks and clinical norms.
Provider Network Intelligence
Identifies collusion networks between providers and claimants by mapping referral patterns, shared patients, and financial relationships.
Cross-Insurer Fraud Indicators
Shares anonymized fraud signals across insurers to detect claimants filing duplicate or coordinated claims with multiple carriers.
Key Metrics
$12B
Global TAM
$200-500M/yr
Annual Value
14 months
Time to MVP
20-40
Target Customers
Target Industries
Life Insurers
Health Insurers
Claims Administrators
Reinsurers
Fraud Investigation Units
Interested in ClaimFraud Shield?
Contact our innovation team to explore life insurance claims fraud intelligence.