Reimburse right. Every time.
Health fund and insurer members expect speed. Fraudsters know it. Forged audio and optical invoices, AI-edited prescriptions, deepfake ID documents, shell care networks: manual checks no longer hold. Our document anti-fraud software verifies every supporting document at the source.
Four realities you already know.
Surging document fraud (audio +441%, endemic optical), volume of supporting documents, regulatory pressure (100% Santé), demand for member responsiveness: four constants of health funds and insurance. The figures below come from French regulators (CNAM 2025, ACPR, French audit court). The underlying fraud patterns are observed across European health-insurance markets.
Fraud climbing relentlessly
Hearing aids +441% in one year, health centers +253%, endemic optics fraud, fake medical certificates. Health funds are on the front line.
Complex incoming documents
Underwriting, benefits, claims. Scanned, native digital, handwritten, photos. Manual checks can't keep up.
Regulatory pressure
Anti-money-laundering vigilance, reinforced internal controls, duty of oversight. Every document gap can cost dearly.
Speed vs control
Your members expect a fast response. Your anti-fraud teams need time. The trade-off is impossible to hold manually.
Four fraud vectors, intercepted at the source.
Four document fraud patterns in health insurance: forged care invoices (optical, audio, dental), workflow diversion, organized networks of fictitious practitioners, AI forgeries. Our anti-fraud software detects them at the source.
Optics, hearing aids, dental...
Document fraud detection on the most exposed verticals: hearing aids +441% in one year, health centers +253% (CNAM 2025). Optics fraud remains endemic, dental follows the same trajectory. Over-billing, forged quotes, inflated invoices, AI-retouched prescriptions.
Optics, hearing aids and dental quotes and invoices, medical prescriptions, third-party payment certificates.
Detect forged documents before reimbursement. Identify over-billing. Spot organized networks.
~70% recall, at less than 5% false-positive rate. See how we detect fraud.
On-premise or dedicated private cloud. Your health data never leaves your perimeter.
A concrete use case, in rollout.
A software vendor for the health funds sector.
Several health funds in rollout
A software vendor in the health funds sector rolls out our platform to its client funds. Classification, extraction, checks and fraud detection across all supporting documents.
Over 30 million pages processed in production. The same classification, extraction and fraud detection engines are used daily by 40+ organizations on industrial volumes.
Automatic classification
Digital and scanned documents sorted and named automatically. Payslips, tax notices, prescriptions, invoices, ID documents.
Data extraction
Structured data extracted from every document, including handwritten ones and low-quality scans.
Automatic ingestion
Structured data is delivered in real time to the case management system. No manual entry.
Automated checks
Consistency, completeness and eligibility checks. 2D-Doc and QR codes cryptographically verified.
Fraud detection
Automated per-document checks. Detection of retouching, forgeries and deepfakes on care and benefit evidence.
86%
of health benefit fraud is not detected.
Audit bodies estimate undetected damage at billions of euros per year for public health insurance. For health funds, that translates into tens of euros per member per year of fraud absorbed silently.
Source: public health-insurance audit reports
What changed. Why it's urgent to act now.
Between surging fraud and tightening regulation, the complementary health-insurance sector faces an unprecedented escalation.
- 2019Report
IGAS estimates €1.5Bn of fraud
France's IGAS inspectorate estimates fraud against complementary health insurance at €1 to €1.5 billion per year. Health funds lack adapted detection tools.
- 2021Law
100% Health reform: a fraud accelerator
The 100% Health reform (optics, dental, hearing aids) comes into effect in France. Zero out-of-pocket cost accelerates volumes and creates new vectors for over-billing and fictitious service provision.
- 2021Market
Shift Technology raises $220M
Record Series D for Shift Technology. Insurance fraud becomes a structured market, with specialized players raising massively.
- 2022Scandal
Shell-style health centers
First revelations of health centers billing fictitious services. French public health insurance detects a phenomenon on a sharp rise, which explodes in the following years.
- May 2023Law
Rist Law: control of care centers
Mandatory prior accreditation for dental and ophthalmology centers in France. Reinforced controls on billing practices.
- Dec. 2023Law
Valletoux Law: health governance
Reinforced access to care and territorial health governance in France. Tighter regulation of medical interim and health centers.
- 2025Report
CNAM detects €723M of fraud
Record result: €723M of fraud detected and stopped by France's CNAM in 2025 (+15%). Health centers: €138M. Hearing aids: €86M. Results have tripled since 2021.
- Feb. 2024Scandal
33 million insured exposed
Massive Viamedis and Almerys data leak. 33 million insured exposed. Re-examination of multi-tenant cloud architectures in the complementary health sector.
- 2024Report
Hearing-aid fraud up 441%
France's CNAM reports an explosion of hearing-aid fraud: +441% in one year, €115M identified. Fictitious dispensing, over-billing, fake fittings.
- 2024Technology
CamScanner launches AI document retouching
The Chinese app CamScanner (750M users worldwide, 4M in France) integrates AI document retouching. Document forgery becomes accessible to anyone, with no technical skills.
- 2024Technology
Consumer-grade document deepfakes
Mobile document-forgery apps, generative AI to fabricate supporting documents. Fakes become democratized and more sophisticated.
- 2025Law
Fraud data exchange between basic and complementary insurance
France's social security finance bill authorizes the exchange of fraud information between basic and complementary insurance. Funds need to equip themselves to exploit this data.
- Jan. 2026Report
HCFiPS values social fraud at €13Bn
France's High Council for Social Protection Financing values direct social fraud at around €13 billion per year, a significant share of which is in the health sector.
- May 2026Law
Social and tax fraud law
Adopted May 5, 2026, about 100 measures. Article 5 secures the exchange between basic and complementary insurance. Target: recover €1.5 billion.
- 2026Provence.ai
Provence.ai
Provence.ai launches its AI solution for document fraud detection and case automation, built for complementary health insurance.
Five questions you may be asking.
Measure your exposure.
30 minutes to analyze your supporting documents and quantify your fraud risk. No commitment.