Skip to content

Fraud Detection Solutions for Every Insurance Line of Business

95%

Decrease in Outstanding
Referrals

50,000+

Settled Investigations

100m+

Fraudulent Claims Managed

10+

Ready Integrations

Unified Platform for Every Insurance Line

Insurance fraud takes many forms across different insurance lines of business, from staged accidents in motor claims to ransomware attacks targeting cyber policies. Traditional systems rarely account for these variations, leaving insurers with blind spots that fraud networks exploit. The lack of sector adaptability often results in slower investigations, higher claim leakage, and wasted resources.

FraudOps transforms this with sector-specific fraud detection that tunes rule-sets, data layers, and dashboards for every business line. Each claims team gets tools aligned to their unique needs, while executives access enterprise-wide visibility and performance insights.

Tailored dashboards align with insurance lines of business, giving investigators only the most relevant insights.

Rule-sets adapt to specific claim types, improving accuracy and reducing false positives in fraud detection.

Public, commercial, and specialty portfolios benefit from unified workflows without duplicate systems or tools.

Centralised reporting delivers seamless cross-sector oversight, avoiding silos and fractured risk management approaches.

Smarter Fraud Solutions Across Industries

FraudOps delivers industry fraud solutions that work across motor, property, liability, cyber, marine, and niche markets. By training models on millions of historic claims and updating continuously with fresh intelligence, the platform adapts to shifting risk profiles and regulatory environments. Each sector benefits from its own tuned workflows while still connected to a common enterprise spine.

This cross-sector fraud prevention ensures insurers balance operational speed with investigative accuracy, protecting both individual business lines and the enterprise. The result is measurable efficiency: faster triage, stronger compliance, and clear demonstration of value in every claim decision.

Models adapt to evolving loss trends in property, liability, motor, cyber, and specialty insurance portfolios.

Cross-sector fraud prevention strengthens oversight by consolidating enterprise intelligence in one investigation platform.

Audit trails ensure transparency and regulatory compliance across all industry fraud solutions and workflows.

Continuous intelligence updates support proactive detection, reducing delays and investigative blind spots across insurance lines.

Experience how FraudOps adapts to every insurance line with tailored detection and investigation workflows.

One Platform, Tailored to Each Sector

Fraud is never uniform across insurance lines. Each sector carries its own vulnerabilities, risks, and fraud methods. Motor claims are targeted differently from home insurance, while travel and health face distinct challenges altogether. FraudOps provides insurance lines of business fraud detection built to adapt to each scenario. By tuning models, workflows, and detection rules to these contexts, investigators gain sharper accuracy and faster results. This sector-focused approach strengthens insurers against typology-driven fraud, helping protect portfolios while maintaining efficiency and fairness in managing claims.

Complete Audit Histories
Motor Insurance
Motor insurance fraud often appears in staged collisions where networks engineer accidents for false payouts. Fraudsters also inflate or fabricate bogus injury claims, exploiting soft-tissue injuries that are difficult to disprove. Repair scams remain common, with garages or claimants exaggerating damage costs. FraudOps applies sector-specific fraud prevention by linking telematics, vehicle history, and repair estimates to uncover anomalies. Its workflows highlight staged crash patterns, cross-reference medical evidence, and validate repair invoices. This targeted approach ensures investigations address motor fraud typologies directly, improving efficiency and reducing false settlements while safeguarding fairness for legitimate claimants.
Complete Audit Histories
Home & Property
Fraud in home and property insurance can involve deliberate damage staged by policyholders to trigger false claims. Contents exaggeration is another common tactic, with inflated inventories or overvalued possessions. Weather event abuse also emerges when claimants misrepresent storm or flood impacts. FraudOps delivers insurance lines of business fraud detection designed for property claims, verifying damage authenticity, matching inventories, and cross-checking meteorological data. Its workflows ensure each case is reviewed for accuracy, reducing inflated or fabricated payouts. By tailoring tools to property-specific schemes, insurers achieve both loss prevention and faster settlement of genuine claims.
Detective analyzing fraud case data
Travel Insurance
Travel insurance fraud is diverse, from fabricated medical-expense submissions overseas to false or inflated luggage loss claims. Cancellation abuse is also common, where policyholders invent circumstances to recover costs. FraudOps applies industry fraud solutions to travel lines by validating medical invoices, verifying baggage documentation, and reviewing cancellation evidence. Its workflows support cross-border investigations with accurate data checks and global oversight. By addressing each typology individually, FraudOps reduces false payouts while accelerating genuine claim processing. Insurers benefit from greater resilience against fraudulent activity and improved trust with policyholders who rely on travel protection.
Detective analyzing fraud case data
Accident & Health Insurance
Fraud in accident and health insurance often revolves around disability exaggeration, where claimants overstate injuries or incapacity to extend benefits. Treatment over-billing is another issue, with providers submitting inflated or unnecessary charges. FraudOps provides sector-specific fraud prevention tools to analyze medical documentation, validate treatment plans, and assess claimant recovery timelines. Its workflows automatically flag patterns of overcharging and exaggerated disability claims. This enables investigators to intervene earlier, reducing leakage while ensuring valid claims are processed fairly. Tailoring detection to these fraud typologies ensures insurers safeguard resources and maintain trust with policyholders in health-related claims.

