Insurance fraud continues to erode profitability
As fraudsters and the technology they use becomes more sophisticated and interconnected, traditional rules‑based and siloed approaches struggle to keep pace — creating blind spots, false positives, and slow investigations that results in increasing loss ratios, operational costs, and customer friction.
Building A Market-Leading Vision For Decision Intelligence
Delivering a category-defining vision for fraud and financial crime prevention - combining agility, scalability, and proven impact to help insurers lead with data-driven intelligence.
HOW WE SOLVE IT
Next generation counter-fraud capabilities
Unify your data estate
Unify internal systems and enrich with external data (corporate registries, industry claims etc) to understand risk holistically
Create a customer and counterparty view
Connect data to reveal hidden relationships across customers, claimants, providers, assets, and organizations
Apply proven fraud analytics
Detect even the most sophisticated fraud with scorecards grounded in contextual data for higher accuracy and better prioritization
Powerful investigation tools
Accelerate fraud investigations and uncover hidden relationships with more accurate contextual intelligence and AI decisioning
THE IMPACT
What we have achieved
$>3Bthe amount of fraud Quantexa has helped organizations detect
in false positive alerts through enrichment
up to 90% increase in fraud impact savings
in loss ratios from improved claims segmentation
WHERE WE HELP
Our Insurance Fraud solutions
Application and Underwriting Fraud
Identify fraud across the full customer lifecycle and all distribution channels.
Claims, Billings, and Provider Fraud
Block fraudulent payments and stop claims leakage across the claim, billing and payment lifecycle.
Internal Fraud Detection
Detect insiders engaged in defrauding the insurance organization or the firm’s customers.
Complex Investigations
Perform complex investigations across all data to identify new and unknown risks.
Increased counter fraud effectiveness and efficiency across the enterprise
Decision Intelligence solutions built on our platform
Data Modernization
Build a trusted data foundation to deliver context for decision-making.
Learn moreCustomer Intelligence
Enhance customer experience and accelerate revenue growth with a 360-degree connected view of customers.
Learn moreKnow Your Customer
Detect risk in real time to identify unknown risks and deliver more accurate risk ratings.
Learn moreRisk Management
Revolutionize risk assessment with a holistic understanding of borrowers, their counterparties and relationships.
Learn moreFinancial Crime
Take a unified approach to fighting financial crime and fraud with our Contextual Monitoring solutions.
Learn moreAML and Investigations
Reduce false positives and focus on real risk by modernizing your AML monitoring, detection, and investigation.
Learn moreFAQs
Does your platform work in real-time?
Yes. Quantexa delivers real-time contextualization and decisioning at the point of need whether that's during claims processing, policy underwriting, or payment approval. Our platform ingests and unifies data from across your organization, then applies entity resolution and network analytics in real-time to surface hidden connections, risk patterns, and fraud indicators before decisions are made.
Beyond real-time scoring, Quantexa also supports batch analytics for deep investigative work and historical pattern analysis. This dual capability means your teams get both the speed to act decisively in the moment and the depth to uncover sophisticated fraud rings operating across time.
What AI and GenAI capabilities do you have in the platform?
Quantexa integrates AI and GenAI across three critical layers: entity resolution, network analytics, and investigative acceleration.
Entity Resolution uses probabilistic AI to connect fragmented identities, resolving the same individual across name variations, multiple addresses, and phone numbers that traditional matching tools miss. This unlocks the hidden fraud concealed in data fragmentation.
Graph Analytics applies advanced AI to reveal multi-hop networks and sophisticated fraud rings. Where rules-based systems analyze transactions in isolation, our AI-powered graph intelligence exposes coordinated schemes involving 5-20+ actors across providers, brokers, and policyholders.
Q Assist, our GenAI copilot, transforms investigative workflows. Investigators ask natural language questions like "What are the hidden connections between this policyholder and other high-risk applications?" and receive instant, contextual insights drawn from unified data reducing investigation times and enabling teams to focus on genuine threats rather than false positives.
Our Agent Gateway enables access to contextual data from Quantexa's Decision Intelligence Platform so that agentic decisions can be grounded in context, as well as enforcing governance and explainability across distributed agent networks.
