Insurance9 weeks
Automated AI Claims Processing & Fraud Detection
Client: SureGuard Insurance
Automate damage assessment and detect fraud rings using CV, NLP, and graph analysis.
The Challenge
SureGuard Insurance needed to accelerate legitimate claims processing from days to minutes while automatically identifying and flagging potentially fraudulent claims for investigation. The challenge was to process claims efficiently while detecting sophisticated fraud patterns.
Key Challenges:
- Accelerate legitimate claims processing from days to minutes
- Automatically identify and flag potentially fraudulent claims
- Detect sophisticated fraud rings and organized fraud patterns
- Maintain accuracy while processing high volumes of claims
Without automated claims processing, the company faced slow claim processing times, high fraud losses, and inability to detect sophisticated fraud rings.
Our Solution
- Computer vision system for automated damage assessment from photos and videos
- NLP analysis of claim descriptions and documentation for fraud indicators
- Graph analysis engine detecting suspicious claim patterns and fraud rings
- Automated legitimate claim processing pipeline reducing processing time
- Real-time fraud scoring flagging suspicious claims for investigation
- Integration with existing insurance systems for seamless workflow
Technology Stack
Computer VisionNLPGNNNeo4jFastAPITensorFlow Serving
Client Testimonial
"Cut average processing from 5 days to 2 hours; uncovered a $12M fraud ring."
— Head of Claims, SureGuard Insurance