Forward to: Claims Team

Claims Investigation
Workflows

Ten agent workflows for the Claims Team — fraud detection through digital footprint analysis, claimant business verification, repair shop and vendor vetting, claims pattern recognition, suspicious provider identification, staged accident detection, medical provider validation, subrogation target intelligence, litigation risk assessment, and claims leakage prevention.

1Claimant Business Verification

AI agent verifies claimant business legitimacy by analyzing their web presence — detecting shell companies, inflated business valuations, and fraudulent loss claims through domain intelligence cross-referencing.

1
Verify Claimant Business Existence
/about /contact /products /careers Domain Ages OpenPageRank
CLAIMANT VERIFICATION — CLAIM #CLM-2026-12847 ════════════════════════════════════════════════════════ Claimant: Elite Luxury Imports LLC Domain: eliteluxuryimports.com Claim: $2.4M business interruption — warehouse fire VERIFICATION RESULTS: Domain Age: 67 days | PageRank: 0.0/10 /about: "Premier luxury goods importer since 2019" → CONFLICT: Domain registered 67 days ago, claims 7 years /products: Stock photos, no actual inventory shown /contact: Gmail address, no business phone /careers: Not present | /leadership: Not present Web Filtering: Uncategorized FRAUD INDICATORS: 8/10 - Domain age contradicts claimed business history - Zero web authority for a "$15M revenue" company - No employee presence (careers/leadership absent) - Stock imagery suggests no real operations ACTION: Refer to SIU for full investigation
2
Cross-Reference Against Legitimate Claims
Domain Signal
eliteluxuryimports.com — Domain registered only 67 days ago with zero PageRank. Claims to be operating "since 2019" but no web archive history exists. /products shows stock photography (reverse image search confirms). /contact lists only a Gmail address — no legitimate $15M importer uses personal email. Every domain signal contradicts the claimed business profile.
FRAUD — 8 of 10 indicators positive, domain age alone disproves business claims
Sector Signal
Claims Verification Results — Of 234 business interruption claims this quarter, domain intelligence flagged 18 (7.7%) with material discrepancies. SIU confirmed fraud in 14 cases, saving $8.2M in fraudulent payouts. False positive rate: only 2.1% — legitimate claimants are not delayed. Domain age is the single most predictive fraud indicator.
$8.2M fraud prevented this quarter with only 2.1% false positive rate
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Output: Claimant Verification Report

CLAIMANT VERIFICATION — Q1 2026

VERIFICATION SUMMARY: ══════════════════════════════════════════════ BI claims screened: 234 | Flagged: 18 (7.7%) SIU confirmed fraud: 14 cases | False positives: 4 (2.1%) Fraud prevented: $8.2M in fraudulent payouts CURRENT CASE — CLM-2026-12847: Claimant: Elite Luxury Imports | Claim: $2.4M BI Fraud score: 8/10 — Refer to SIU immediately Key evidence: Domain age 67 days vs. claimed 7 years Enrichment: Domain Ages, PageRank, /about, /contact, /careers Total annual fraud prevention value: $32.8M

2Repair Shop & Vendor Vetting

AI agent evaluates repair shops, contractors, and service vendors used in claims — identifying legitimate businesses versus fraudulent or inflated-billing operations through comprehensive domain analysis.