Commercial Lines

Commercial insurance fraud brings higher values, complex documentation, and multiple stakeholders, making it harder to investigate. Each line carries its own typologies, from property fires to professional negligence claims. FraudOps delivers insurance lines of business fraud detection with workflows tuned to commercial environments. By applying sector-specific fraud prevention, insurers improve accuracy, reduce leakage, and maintain fairness while handling large-scale, high-value claims.

Detective analyzing fraud case data
Commercial Property
Commercial property fraud often involves deliberate arson staged to trigger payouts. Fraudsters also inflate business interruption losses, exaggerating financial damages well beyond actual impact. Equipment theft claims may involve overstated values or even nonexistent assets. FraudOps applies industry fraud solutions by integrating forensic accounting, asset verification, and property data checks. Its workflows cross-validate financial submissions, review fire indicators, and confirm ownership of equipment. This sector-driven approach ensures insurers reduce exposure to inflated or fabricated claims while safeguarding business clients. FraudOps enhances the efficiency of investigators, ensuring accurate and timely handling of property-related fraud.
Detective analyzing fraud case data
Liability
Fraud in liability insurance often stems from staged public accidents, fabricated slips, or falsified employer negligence. Claimants may exaggerate workplace injuries or construct scenarios to blame employers unfairly. FraudOps equips insurers with sector-specific fraud prevention designed for liability cases, validating incident reports, cross-checking witness statements, and analyzing workplace compliance. Its workflows reveal patterns in recurring fraud schemes and highlight exaggerated negligence claims. By streamlining evidence collection, the platform reduces investigation delays while meeting regulatory obligations. This tailored approach strengthens insurers’ ability to manage liability fraud, protecting both operational efficiency and fairness for genuine claimants and employers.
Detective analyzing fraud case data
Professional Indemnity
Professional indemnity fraud can involve fabricated or exaggerated malpractice claims against lawyers, doctors, or financial professionals. Fraudsters exploit the complexity of professional services to inflate damages or misrepresent negligence. FraudOps delivers insurance lines of business fraud detection built for this sector, integrating client validation, malpractice record analysis, and document verification. Its workflows highlight anomalies in claim narratives, supporting evidence-driven investigations. This targeted approach reduces leakage and prevents fraudulent payouts, while ensuring fair resolution of genuine cases. With tailored solutions for legal, medical, and financial malpractice, FraudOps enables insurers to handle indemnity fraud more effectively and efficiently.
Detective analyzing fraud case data
Directors & Officers
D&O insurance fraud may involve fabricated governance breaches or inflated regulatory investigation costs. Claimants sometimes misrepresent compliance failures or overstate expenses tied to regulatory reviews. FraudOps offers industry fraud solutions tailored to D&O claims, validating regulatory notices, reviewing internal governance documentation, and auditing investigation invoices. Its workflows flag red flags early, allowing investigators to focus on anomalies while supporting compliance obligations. This precision-driven approach reduces false payouts and strengthens oversight in corporate claims. By tailoring detection models to D&O risks, FraudOps ensures insurers safeguard financial resources while maintaining efficiency and trust with business leadership clients.

