Claims Avoidance Analytics AI Market Report 2026

The claims avoidance analytics artificial intelligence (AI) market size has grown exponentially in recent years. It will grow from $2.48 billion in 2025 to $3.15 billion in 2026 at a compound annual growth rate (CAGR) of 27.1%. The growth in the historic period can be attributed to rising fraud detection initiatives, increasing adoption of data-driven claims processes, growing use of automated risk assessment, expansion of insurance digitalization, and rising focus on loss prevention.

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.

The rapid expansion of digitalization in the insurance sector is expected to drive the growth of the claims avoidance analytics artificial intelligence (AI) market in the coming years. Digitalization involves the use of digital technologies and platforms to optimize operations, improve customer interaction, and enhance service delivery across insurance activities. The increase in digitalization within the insurance industry is driven by a growing preference for online policy management and digital claims processing, as customers increasingly look for faster, more convenient, and paperless solutions for managing their insurance requirements. Claims avoidance analytics artificial intelligence (AI) supports digitalization in the insurance sector by enabling data-driven decision-making and automating claims evaluation processes. It enhances operational efficiency, minimizes fraudulent or unnecessary claims, and enables proactive risk management, reinforcing the overall digital transformation of insurance operations. For instance, in June 2025, according to Guidewire Software Inc., a US-based insurtech company, the share of customers using AI tools for insurance at least once a week rose from 21% in 2024 to 33% in 2025. Therefore, the growing digitalization of the insurance sector is driving the growth of the claims avoidance analytics artificial intelligence (AI) market.

Major companies operating in the claims avoidance analytics artificial intelligence (AI) market are prioritizing the development of advanced solutions, such as AI-driven automation platforms, to improve efficiency, increase accuracy, and lower operational expenses. AI-driven automation platforms are intelligent systems that optimize the end-to-end claims lifecycle by automating processes, extracting and analyzing data, and supporting informed decision-making. For instance, in March 2024, EIS Group Ltd., a US-based provider of core insurance software, introduced ClaimSmart, an AI-powered, cloud-native claims automation platform designed to reduce claims-related costs. The platform uses AI and machine learning to automate up to 80% of claims activities, from First Notice of Loss (FNOL) through payment, and offers capabilities including automated document ingestion, fraud scoring, and reserve setting, enabling accurate and efficient claims processing with minimal manual involvement. It also incorporates predictive analytics to detect high-risk or potentially fraudulent claims at an early stage, allowing insurers to proactively manage losses. Additionally, the platform supports seamless integration with existing core insurance systems, ensuring scalability and improved operational efficiency across the organization.

In January 2025, CCC Intelligent Solutions Inc., a US-based insurance technology company, acquired EvolutionIQ for an undisclosed amount. Through this acquisition, CCC seeks to strengthen its AI-powered claims capabilities and broaden its presence across disability, workers’ compensation, and auto-casualty insurance segments. EvolutionIQ is a US-based insurtech firm that specializes in AI-driven claims guidance and analytics solutions.

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.

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 the claims avoidance analytics artificial intelligence (AI) market report are Asia-Pacific, South East Asia, Western Europe, Eastern Europe, North America, South America, Middle East, Africa. The countries covered in the claims avoidance analytics artificial intelligence (AI) market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Taiwan, Russia, South Korea, UK, USA, Canada, Italy, Spain.

Note that the outlook for this market is being affected by rapid changes in trade relations and tariffs globally. The report will be updated prior to delivery to reflect the latest status, including revised forecasts and quantified impact analysis. The report’s Recommendations and Conclusions sections will be updated to give strategies for entities dealing with the fast-moving international environment.

Tariffs have had a moderate impact on the claims avoidance analytics artificial intelligence market by increasing costs associated with imported hardware components such as servers, storage devices, and networking equipment used in on-premises deployments. The impact is more visible in hardware-intensive segments and in regions reliant on cross-border technology trade, particularly Asia-Pacific and parts of North America. Software- and cloud-based solutions are less affected, encouraging insurers to shift toward cloud deployment models. In some cases, tariffs have positively supported local data center investments and accelerated adoption of software-centric analytics platforms.

Claims avoidance analytics artificial intelligence (AI) refers to the application of advanced AI and machine learning technologies to predict, prevent, and reduce unnecessary or incorrect insurance claims. These systems examine historical patterns, customer behavior, risk indicators, and operational data to detect potential claim triggers before they arise. The main objective is to lower 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 consists of AI-powered applications and analytics platforms that analyze claims data, identify anomalies, assess risk, and help prevent fraudulent or unnecessary claims. These solutions are deployed through on-premises and cloud environments and are adopted by both small and medium enterprises (SMEs) and large enterprises. The applications span healthcare, insurance, banking and financial services, retail, manufacturing, and others, and they are used by various end users such as insurance companies, healthcare providers, financial institutions, and others.

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.

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.

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