1
Vet Claims Service Providers
/about /pricing /contact /legal Domain Ages OpenPageRank Web Filtering
VENDOR VETTING — AUTO CLAIMS REPAIR SHOPS (Q1 2026) ════════════════════════════════════════════════════════ APPROVED — High Confidence precisionautobody.com Age: 4,380 days | PR: 3.8 | /about: Est. 2008, ASE certified /pricing: Transparent labor rates posted | /contact: 3 locations Consistent with legitimate, established shop FLAGGED — Suspicious Vendor premiumrepairspecialists.net Age: 42 days | PR: 0.0 | /about: Vague, no certifications /pricing: Not present | /contact: Cell phone only /legal: Not present — no business license references Submitted 12 invoices in 6 weeks, avg $8,400 each PATTERN: New entity, high volume, no web legitimacy ACTION: Suspend payments, refer to SIU, audit all invoices MONITORING — New Vendor quickfixautoglass.com Age: 189 days | PR: 1.2 | /about: "Locally owned" Too new to fully assess — limit to $2K per claim
2
Assess Vendor Risk Levels
Domain Signal
premiumrepairspecialists.net — Domain age 42 days with zero PageRank. No /pricing page (legitimate shops post rates), no /legal page (no business license or insurance references), and /contact lists only a cell phone number. Submitted 12 invoices averaging $8,400 in 6 weeks — billing velocity is 4x the rate of legitimate new repair shops in the network.
SUSPEND PAYMENTS — New entity with no legitimacy signals and 4x billing velocity
Sector Signal
Vendor Network Health — Of 342 vendors vetted this quarter, 28 (8.2%) were flagged for suspicious activity. Domain age under 6 months is the strongest predictor of vendor fraud (89% of confirmed fraudulent vendors had domains under 180 days). Implementing domain-based vetting reduced vendor fraud payouts by $3.8M quarterly.
$3.8M quarterly savings from domain-based vendor vetting program
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Output: Vendor Vetting Report

VENDOR VETTING — Q1 2026

VENDOR NETWORK STATUS: ══════════════════════════════════════════════ Vendors vetted: 342 | Approved: 298 | Flagged: 28 | Monitoring: 16 Fraud confirmed: 19 vendors | Savings: $3.8M FLAGGED VENDOR — IMMEDIATE ACTION: premiumrepairspecialists.net — 42-day domain, zero PR 12 invoices ($100K total) — suspend and audit all payments Key predictor: Domain age under 180 days (89% fraud correlation) Annual vendor fraud prevention value: $15.2M

3Fraud Ring Detection

AI agent identifies fraud rings by analyzing domain relationships across multiple claims — detecting shared infrastructure, common registration patterns, and linked business entities that indicate organized fraud schemes.

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Map Domain Relationships Across Claims
/about /contact /legal Domain Ages Countries Web Filtering
FRAUD RING DETECTION — CLUSTER ANALYSIS ════════════════════════════════════════════════════════ RING IDENTIFIED — Cluster #FR-2026-034 Connected entities across 23 claims ($1.8M total): southfloridarestoration.com — Restoration contractor rapidwaterdamage.com — Water damage services elitemooldremoval.net — Mold remediation premiumpaintpros.com — Painting services SHARED INDICATORS: All domains: Registered within 30-day window All domains: Same hosting provider (offshore) /contact pages: Overlapping phone numbers /about pages: Similar template language All claims: Filed through same 2 public adjusters PATTERN: Coordinated water damage claims ring Estimated exposure: $1.8M paid, $3.2M pending ACTION: Freeze all pending payments, notify NICB, SIU takeover
2
Assess Ring Scope & Exposure
Domain Signal
4 Linked Domains — All registered within a 30-day window using the same offshore hosting provider. /contact pages share 2 overlapping phone numbers. /about pages use identical template language with only business names changed. Domain ages range from 45-75 days. This pattern is consistent with organized fraud ring infrastructure — a single entity creating multiple vendor identities.
ORGANIZED RING — 4 domains with shared infrastructure, registration timing, and contacts
Sector Signal
Water Damage Fraud Trend — Water damage claims rings are the fastest-growing fraud pattern in South Florida, up 67% YoY. Domain intelligence has identified 3 rings this quarter totaling $5M in exposure. The pattern is consistent: new vendor domains, shared hosting, overlapping contacts, and routing through specific public adjusters. NICB reports this as a top-5 industry fraud scheme.
EPIDEMIC — Water damage fraud rings up 67% YoY in South Florida
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Output: Fraud Ring Investigation Report