Specialty Lines

Specialty insurance involves high-value, complex risks across global markets. From maritime trade to cyber incidents, each line demands unique fraud detection. FraudOps delivers sector-specific fraud prevention tools that address these distinct challenges. With tailored workflows, analytics, and intelligence, the platform empowers investigators to manage fraud effectively across marine, aviation, cyber, and credit or political risk. This ensures both operational efficiency and strong protection against specialized fraud typologies.

Detective analyzing fraud case data
Marine & Cargo
Marine and cargo fraud includes vessel scuttling staged to claim insurance, cargo diversion involving rerouted shipments, and organized international fraud rings exploiting global trade. FraudOps delivers insurance lines of business fraud detection for maritime claims, integrating shipping records, vessel tracking, and cargo manifests. Its workflows highlight suspicious vessel losses, cargo discrepancies, and network connections across borders. By tailoring detection to marine fraud schemes, insurers reduce costly exposures while protecting legitimate clients. FraudOps enables faster resolutions and stronger oversight, ensuring insurers manage maritime fraud risks effectively in this highly globalized and complex sector.
Detective analyzing fraud case data
Aviation
Aviation fraud frequently involves inflated damage claims for aircraft, falsified baggage loss submissions, or padded maintenance invoices. FraudOps applies industry fraud solutions specific to aviation risks, validating aircraft repair invoices, auditing baggage records, and cross-referencing maintenance documentation. Its workflows detect anomalies in claims, flagging overcharging and fabricated narratives. With aviation’s strict regulatory requirements, the platform ensures compliance while maintaining investigation efficiency. By tailoring detection tools to aviation fraud, FraudOps empowers insurers to manage risks more effectively, safeguarding against inflated losses while supporting genuine operators and passengers. This ensures balanced protection and fair outcomes across aviation claims.
Detective analyzing fraud case data
Cyber
Cyber insurance fraud is growing, with staged breaches designed to mimic real attacks, bogus ransomware demands fabricated by insiders, and exaggerated business interruption claims following alleged cyber events. FraudOps equips insurers with sector-specific fraud prevention tailored for cyber risks, analyzing breach data, verifying ransomware evidence, and reviewing downtime claims. Its workflows streamline collaboration between IT and fraud investigators, improving detection speed. By tailoring models to cyber-specific fraud, FraudOps reduces exposure to fabricated cyber losses while safeguarding legitimate policyholders. This approach enhances trust and resilience in a sector increasingly targeted by sophisticated fraudsters.
Detective analyzing fraud case data
Credit & Political Risk
Fraud in credit and political risk insurance includes staged debtor defaults, where nonpayment is fabricated, and invented political events used to trigger claims. FraudOps delivers insurance lines of business fraud detection built for this line, combining financial audits, contract reviews, and geopolitical intelligence. Its workflows reveal inconsistencies in debtor histories and expose fabricated political disruptions. This enables insurers to identify fraudulent claims early, reducing losses while ensuring accurate payouts for legitimate cases. By tailoring solutions to these complex risks, FraudOps helps insurers manage specialized fraud effectively across volatile global environments.

See how insurers reduced losses with sector-specific fraud prevention and cross-line resilience.

Why Sector Specific Matters

Fraud in one insurance line looks nothing like fraud in another. A staged crash ring operates differently from a ransomware scheme, and liability claims differ again. FraudOps delivers sector-specific fraud prevention by tuning workflows, rules, and analytics to the unique context of each line. This flexibility enables insurers to strengthen fraud detection without sacrificing cross-line oversight.

