Claims Fraud Detection demo
Every new claim read in full by agents; the ones that need an investigator arrive with the reasons and the evidence. 1:15
What the demo shows
A fraud detection solution that reads every new claim and refers the suspect ones to the SIU.
Six agents read every new claim within minutes of first notice: notes, documents, photos and prior claims. Each claim gets a score out of 1,000 built from plain-word reasons, each reason opening to the exact passage, record or receipt behind it and to the innocent explanations that were checked. Claims above the referral line wait for the SIU intake analyst, who accepts, returns or closes; accepted referrals move to the SIU with a written packet, and SIU outcomes come back as proposed changes for the fraud manager to approve.
Transcript
- Claims Fraud Detection reads every new claim and refers the suspect once to your investigators.
- Today, referrals arrive weeks after first notice and investigators rebuild the file.
- Here, six agents read every claim in minutes, notes, documents, photos and prior claims.
- Each claim gets a score and its reasons.
- Above the line, it waits for Imani.
- Darren Meacham's burglary scores 812.
- The top reason, a policy bought nine days before the loss.
- Each reason opens to its proof like a theft at the same address and the innocent explanations checked.
- Imani accepts. The case moves to an investigator with its packet one day after first notice.
- Referrals in days, not weeks, each with its evidence.
- Built on Botminds: agents, data, screens, and governance on one platform.
Transcribed from the film’s narration. Captions are on the player.