FRAUD RING DETECTION — CLUSTER #FR-2026-034

RING SUMMARY: ══════════════════════════════════════════════ Connected entities: 4 vendor domains | Claims: 23 Amount paid: $1.8M | Amount pending: $3.2M Total exposure: $5.0M EVIDENCE: Shared registration window (30 days), same hosting, overlapping phones Same 2 public adjusters on all 23 claims Domain ages: 45-75 days (all newly created) ACTIONS TAKEN: 1. All pending payments frozen ($3.2M preserved) 2. NICB notification filed 3. SIU assigned dedicated investigator 4. Public adjuster licenses under review

4Medical Provider Validation

AI agent validates medical providers involved in injury claims — verifying practice legitimacy, identifying suspicious billing patterns, and detecting provider mills through web presence analysis.

1
Validate Medical Provider Legitimacy
/about /leadership /contact /compliance Domain Ages OpenPageRank
MEDICAL PROVIDER VALIDATION — WORKERS COMP CLAIMS ════════════════════════════════════════════════════════ FLAGGED — Suspicious Provider advancedpainmanagement247.com Domain Age: 91 days | PageRank: 0.1 /about: No physician names, generic facility description /leadership: Not present — no doctors listed /compliance: Not present — no HIPAA or accreditation references Claims volume: 87 referrals in 3 months (unusually high) Avg bill: $12,400 (3.2x market average) VERDICT: Possible provider mill — refer to SIU VALIDATED — Legitimate Provider oregonorthopedics.com Domain Age: 6,205 days | PageRank: 4.7 /about: Est. 1998, 12 board-certified physicians /leadership: Full physician directory with credentials /compliance: Joint Commission accredited VERDICT: Established, legitimate practice
2
Assess Provider Risk Indicators
Domain Signal
advancedpainmanagement247.com — Domain age 91 days, PageRank 0.1. No /leadership page listing any physicians. No /compliance page referencing HIPAA, Joint Commission, or state licensing. 87 WC referrals in 3 months with average billing 3.2x the market rate. Legitimate pain management practices have domain ages over 3 years and list treating physicians — this entity shows none of these signals.
PROVIDER MILL — New domain, no physicians listed, billing 3.2x market rate
Sector Signal
Medical Provider Fraud — Domain intelligence flagged 12 suspicious medical providers this quarter with $4.8M in total billing. Common pattern: domain age under 6 months, no /leadership page, no /compliance page, and billing volume exceeding 2x market average. Provider mills account for an estimated 8% of WC medical spend nationally.
GROWING TREND — 12 suspicious providers flagged, $4.8M in questionable billing
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Output: Provider Validation Report

MEDICAL PROVIDER VALIDATION — Q1 2026

PROVIDER VALIDATION RESULTS: ══════════════════════════════════════════════ Providers analyzed: 189 | Validated: 165 | Flagged: 12 | Monitoring: 12 Suspicious billing total: $4.8M Confirmed provider fraud: 8 providers ($3.2M recovered) TOP FLAG — advancedpainmanagement247.com: 91-day domain, no physicians, no compliance, 3.2x billing rate 87 referrals in 3 months — refer to SIU and state medical board Key indicators: Domain age, /leadership absence, billing velocity Annual medical provider fraud savings: $12.8M

5Subrogation Target Intelligence

AI agent identifies and evaluates subrogation recovery targets — assessing third-party financial strength, insurance coverage indicators, and business viability through domain intelligence to maximize recovery potential.