Detective analyzing fraud case data
Different Typologies
Fraud typologies vary greatly across lines. A motor crash ring relies on staged accidents and injury exaggeration, while a cyber-ransom event involves fabricated breaches and bogus ransom demands. Treating both with the same models produces inefficiencies and errors. FraudOps applies insurance lines of business fraud detection tailored to each typology, enabling investigators to address risks appropriately. By customizing detection workflows for motor and cyber fraud, the system ensures higher accuracy and reduced leakage. This approach strengthens investigation precision and allows insurers to manage diverse fraud schemes effectively across different business lines.
Detective analyzing fraud case data
Regulation Shifts
Insurance fraud detection must account for regulatory variations across different sectors. FCA compliance applies to UK financial services, IMO sets maritime standards, GDPR governs data, and CAA regulates aviation. FraudOps integrates industry fraud solutions that adjust workflows according to each regulatory framework. This ensures compliance while maintaining investigation effectiveness. By embedding sector-specific regulatory checks, the platform reduces the risk of penalties and legal challenges. Insurers gain confidence in managing fraud while adhering to shifting regulations. This tailored approach combines compliance and accuracy, ensuring fraud detection remains effective across every regulated insurance sector.
Detective analyzing fraud case data
Operational Pressure
Each insurance line brings unique operational pressures. Motor claims carry high volumes requiring fast turnaround. Liability demands careful evidence handling. Cyber requires IT forensics. FraudOps applies sector-specific fraud prevention by aligning workflows with these pressures. Its models adapt to volume-driven environments, extended investigations, or highly technical evidence. This ensures faster fraud detection without compromising thoroughness. By customizing processes to sector requirements, the platform balances speed and accuracy. Insurers benefit from operational resilience, improved efficiency, and consistent fraud detection outcomes regardless of whether they manage high-volume or highly specialized claims.
Detective analyzing fraud case data
Tailored Models
FraudOps lets insurers tune detection models, rules, and workflows for specific lines while preserving oversight across portfolios. This ensures fraud in one sector is not missed in another. By applying insurance lines of business fraud detection consistently, investigators gain sharper accuracy within each line while retaining cross-line visibility. Tailored models prevent false positives, reduce leakage, and accelerate investigations. Insurers benefit from unified oversight that spans personal, commercial, and specialty lines. This balance of sector-specific precision and organizational control enables stronger fraud resilience across the enterprise. FraudOps combines customization with holistic visibility for optimal fraud prevention.

Cross-Line Strength

Fraud schemes rarely stay confined to one line of insurance. Organized rings exploit multiple sectors, shifting tactics across motor, property, and liability claims. FraudOps provides industry fraud solutions that unify intelligence across all lines, enabling insurers to connect cases, reuse investigation knowledge, and strengthen oversight. This approach enhances resilience against fraud networks operating across diverse insurance portfolios.

Detective analyzing fraud case data
Detect Rings Operating Across Personal and Commercial Books
Fraud rings often span both personal and commercial insurance, staging crashes in motor lines while inflating losses in commercial property. Without cross-line insight, patterns remain hidden. FraudOps applies insurance lines of business fraud detection to uncover these networks. Its tools link suspicious activity across books, highlighting common participants and coordinated claims. By detecting fraud rings early, insurers reduce losses and prevent systemic leakage. This cross-line capability ensures fraud detection is comprehensive, targeting not only isolated schemes but also organized groups operating across multiple insurance lines.
Detective analyzing fraud case data
Consolidate Intelligence and Reporting for Group Oversight
Group insurers need consolidated intelligence to manage fraud consistently across subsidiaries and portfolios. FraudOps provides sector-specific fraud prevention tools that unify reporting across lines. Its dashboards present aggregated intelligence, enabling executives to track fraud trends, losses, and investigation outcomes at group level. This consolidated view strengthens strategic decision-making and resource allocation. By uniting intelligence across personal, commercial, and specialty books, insurers enhance organizational resilience. FraudOps supports clear reporting, regulatory compliance, and executive oversight, ensuring leaders can monitor fraud comprehensively. This strengthens governance while enabling tactical responses to emerging fraud risks across the enterprise.
Detective analyzing fraud case data
Re-Use Investigation Knowledge Between Sectors
Fraud patterns identified in one insurance line often resurface in another. Knowledge from motor fraud schemes can inform liability cases, while insights from property claims can improve commercial investigations. FraudOps enables insurers to re-use investigation intelligence across sectors through its industry fraud solutions platform. This prevents duplication of effort and accelerates learning across teams. By sharing fraud typologies and evidence templates, insurers strengthen their defenses against recurring schemes. FraudOps ensures expertise is not siloed but leveraged organization-wide, enhancing efficiency and consistency in fraud investigations. This approach improves outcomes while reducing costs across multiple insurance lines.
Detective analyzing fraud case data
Unified Oversight – Enterprise-Wide Fraud Resilience
Enterprise-wide oversight is essential for managing fraud that crosses multiple insurance sectors. FraudOps delivers insurance lines of business fraud detection with unified oversight, integrating intelligence from personal, commercial, and specialty portfolios. Its workflows ensure consistent application of rules while allowing customization for each sector. This dual capability provides precision at line level with cohesion at enterprise level. Insurers gain resilience against fraud networks operating across portfolios, reducing exposure and maintaining operational efficiency. By combining sector-specific insights with holistic control, FraudOps strengthens organizational defenses and ensures fraud prevention remains effective at every level.

