Real-time anomaly scoring on incoming claims — flag the 5% worth investigating, auto-approve the rest. Save ₹4.5 Cr/yr at industry scale.
Indian insurers absorb thousands of crores in claim fraud annually — fabricated medical bills, staged motor accidents, ghost beneficiaries. Our model scores every claim in real time against historic fraud patterns, claimant behaviour and provider networks. Investigators spend 100% of their time on the 5% of claims that matter.
A typical claim fraud flow, end-to-end.
Claim arrives via your existing intake — portal, agent, or insurer-side system.
Model evaluates frequency, amount, provider, claimant history, network exposure.
Low-risk claims auto-approve. Medium-risk gets flagged for review with reasoning. High-risk goes straight to SIU.
Flagged claims arrive in your investigator queue with explanation, peer comparisons, and confidence score.
Multi-feature claim scoring with explainable output for investigators.
See the model on your historic claim data — sandbox in 1 day.