Check claim notifications for signs of fraud

Insurers detect fraud in claims

Needs setupAI Act: no extra obligationsFinding anomalies & fraudInsurance

Fits: Finance & accounting · Legal & compliance

Suspicious claim notifications, such as a burglary shortly after the policy starts, receipts that do not match the item, or the same people involved again and again, are passed to the specialists early. In return, the large majority of honest customers have their claims settled faster and without mistrust.

Is this for you?

  • You settle many claims in lines of business with a known fraud risk, such as household contents, motor or liability.
  • Claim files with notification, receipts and outcome are digital, and there are cases in which fraud was proven.
  • You have a special investigations unit for fraud or want to set one up.
First step today

Write eight made-up claims in a table, with policy start, date of loss, amount claimed, receipts and notes. Build in two cases with warning signs and one with a typo in the date. Have them checked with the template below and see whether the typo is recognised as such.

How to go about it

  1. Define fraud indicators for each line of business
  2. Link claim files, policies and previous claims
  3. Set up indicator rules and a model
  4. Have suspicious cases reviewed by the special investigations unit
  5. Define the procedure when suspicion is confirmed
  6. Adapt indicators to new schemes

Templates to copy

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Included in the training

The complete guide

  • 6 steps explaining exactly what to do
  • 3 proven templates to copy into your own AI
  • Safe use: data, checking, deciding, informing
  • Pitfalls, effort and how to recognise success

With the training you get all 430 guides for as long as your access runs.

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Same approach, other use cases

12 more use cases follow the pattern “Finding anomalies & fraud”.

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VS-04 · Legal status 08.10.2026