Decision Support Systems

Fraud investigations often involve judgment calls under pressure. FraudOps strengthens those decisions with systems designed to provide structured, evidence-backed guidance. From real-time risk scores to resource planning tools, every recommendation is rooted in data. These capabilities improve consistency, reduce uncertainty, and align investigation choices with broader business and compliance objectives.

Detective analyzing fraud case data
Evidence-Based Recommendations
Fraud teams gain stronger direction through tools that surface clear, fraud case insights based on case data, previous decisions, and emerging patterns. FraudOps analyses inputs across investigations and applies logic models to recommend next steps that reflect best practices.

Whether suggesting document reviews, escalation paths, or case closures, these insights are tailored to investigation context. Recommendations adapt as new evidence is added, ensuring investigators stay aligned with protocols. This guided decision-making improves accuracy, reduces oversight gaps, and supports quality-driven outcomes across all fraud case workflows.
Detective analyzing fraud case data
Risk Assessment
Tools
FraudOps enhances quality management by equipping investigators with consistent, objective risk scoring frameworks. These tools assess each case using configurable parameters like data inconsistencies, behavioural anomalies, and prior fraud indicators.

Risk levels are continuously updated as investigations progress, allowing for smarter task allocation and faster resolution of high-risk claims. Built-in visualisations help teams quickly understand which cases need urgent attention and why. This not only improves efficiency but also supports compliance documentation by making risk evaluation steps transparent and auditable. It ensures decisions are made systematically and defended with clear evidence.
Detective analyzing fraud case data
Investigation Guidance
Real-time tools within FraudOps offer structured prompts and decision frameworks to guide investigators through complex case scenarios. These tools incorporate real-time reporting elements such as status indicators, evidence timelines, and case-specific flags to keep investigators focused on key details.

Suggestions evolve dynamically as new evidence enters the system, helping to avoid missed steps or premature decisions. This built-in guidance supports consistency across teams and improves onboarding for newer investigators. By combining process knowledge with smart prompts, teams achieve better alignment, reduced variance in decisions, and more predictable case outcomes.
Detective analyzing fraud case data
Resource Allocation Insights
Making strategic use of limited resources depends on visibility into investigator performance, case complexity, and fraud exposure. FraudOps supports better planning with fraud case insights that show which types of cases demand more time, which teams are under strain, and where productivity gaps exist.

These insights help managers assign resources more effectively and anticipate investigation delays. Data-driven dashboards offer real-time inputs on task distribution, case load balance, and backlog risk. With clearer visibility into operations, leaders can reallocate efforts where most needed and maintain consistent case outcomes even under shifting workloads.

Compliance and Governance

Meeting regulatory expectations and internal policy standards is essential for fraud operations. FraudOps reinforces this through systems that document, enforce, and monitor every step of the investigation process. By maintaining full audit trails, supporting policy adherence, and ensuring data security, it helps teams stay aligned with external regulations and internal governance models, while enhancing confidence in outcomes.

