Fraud Detection
Application & claims-stage scoring · rules + model + network analysis
Application Flags
63
Claims Flags
37
SIU Referral Rate
4.1%
Confirmed Fraud (YTD)
$2.9M
Network Analysis
Ring detection activeApplication Fraud
Claims Fraud
| Applicant | Risk Signals | Score | Status |
|---|---|---|---|
| R. Castellanos | Mismatched garaging address; VIN registered out-of-state | 74 | Under Review |
| B. Whitfield | Prior identity linked to a denied claim | 82 | SIU Referred |
| S. Kim | None triggered | 9 | Cleared |
| Claim # | Pattern Detected | Network Matches | Score | SIU |
|---|---|---|---|---|
| CLM-2026-04398 | Staged-accident indicators | 3 | 81 | Referred |
| CLM-2026-04310 | Duplicate claim across carriers | 2 | 69 | Reviewing |
| CLM-2026-04471 | Invoice date precedes loss date | 0 | 18 | No Referral |