🚀 Now available for enterprise pilots

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ClaimsNet

Next-Generation Insurance Fraud Intelligence

Revolutionary federated learning platform that transforms insurance claims fraud detection through privacy-preserving AI across insurance providers and underwriters.

~90%
Fraud Detection Accuracy
60%
False Positive Reduction
50ms
Real-Time Claim Scoring

Federated Insurance Intelligence Architecture

Collaborative fraud detection across insurance providers while maintaining complete data sovereignty and regulatory compliance

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ClaimsNet Federated Hub

Secure aggregation of insurance fraud intelligence without exposing sensitive claim data

Zero Raw Data HIPAA Compliant Real-Time Intelligence Cross-Provider Patterns
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Health Insurance Provider

🏥 Medical Claims Data
🧠 Local Fraud Model
🔐 Secure Parameters
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Auto Insurance Carrier

🚗 Vehicle Claims Data
🧠 Local Fraud Model
🔐 Secure Parameters
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Property Insurance

🏠 Property Claims Data
🧠 Local Fraud Model
🔐 Secure Parameters
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Life Insurance

💼 Life Claims Data
🧠 Local Fraud Model
🔐 Secure Parameters
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Complete Data Sovereignty

Sensitive claims data never leaves your infrastructure. Only anonymized model parameters are shared for collective fraud intelligence.

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Cross-Provider Intelligence

Benefit from fraud patterns discovered across the entire insurance ecosystem without exposing policyholder data.

Real-Time Claims Scoring

Instant claims risk assessment with continuously updated models trained on the latest fraud patterns.

Absolute Policyholder Privacy Protection

Your Claims Data, Your Control, Your Compliance

ClaimsNet revolutionizes insurance fraud detection by enabling unprecedented collaboration between insurance providers while maintaining absolute policyholder privacy.

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Zero Claims Data Transmission

Sensitive claim information including medical records, damage assessments, and personal details never leave your environment

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Encrypted Model Parameters Only

Only mathematical model updates are shared using advanced homomorphic encryption protocols

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HIPAA & SOC2 Compliance

Built-in compliance frameworks for healthcare data, financial records, and insurance regulations

Privacy-Preserving Data Flow

🏢 Your Insurance Environment

📋 Claims Data Processing
🧠 Local Fraud Model Training
🔒 Parameter Encryption
🔑 Encrypted Model Parameters Only

🌐 Global Insurance Intelligence

📊 Secure Cross-Provider Aggregation
🛡️ Enhanced Fraud Model
📤 Improved Detection Return

Insurance Fraud Detection Excellence

Advanced AI-powered fraud detection that combines the collective intelligence of multiple insurance providers while maintaining complete policyholder privacy

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Sophisticated Claims Fraud Patterns

Detect complex fraud schemes that span across insurance providers through federated pattern recognition and collaborative intelligence.

  • 🏥 Medical billing fraud detection
  • 🚗 Staged accident identification
  • 🏠 Property damage exaggeration
  • 👥 Identity theft prevention

Real-Time Claims Scoring

Instantaneous fraud risk assessment powered by continuously learning models trained on claims data from participating insurance providers.

  • 🚀 Sub-15ms claims scoring
  • 🎯 Dynamic risk thresholds
  • 📈 Behavioral pattern analysis
  • 🔍 Multi-factor fraud assessment
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Collaborative Intelligence

Leverage the collective fraud expertise of multiple insurance providers without compromising policyholder privacy or regulatory requirements.

  • 🌐 Cross-provider fraud patterns
  • 📊 Continuous model improvement
  • 📋 Claims data collaboration
  • 🛡️ Privacy-preserving insights

Advanced Insurance Fraud Detection Capabilities

State-of-the-art insurance AI powered by federated learning and privacy-preserving technologies designed specifically for insurance environments

🏥 Medical Claims Fraud Detection

Medical Billing Fraud

Advanced detection of upcoding, unbundling, and phantom services through pattern analysis and provider behavior monitoring

Provider Network Fraud

Identify suspicious patterns across medical provider networks and detect coordinated fraud schemes

Prescription Drug Fraud

Detect prescription fraud, drug diversion, and abuse patterns across pharmacy networks and providers

Patient Identity Verification

Advanced biometric and behavioral analysis to prevent medical identity theft and false claims

🚗 Auto Insurance Intelligence

Staged Accident Detection

Identify orchestrated collisions and staged accidents through collision pattern analysis and damage assessment AI

Injury Claim Validation

Advanced analysis of injury claims correlating medical records, accident severity, and recovery patterns

Vehicle Damage Assessment

AI-powered damage analysis using computer vision to detect inconsistencies and exaggerated claims

Hit and Run Analysis

Cross-reference accident patterns, damage types, and location data to identify fraudulent hit-and-run claims

🏠 Property & Casualty Intelligence

Property Damage Verification

Computer vision analysis of property damage photos to detect manipulation, staging, or pre-existing conditions

Weather Correlation Analysis

Cross-reference weather data with property damage claims to identify impossible or exaggerated weather-related damages

Contractor Fraud Detection

Analyze contractor networks and repair estimates to identify inflated costs and kickback schemes

Serial Claimant Identification

Detect patterns of frequent claims across multiple properties and insurance providers indicating potential fraud

Cross-Provider Fraud Intelligence

Collaborative Detection Without Data Sharing

ClaimsNet enables insurance providers to benefit from collective fraud detection expertise while maintaining complete data sovereignty and regulatory compliance.

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Cross-Provider Pattern Recognition

Detect fraud patterns that span multiple insurance companies without exposing sensitive policyholder information

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Industry-Wide Fraud Trends

Access real-time insights about emerging fraud trends across health, auto, property, and life insurance sectors

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Regulatory Compliance Monitoring

Automated compliance checking ensures all fraud detection activities meet insurance industry regulations

Instant Fraud Alerts

Real-time notification system for high-risk claims that match known fraud patterns from the federated network

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Claims Submission

New insurance claim enters the system

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AI Analysis

Federated model analyzes claim patterns

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Risk Scoring

Real-time fraud probability assessment

Instant Decision

Automated flagging and priority routing

Regulatory Compliance & Security

Built for the most stringent insurance industry regulations and privacy requirements

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HIPAA Compliance

Full compliance with healthcare data protection requirements for medical insurance claims and patient information

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SOC 2 Type II

Comprehensive security controls for data processing, storage, and transmission in insurance environments

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GDPR Ready

European data protection compliance with right to be forgotten and data minimization principles

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ISO 27001

Information security management standards specifically designed for financial and insurance data

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State Insurance Regulations

Compliance with state-specific insurance regulations and fraud investigation requirements

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NAIC Standards

National Association of Insurance Commissioners data security and privacy standards compliance

Proven Insurance Fraud Detection Performance

Real-world results from insurance providers using ClaimsNet federated fraud detection

~90%
Fraud Detection Rate

Industry-leading accuracy in identifying fraudulent insurance claims across all coverage types

60%
False Positive Reduction

Significant reduction in legitimate claims incorrectly flagged as fraudulent, improving customer experience

50ms
Real-Time Scoring

Lightning-fast fraud risk assessment for immediate claims processing and decision support

99.9%
Privacy Preserved

Complete policyholder data privacy with zero exposure of sensitive claims information

24/7
Continuous Protection

Round-the-clock fraud monitoring with real-time model updates and threat intelligence

Transform Your Insurance Fraud Detection

Join the federated network of forward-thinking insurance providers revolutionizing fraud detection while preserving customer privacy.

Trusted by leading insurance providers • HIPAA Compliant • SOC 2 Compliant