Detective analyzing fraud case data
Regulatory Compliance
Compliance processes are streamlined through features that support case traceability, structured decision-making, and secure data access. FraudOps helps improve quality management by embedding compliance workflows within the investigation lifecycle.

The platform ensures that all necessary documentation is captured, logged, and easily retrievable for audits or reviews. Alerts and validations flag missing elements before cases can progress, ensuring regulatory readiness throughout. Customisable rules reflect jurisdiction-specific mandates, giving teams flexibility without compromising structure. These tools reduce manual compliance checks and ensure standardisation across regions. With automated documentation and real-time monitoring, organisations stay audit-ready and focused on quality-driven investigation outcomes.
Detective analyzing fraud case data
Governance Frameworks
Strong governance depends on clear policies and consistent enforcement. FraudOps supports this by helping teams apply organisational rules throughout the investigation cycle. These rules guide users through evidence handling, escalation, resolution, and closure stepsu2014ensuring work aligns with defined protocols.

Through built-in workflows and permission-based access, FraudOps delivers fraud case insights that show where governance lapses may occur and how they can be prevented. Custom governance settings can vary by department or jurisdiction, offering flexibility alongside accountability. These frameworks also make it easier to onboard new team members, drive compliance culture, and maintain operational standards across case types.
Detective analyzing fraud case data
Policy Enforcement
Teams must adhere to internal policies as much as regulatory ones. FraudOps enforces compliance with internal procedures through automated rules and built-in checkpoints. These checkpoints verify task completion, documentation accuracy, and reviewer approvals before cases advance.

This supports better real-time reporting and minimises risks tied to oversight failures. Case actions are monitored and flagged when policies are bypassed, enabling managers to intervene before issues escalate. Enforcement rules are configurable, allowing organisations to reflect policy updates quickly across workflows. With stronger enforcement, investigation quality improves, and operational discipline is preserved even in high-volume environments.
Detective analyzing fraud case data
Audit Trail Management
A complete audit trail is a foundation for reliable investigations. FraudOps captures every system event, case modification, and decision point with full attribution. These logs strengthen fraud case insights by offering a clear view of who did what, when, and why.

Timeline views help trace decisions and provide critical evidence in legal or compliance reviews. Data is stored securely and can be exported for third-party auditing or internal review. Teams can use these records to support root cause analysis, uncover process bottlenecks, and demonstrate accountability. This transparency supports both quality control and regulatory defence.

Integration and Customisationn

FraudOps is built to integrate seamlessly with enterprise systems and adapt to diverse investigation needs. It enhances your fraud analytics platform by aligning tools, users, and processes into a centralised workflow. These capabilities support efficient operations while improving investigation quality management across all environments.
System Integration

System Integration

Connect easily with claims, policy, CRM, and identity systems through secure and reliable APIs.nn
Custom Workflows

Custom Workflows

Adapt workflows to match internal SLAs, team structures, and jurisdiction-specific procedures.nn
Flexible Dashboards

Flexible Dashboards

Tailor dashboards for investigators, reviewers, or executives with role-specific data views.nn
Team-Level Configuration

Team-Level Configuration

Support multi-region setups and user roles with granular access and case visibility settings.nn
Reporting Compatibility

Reporting Compatibility

Export data in multiple formats and connect with BI tools for flexible analysis and reportingn
Scalable Deployment

Scalable
Deployment

Add features, users, and functions as operations grow without disrupting ongoing investigations.

Comprehensive Sector Fraud Detection Guide

Gain detailed insights with our comprehensive sector fraud detection guide, designed to help insurers understand the specific risks across personal, commercial, and specialty lines. This resource explains how insurance lines of business fraud detection can be applied effectively to each sector, highlighting common fraud typologies, regulatory considerations, and operational pressures. By reviewing sector-specific strategies, insurers can strengthen fraud prevention frameworks, improve investigative accuracy, and ensure consistent protection across portfolios. Download the guide to explore tailored approaches for fraud resilience.

Book a session with a FraudOps expert to discuss your industry fraud solutions.

Popup Download Guide

Get Access to Our Latest Industry Insights