1
Assess Subrogation Recovery Potential
/about /investors /press /legal OpenPageRank Domain Ages
SUBROGATION TARGET ASSESSMENT — 12 PENDING RECOVERIES ════════════════════════════════════════════════════════ HIGH RECOVERY POTENTIAL — $4.2M at stake nationaltruckfleet.com — Claim: $1.8M auto liability PR: 6.8 | Age: 14yr | /investors: Public company (NYSE) /about: 4,200 employees, $890M revenue Excellent financial strength — pursue aggressively industrialchemcorp.com — Claim: $2.4M product liability PR: 5.4 | Age: 11yr | /about: Fortune 1000 subsidiary Strong parent backing — demand letter within 30 days LOW RECOVERY POTENTIAL — $890K at stake budgetcontractorsllc.net — Claim: $340K property damage PR: 0.3 | Age: 234 days | /about: "Small team" Likely judgment-proof — minimize legal spend quickhaul-transport.com — Claim: $550K auto liability PR: 0.8 | Age: 1.2 years /press: Recent layoff announcement Financial distress — negotiate quick settlement
2
Prioritize Recovery Strategy
Domain Signal
nationaltruckfleet.com — PageRank 6.8, domain age 14 years, /investors page confirms NYSE listing. /about states 4,200 employees and $890M revenue. /legal page references comprehensive insurance program. This is a financially strong target with deep pockets — aggressive subrogation pursuit is warranted. Expected recovery rate: 85-95% of $1.8M claim.
HIGH RECOVERY — NYSE-listed, $890M revenue, pursue aggressively for full amount
Sector Signal
Subrogation Portfolio — Of 12 pending recoveries totaling $5.1M, domain intelligence categorizes $4.2M (82%) as high-recovery potential and $890K (18%) as low-recovery. Prioritizing high-PR, established-domain targets first increases recovery rate from 41% (pre-intelligence) to 72%. Avoiding legal spend on judgment-proof targets saves $340K in outside counsel fees.
RECOVERY RATE — Domain intelligence improved subrogation recovery from 41% to 72%
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Output: Subrogation Strategy Report

SUBROGATION INTELLIGENCE — Q1 2026

RECOVERY PRIORITIZATION: ══════════════════════════════════════════════ Total pending: $5.1M across 12 targets High recovery: $4.2M (82%) — pursue aggressively Low recovery: $890K (18%) — minimize legal spend TOP TARGETS: National Truck Fleet (NYSE): $1.8M — 85-95% recovery expected Industrial Chem Corp (Fortune 1000): $2.4M — demand letter issued PORTFOLIO IMPACT: Recovery rate: 72% (was 41% pre-intelligence) Total recovered YTD: $8.7M (up $3.4M from prior year) Legal spend saved: $340K from avoiding judgment-proof targets

6Litigation Risk Assessment

AI agent evaluates litigation risk for open claims by analyzing claimant attorney firms, expert witnesses, and opposing parties through domain intelligence — predicting case outcomes and optimal reserve levels.

1
Assess Attorney & Expert Witness Profiles
/about /case-studies /leadership /blog OpenPageRank Domain Ages
LITIGATION RISK — CLAIM #CLM-2026-9847 ════════════════════════════════════════════════════════ Claimant Attorney: morgansternlaw.com PR: 7.2 | Age: 8,401 days | /about: "Top 50 PI firm" /case-studies: $47M average verdict in similar cases /leadership: 12 partners, all with 15+ years experience /blog: Recent article on exact same injury type /press: 3 record verdicts in past 2 years LITIGATION RISK: VERY HIGH — Elite plaintiff firm Expert Witness: drsmithforensics.com PR: 3.4 | /about: Board-certified forensic specialist /case-studies: Testified in 200+ cases CREDIBILITY: HIGH — Well-established expert RECOMMENDATION: Increase reserve from $450K to $1.2M Engage tier-1 defense counsel immediately Consider early mediation — settlement range $600K-$900K
2
Evaluate Settlement Strategy
Domain Signal
morgansternlaw.com — PageRank 7.2 (top 0.1% of law firm domains), domain age 23 years. /case-studies lists $47M average verdict in comparable injury cases. /blog published a detailed article on this exact injury type 30 days before filing suit — this was a strategic case selected by the firm. /press shows 3 record verdicts in 2 years. This firm does not take cases it expects to lose.
ELITE PLAINTIFF FIRM — $47M avg verdict, 3 record verdicts in 2 years
Sector Signal
Litigation Risk Trends — Claims involving plaintiff firms with PageRank above 6 settle at 2.4x the average. Claims where the plaintiff firm published pre-suit blog content on the injury type (strategic case selection) settle at 3.1x average. This claim has both indicators. Early mediation produces 30% lower outcomes than trial verdicts for cases with these characteristics.
MEDIATE EARLY — Strategic case selection pattern, mediation saves 30% vs. trial
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Output: Litigation Risk Report

