Claims Avoidance Analytics Artificial Intelligence (AI) Market Report 2026

Claims Avoidance Analytics Artificial Intelligence (AI) Market Overview

• Claims Avoidance Analytics Artificial Intelligence (AI) market size has reached to $2.48 billion in 2025 • Expected to grow to $8.16 billion in 2030 at a compound annual growth rate (CAGR) of 26.9% • Growth Driver: Surge In Digitalization Within The Insurance Sector Fueling The Growth Of The Market Due To Rising Adoption Of Online Policy Management And Claims Processing • Market Trend: AI-Driven Automation Platforms Streamline End-to-End Claims Processes • North America was the largest region in 2025 and Asia-Pacific is the fastest growing region.

What Is Covered Under Claims Avoidance Analytics Artificial Intelligence (AI) Market?

Claims avoidance analytics artificial intelligence (AI) refers to the use of advanced AI and machine learning technologies to predict, prevent, and minimize unnecessary or erroneous insurance claims. These systems analyze historical patterns, customer behavior, risk indicators, and operational data to identify potential claim triggers before they occur. The primary purpose is to reduce claim losses, improve insurer profitability, enhance underwriting accuracy, and support proactive risk mitigation strategies. The main components of the claims avoidance analytics artificial intelligence (AI) market include software, hardware, and services. Software refers to the AI-powered applications and analytic platforms that process claims data, detect anomalies, assess risk and help avoid fraudulent or unnecessary claims. These solutions are deployed through on-premises and cloud environments, and they are adopted by both small and medium enterprises (SMEs) and large enterprises. The various applications include healthcare, insurance, banking and financial services, retail, manufacturing, and others and are used by several end- users, such as insurance companies, healthcare providers, financial institutions, and others.

What Is The Claims Avoidance Analytics Artificial Intelligence (AI) Market Growth Forecast?

The claims avoidance analytics artificial intelligence (AI) market size is expected to see exponential growth in the next few years. It will grow to $8.16 billion in 2030 at a compound annual growth rate (CAGR) of 26.9%. The growth in the forecast period can be attributed to increasing demand for automated claims triage, growing deployment of advanced analytics platforms, rising need to reduce claim processing costs, expansion of real-time risk monitoring, and increasing focus on claim accuracy and transparency. Major trends in the forecast period include advancements in predictive analytics models, innovations in real-time risk scoring, developments in AI-driven decision engines, research and developments in automated claims review, advancements in natural language processing for claims, and innovations in behavioural analytics tools.

Global Claims Avoidance Analytics Artificial Intelligence (AI) Market Segmentation

1) By Component: Software, Hardware, Services 2) By Deployment Mode: On-Premises, Cloud 3) By Organization Size: Small And Medium Enterprises, Large Enterprises 4) By Application: Healthcare, Insurance, Banking And Financial Services, Retail, Manufacturing, Other Applications 5) By End-User: Insurance Companies, Healthcare Providers, Financial Institutions, Other End-Users Subsegments: 1) By Software: Predictive Analytics, Fraud Detection, Risk Assessment, Claims Workflow Automation, Reporting And Visualization 2) By Hardware: Servers, Storage Devices, Networking Equipment, Processing Units, Data Centers 3) By Service: Consulting, Implementation, Integration, Training And Support, Maintenance And Monitoring

What Is The Driver Of The Claims Avoidance Analytics Artificial Intelligence (AI) Market?

The surge in digitalization within the insurance sector is expected to propel the growth of the claims avoidance analytics artificial intelligence (AI) market going forward. Digitalization refers to the adoption of digital technologies and platforms to streamline operations, enhance customer engagement, and improve service delivery across insurance functions. The rise of digitalization within the insurance sector is due to the rising preference for online policy management and claims processing, as consumers increasingly seek faster, more convenient, and paperless ways to handle their insurance needs. Claims Avoidance Analytics Artificial Intelligence (AI) enhances digitalization within the insurance sector by enabling data-driven decision-making and automating claims assessment processes. It improves operational efficiency, reduces fraudulent or unnecessary claims, and supports proactive risk management, strengthening the overall digital transformation of insurance operations. For instance, in June 2025, according to Guidewire Software Inc., a US-based insurtech company, the proportion of customers using AI tools for insurance at least once a week increased from 21% in 2024 to 33% in 2025. Therefore, the surge in digitalization within the insurance sector is driving the growth of the claims avoidance analytics artificial intelligence (AI) industry.

