Agentic Insurance

DETECT → INVESTIGATE

Fraud signals & anomaly detection

Investigate behavioural and operational anomalies as leads for careful assessment. Signals should inform investigation, not become unsupported accusations.

THE QUESTIONS WE INVESTIGATE

Start with
the right question.

  • Which patterns merit investigation?
  • How do false positives affect customers and teams?
  • Can your teams explain and challenge each signal?
Discuss an engagement

What an engagement can include

  • Authorised anomaly and behavioural analysis
  • Signal quality and false-positive review
  • Evaluation, escalation and oversight design

What you take away

  • Signal evaluation framework
  • Investigation support priorities
  • Human-review and exception model

Methods, access, evaluation, deliverables, timing and fees are agreed in a written scope. Findings depend on the data and evidence available. Claims and fraud outcomes require accountable human review.