SkyNet
SkyNet - Insurance Fraud Engine
Manual insurance fraud investigations are slow, inconsistent, and resource-intensive, often leading to missed fraud indicators, delayed claims, and increased costs.
Skynet, transforms fraud detection with AI-driven automation. It replicates the logic of expert investigators, delivering fast, consistent, and precise risk assessments for insurance claims.
Why Use Skynet Fraud Detection Solution?
Skynet's capabilities streamline the fraud investigation lifecycle, enhancing accuracy and reducing operational overhead.
-
Unified Evidence Hub: Consolidates all claim-related documents into a single, accessible platform for consistent analysis.
-
Automated Red Flag Checks: Systematically evaluates each claim against predefined fraud indicators, marking them as True, False, or requiring further evidence.
-
SME-Driven Insights: Uses digital models of Subject Matter Experts to ask claim-specific questions, ensuring expert-level scrutiny.
-
Risk Date Evaluation: Flags claims filed during high-risk periods for closer review.
-
JSON Report Generation: Produces structured, actionable reports with detailed risk assessments for seamless integration into existing systems.
-
Scalable Architecture: Handles growing claim volumes without compromising speed or accuracy.
-
Background Automation: Runs checks and analyses in the background, freeing investigators for strategic decision-making.
Transform Fraud Detection with Skynet
Skynet replaces manual claim investigations with a powerful, automated solution that ensures no fraud indicator is overlooked, allowing your team to focus on high-priority cases.
-
Comprehensive Evidence Collection: Automatically gathers claim forms, policy schedules, police reports, emails, and other relevant documents.
-
Intelligent Preliminary Checks: Identifies claims involving stolen goods, fast-track cases (e.g., cellphones, storm damage), or low-priority claims (e.g., windscreen replacements).
-
Red Flag Analysis: Evaluates claims against insurer-defined fraud indicators, flagging suspicious patterns with precision.
-
SME Digital Twin: Applies expert-trained models to ask targeted questions, grading claims as Red (high risk), Amber (needs review), or Green (low risk).
-
Contextual Risk Analysis: Assesses incident dates for high-risk periods, such as public holidays or weekends.
-
Structured Output: Delivers machine-readable JSON reports with claim type, red flags, SME question/answer sets, and risk scores.
Unified Evidence Collection: Automatically compiles all relevant claim documents into a single, accessible evidence set.
Intelligent Fraud Detection: Combines rule-based red flag analysis with AI-driven SME models for precise, reliable risk scoring.
Streamlined Workflow: Guides claims through automated evidence collection, checks, fraud analysis, and expert review for efficiency.
Seamless System Integration: Outputs structured JSON reports that integrate effortlessly with claims management systems.
Value for Your Organization
-
Cost Savings: Reduces manual investigation time and error-related losses with automated processes.
-
Enhanced Accuracy: Ensures consistent, expert-level fraud detection, minimizing missed indicators.
-
Faster Claim Processing: Speeds up legitimate claim resolutions by prioritizing high-risk cases for review.
-
Improved Compliance: Delivers transparent, structured outputs for audit-ready investigations.
-
Scalable Growth: Manages increasing claim volumes effortlessly, supporting long-term operational efficiency.
-
Better Resource Allocation: Frees investigators to focus on complex cases by automating routine checks.
Skynet acts as a tireless, AI-driven fraud filter, ensuring your insurance claims process is faster, smarter, and more secure.
Request a Demo
Intrigued by Skynet's Fraud Detection solution? Book a personalized demo with our expert team today and discover how our cutting-edge Fraud Detection tools can revolutionize your insurance operations, enhancing security and minimizing risks.