LITIGATION RISK ASSESSMENT — CLM-2026-9847

RISK ASSESSMENT: ══════════════════════════════════════════════ Litigation risk: VERY HIGH Plaintiff firm: Morgan Stern (PR 7.2, Top 50 PI) Expert credibility: HIGH (board-certified, 200+ cases) Current reserve: $450K | Recommended: $1.2M SETTLEMENT STRATEGY: Mediation range: $600K-$900K (30% below likely verdict) Trial risk: $1.2M-$2.4M based on firm's track record Recommendation: Early mediation, settle at $750K Savings vs. trial: $450K-$1.65M Engage tier-1 defense counsel immediately

7Claims Pattern Analysis

AI agent identifies emerging claims patterns by correlating domain intelligence with claims data — detecting systemic issues, seasonal trends, and geographic clusters before they impact the book.

1
Detect Emerging Claims Patterns
/products /press /blog IAB Categories Web Filtering
CLAIMS PATTERN DETECTION — FEBRUARY 2026 ════════════════════════════════════════════════════════ EMERGING PATTERN #1: E-bike Battery Fires 12 property claims in 60 days (vs. 2/month baseline) All involve e-bike/e-scooter battery charging Manufacturer domains analyzed: velocitye-bikes.com — /products: Model X-700 battery urbanriderco.com — /press: No recall notices IAB cluster: Electric Vehicles & Micromobility ACTION: Issue underwriting bulletin, review e-bike exposures EMERGING PATTERN #2: Restaurant Slip-and-Fall Cluster Southeast region: 34 GL claims in 45 days (+180% vs. baseline) Common factor: New restaurant chains expanding rapidly fastwokexpress.com — /careers: 47 positions (rapid hiring) burgerblastusa.com — /press: 23 new locations this quarter Rapid expansion + new staff = insufficient training ACTION: Review all rapid-growth restaurant accounts
2
Assess Pattern Impact on Portfolio
Domain Signal
velocitye-bikes.com — /products page lists the Model X-700 with lithium battery specs. /press has no recall notices despite 12 fire claims. /about shows rapid growth ("50,000 units sold in 2025"). Domain intelligence identifies 47 insured properties in our book that sell or store e-bikes from this manufacturer — representing $34M in property exposure to battery fire risk.
PRODUCT RISK — 47 insured properties exposed to e-bike battery fire, $34M at risk
Sector Signal
Emerging Claims Trends — E-bike battery fires are the fastest-growing property claims trend, up 500% in 60 days. Restaurant GL claims in the Southeast are up 180% driven by rapid chain expansion. Both patterns were invisible in traditional claims data but became clear when correlated with /products page analysis and /careers hiring velocity signals.
EARLY WARNING — Two emerging patterns detected before they impacted loss ratios
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Output: Claims Pattern Report

CLAIMS PATTERN ANALYSIS — Q1 2026

EMERGING PATTERNS DETECTED: ══════════════════════════════════════════════ Pattern 1: E-bike battery fires (+500% frequency) Exposed policies: 47 | Total exposure: $34M Action: Underwriting bulletin, e-bike endorsement Pattern 2: Restaurant slip-and-fall cluster (+180%) Affected accounts: 23 rapid-growth restaurants Action: Risk engineering reviews, training requirements EARLY DETECTION VALUE: Patterns identified 60-90 days before loss ratio impact Estimated avoidance: $4.8M in losses through proactive action

8Catastrophe Claims Triage

AI agent accelerates catastrophe claims processing by pre-verifying insured businesses, prioritizing claims by business criticality, and identifying which affected businesses are most likely to have legitimate large losses.

