Detects suspicious claims and organized schemes using cross-carrier intelligence, triages high-risk cases to the SIU, and drafts investigation plans and case briefs so investigators move faster.
Not yet specifiedSemi-autonomousComplexity: High
This agent is in the backlog. Registered interest decides which agents are specified and prototyped next.
What it does
Score claims for fraud indicators at FNOL and throughout the life cycle
Enrich with cross-carrier network data
Triage and prioritize referrals
Draft investigation plans, case briefs and next steps
Automate routine investigative tasks and document requests
Report SIU metrics and propose new fraud scenarios