Insurance Fraud Market Report 2025: Navigating the AI Era of Risk, Complexity, and Collaboration

Insurance fraud is rapidly evolving from isolated claims events to systemic, AI-driven threats that span the entire policy life cycle. Fraudsters are exploiting automation gaps, generative AI tools, and digital platforms to scale manipulation tactics such as deepfakes, synthetic identities, and orchestrated claims. As insurers face rising claims leakage and customer dissatisfaction, regulators are pushing for more transparent and explainable fraud defenses. This environment is prompting insurers to rethink detection, prevention, and investigation strategies. Generative AI acts as both a threat vector and a potential defense enabler, heightening the urgency for enterprise-wide fraud transformation.

Insurers are increasingly collaborating with providers and technology platforms to combat fraud across distribution, underwriting, and claims. The report outlines key market trends such as regional variations in fraud prevalence, new fraud archetypes, and a growing emphasis on cross-carrier intelligence. It also assesses the emerging landscape of fraud-focused platforms, analytics tools, and outsourcing models that are helping insurers modernize fraud operations. A strategic shift toward holistic, AI-augmented solutions is essential to mitigate risk and uphold customer trust in a digitally disrupted environment.