ProTect

ProTect: Fraud Detection Built for Health Insurers

ProTect (formerly HAMBS Appraise) is Australia’s only fraud detection system designed specifically for private health insurers. It combines advanced statistical models, behavioural analytics, and investigator-friendly dashboards to surface risky providers, suspicious networks, and anomalies that traditional systems miss.

With intuitive provider drill-downs, ProTect equips fraud and investigations teams to detect, investigate, and prevent fraudulent activity with speed and confidence.

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The Problem It Solves

Hidden Health Fund Losses

Silent Health Fund Losses

Reporting Gaps Exposed

Complex Fraud Goes Unseen

Beyond Surface-Level Data

Deeper Analytics, Clearer Truth

Spot the Unusual Early

Complex Fraud Goes Unseen

Connect the Dots That Matter

Complex Fraud Goes Unseen

Protect Every Health Dollar

Prevent Loss, Maximise Value

Why it Matters

Fraud doesn’t just impact bottom lines; it directly affects the sustainability of fundsand the affordability of premiums. Regulators and members alike are demanding more transparency, while larger funds are investing heavily in fraud prevention.Without an industry-specific system, smaller and mid-tier funds risk being outpaced in efficiency, compliance, and competitiveness.

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Fraud Threatens Fund Sustainability.
Transparency Is No Longer Optional.
Larger Funds Lead in Prevention.
Smaller Funds Risk Falling Behind.

The Risk of Not Having Protect

Failing to address fraud directly puts health funds at risk, leading to financial losses, regulatory penalties, and reduced member trust. Proactive detection and prevention are essential to safeguard funds and maintain competitiveness.

Financial losses multiply

Hidden fraud continues unchecked, often running into millions.

Reactive investigations

Funds respond too late, once losses are embedded.

Regulatory pressure

Inability to demonstrate robust fraud controls may trigger compliance issues.

Reputation Damage

Members lose trust if fraud inflates costs and premiums.

Our Vaues

With ProTect, insurers shift from chasing problems to stopping them at the source.

The result is a healthier fund, stronger member trust, and freed-up resources to focus on delivering better outcomes and value for members. ProTect transforms fraud prevention from a reactive cost centre into a strategic advantage.