Key Players In The Global Claims Avoidance Analytics Artificial Intelligence (AI) Market

Major companies operating in the claims avoidance analytics artificial intelligence (AI) market are International Business Machines Corporation, Oracle Corporation, Verisk Analytics Inc., Palantir Technologies Inc., Fair Isaac Corporation, Guidewire Software Inc., CCC Intelligent Solutions Inc., DataRobot Inc., Duck Creek Technologies Inc., Matterport Inc., Shift Technology Inc., H2O.ai Inc., Tractable Inc., FRISS Inc., Gradient AI Inc., EagleView Technologies Inc., CLARA Analytics Inc., RightIndem Ltd., SAS Institute Inc., EIS Group Inc.

Global Claims Avoidance Analytics Artificial Intelligence (AI) Market Trends and Insights

Major companies operating in the claims avoidance analytics artificial intelligence (AI) market are focusing on developing advanced solutions, such as AI-driven automation platforms, to boost efficiency, enhance accuracy, and reduce operational costs. AI-driven automation platforms refer to intelligent systems that streamline the end-to-end claims process by automating tasks, extracting and analyzing data, and facilitating decision-making. For instance, in March 2024, EIS Group Ltd., a US-based provider of core insurance software, launched ClaimSmart. It is an AI-powered, cloud-native claims automation platform designed to drive down the cost of claims. It leverages AI and machine learning to automate up to 80% of claims tasks, from First Notice of Loss (FNOL) to payment, and includes features such as automatic document ingestion, fraud scoring, and reserve setting, enabling seamless and accurate claims handling with minimal manual intervention. The platform also integrates predictive analytics to identify high-risk or potentially fraudulent claims early, helping insurers proactively mitigate losses. It supports seamless integration with existing core insurance systems, ensuring scalability and enhanced operational efficiency across the enterprise.

What Are Latest Mergers And Acquisitions In The Claims Avoidance Analytics Artificial Intelligence (AI) Market?

In January 2025, CCC Intelligent Solutions Inc., a US-based insurance technology company, acquired EvolutionIQ for an undisclosed amount. With this acquisition, CCC aims to enhance its AI-driven claims capabilities and expand its reach into disability, workers’ compensation, and auto-casualty insurance lines. EvolutionIQ is a US-based insurtech company specializing in AI-driven claims guidance and analytics.

Regional Insights

North America was the largest region in the claims avoidance analytics artificial intelligence (AI) market in 2025. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in this market report are Asia-Pacific, South East Asia, Western Europe, Eastern Europe, North America, South America, Middle East, Africa. The countries covered in this market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Taiwan, Russia, South Korea, UK, USA, Canada, Italy, Spain.

What Defines the Claims Avoidance Analytics Artificial Intelligence (AI) Market?

The claims avoidance analytics artificial intelligence (AI) market consists of revenues earned by entities by providing services such as predictive claims analysis, real-time risk assessment, automated anomaly detection, claims fraud prevention, data-driven underwriting support, claim escalation alerts, loss prevention analytics, and AI-enabled decision support for proactive risk management. The market value includes the value of related goods sold by the service provider or included within the service offering. The claims avoidance analytics artificial intelligence (AI) market also includes sales of AI-powered claims analytics platforms, risk prediction software, automated claim assessment tools, fraud detection systems, data integration solutions, and other advanced analytical products. Values in this market are ‘factory gate’ values, that is the value of goods sold by the manufacturers or creators of the goods, whether to other entities (including downstream manufacturers, wholesalers, distributors and retailers) or directly to end customers. The value of goods in this market includes related services sold by the creators of the goods.

How is Market Value Defined and Measured?

The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD unless otherwise specified). The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.

What Key Data and Analysis Are Included in the Claims Avoidance Analytics Artificial Intelligence (AI) Market Report 2026?

The claims avoidance analytics artificial intelligence (ai) market research report is one of a series of new reports from The Business Research Company that provides market statistics, including industry global market size, regional shares, competitors with the market share, detailed market segments, market trends and opportunities, and any further data you may need to thrive in the claims avoidance analytics artificial intelligence (ai) industry. The market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future state of the industry.