1
Triage CAT Claims by Business Profile
/about /products /careers OpenPageRank IAB Categories Countries
CAT TRIAGE — HURRICANE EVENT (847 CLAIMS FILED) ════════════════════════════════════════════════════════ PRIORITY 1 — Large Verified Operations (89 claims) Pre-verified via domain intelligence: legitimate, large businesses gulfcoastmedical.org — Hospital, 800 employees southerntextiles.com — Manufacturing, 340 employees Fast-track: Assign senior adjusters, expedite payments PRIORITY 2 — Standard Verified (612 claims) Domain intelligence confirms legitimate businesses, smaller scale Standard adjuster assignment, normal processing PRIORITY 3 — Enhanced Scrutiny (146 claims) Domain intelligence flags requiring verification: - 34 claims: Domain age <1 year (possible storm-chasing) - 28 claims: No web presence found (verify business exists) - 84 claims: Claimed damages exceed business profile ACTION: SIU screening before payment, require documentation
2
Assess Triage Effectiveness
Domain Signal
gulfcoastmedical.org — PageRank 5.8, domain age 18 years, /about lists 800 employees across 3 facilities. /careers shows active hiring including emergency preparedness roles. This is a verified, critical-infrastructure insured — their hurricane claim should be fast-tracked with senior adjuster assignment to restore medical services to the community.
FAST-TRACK — Critical healthcare facility, pre-verified, expedite payment
Sector Signal
CAT Claims Triage Results — Domain intelligence enabled instant triage of 847 hurricane claims into 3 priority tiers. Priority 1 (pre-verified large operations) received payments 14 days faster. Priority 3 (enhanced scrutiny) yielded 23 confirmed fraudulent claims ($8.4M in storm-chasing prevented). Triage accuracy: 94% — only 6% required reclassification.
94% TRIAGE ACCURACY — Faster payments for legitimate claims, fraud caught early
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Output: CAT Triage Report

CATASTROPHE CLAIMS TRIAGE — HURRICANE EVENT

TRIAGE SUMMARY: ══════════════════════════════════════════════ Total claims: 847 | Priority 1 (fast-track): 89 Priority 2 (standard): 612 | Priority 3 (scrutiny): 146 Triage accuracy: 94% RESULTS: Fast-track claims paid 14 days faster than traditional process Storm-chasing fraud detected: 23 claims ($8.4M prevented) Customer satisfaction (Priority 1): 96% positive Domain intelligence value in CAT events: $8.4M fraud prevention + faster service

9Claims Leakage Prevention

AI agent identifies claims leakage by comparing actual payments against expected costs based on business profiles — detecting overpayments, unnecessary services, and inflated estimates before they are finalized.

1
Detect Payment Anomalies
/about /pricing /products OpenPageRank IAB Categories
CLAIMS LEAKAGE ANALYSIS — JANUARY 2026 ════════════════════════════════════════════════════════ LEAKAGE DETECTED — 23 claims flagged ($1.2M potential savings) Claim #CLM-2026-8912: Business interruption — $340K claimed smalltownbakery.com /about: "Family bakery, 4 employees" | PR: 1.2 BI claim inconsistent with business scale Expected BI exposure: $45K-$80K based on web profile Savings: $260K-$295K Claim #CLM-2026-9034: Equipment replacement — $180K claimed Vendor: premiumequipmentbrokers.com /pricing: Same equipment listed for $87K on vendor site Invoice inflated 2x vs. vendor's own published pricing Savings: $93K MONTHLY LEAKAGE SUMMARY: Claims reviewed: 1,847 | Leakage flagged: 23 (1.2%) Potential savings: $1.2M | Confirmed savings: $890K
2
Validate Leakage Findings
Domain Signal
smalltownbakery.com — PageRank 1.2, domain age 3 years. /about describes "family bakery, 4 employees." /products shows pastries and bread. /careers not present. A $340K BI claim for a 4-person bakery exceeds the web-derived revenue estimate of $180K-$320K annually — the entire annual revenue is less than the BI claim, indicating significant inflation.
INFLATED CLAIM — $340K BI claim exceeds estimated annual revenue of business
Sector Signal
Claims Leakage Trends — Domain intelligence detects leakage in 1.2% of all claims reviewed, with an average savings of $39K per flagged claim. The two most common patterns: BI claims exceeding web-derived revenue estimates (48% of flags), and invoices exceeding vendor's own published /pricing page rates (31% of flags). Both are verifiable, objective anomalies.
MEASURABLE SAVINGS — $890K confirmed savings from 23 flagged claims this month
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Output: Claims Leakage Report

CLAIMS LEAKAGE PREVENTION — JANUARY 2026

LEAKAGE DETECTION RESULTS: ══════════════════════════════════════════════ Claims reviewed: 1,847 | Flagged: 23 (1.2%) Potential savings: $1.2M | Confirmed: $890K TOP LEAKAGE PATTERNS: BI exceeding web revenue: 11 claims ($680K savings) Invoice exceeding published pricing: 7 claims ($210K) Vendor not matching business profile: 5 claims ($120K) ANNUAL IMPACT: Projected annual leakage prevention: $10.7M Detection rate: 1.2% of claims (industry average: 0.3%) ROI: 428x return on database investment

10Claims Performance Dashboard

AI agent generates comprehensive claims performance analytics — measuring fraud detection rates, recovery improvements, leakage prevention, and overall claims handling efficiency powered by domain intelligence.

1
Aggregate Claims Intelligence Metrics
/about /products OpenPageRank Domain Ages IAB Categories
CLAIMS INTELLIGENCE AGGREGATION — Q1 2026 ════════════════════════════════════════════════════════ FRAUD DETECTION: Claims screened: 4,891 | Fraud referrals: 187 (3.8%) SIU confirmed fraud: 142 | Fraud prevented: $12.4M Detection accuracy: 76% (was 31% pre-intelligence) VENDOR MANAGEMENT: Vendors vetted: 342 | Flagged: 28 (8.2%) Vendor fraud confirmed: 19 | Savings: $3.8M SUBROGATION: Targets assessed: 89 | Recovery rate: 72% (was 41%) Total recovered: $8.7M (up $3.4M from prior year) CLAIMS LEAKAGE: Leakage detected: $4.8M | Recovered: $3.6M
2
Synthesize Claims Intelligence Impact
Domain Signal
Claims Intelligence Portfolio — Domain intelligence has been applied across all claims functions: 4,891 claims screened for fraud (142 confirmed), 342 vendors vetted (19 fraudulent), 89 subrogation targets assessed (72% recovery), and 1,847 claims reviewed for leakage ($3.6M recovered). The system processes each claim against PageRank, domain age, page presence, and IAB category data in real-time.
COMPREHENSIVE — Domain intelligence applied to every claims function
Sector Signal
Claims Division ROI — Total claims intelligence value this quarter: $28.5M across fraud prevention ($12.4M), vendor fraud ($3.8M), subrogation improvement ($3.4M incremental), leakage prevention ($3.6M), and CAT triage efficiency ($5.3M). Annual run rate: $114M from a $25K database investment, delivering an ROI of 4,560x.
4,560x ROI — $114M annual claims intelligence value from $25K database
3
Output: Claims Intelligence Dashboard

CLAIMS INTELLIGENCE IMPACT — Q1 2026

FRAUD DETECTION: ══════════════════════════════════════════════ Claims screened: 4,891 | Fraud referrals: 187 (3.8%) SIU confirmed fraud: 142 | Fraud prevented: $12.4M Detection accuracy: 76% (was 31% pre-intelligence) VENDOR MANAGEMENT: Vendors vetted: 342 | Flagged: 28 (8.2%) Vendor fraud confirmed: 19 | Savings: $3.8M SUBROGATION RECOVERY: Targets assessed: 89 | Recovery rate: 72% (was 41%) Total recovered: $8.7M (up $3.4M from prior year) CLAIMS LEAKAGE: Leakage detected: $4.8M | Recovered: $3.6M TOTAL ANNUAL VALUE: $28.5M ROI: 1,140x return on database investment
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