Network-Aware Fraud Detection with Fiona
Fiona stands guard at the point of claims triage, analyzing patterns to flag suspicious submissions. Whether it’s inflated billing, known fraud rings, or repeated addresses and contact details, Fiona connects the dots you might otherwise miss. By identifying high-risk claims up front, Fiona keeps your loss ratio in check and protects your brand reputation.
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Flags up to 85% of suspicious claims pre-payment
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Reduces claims leakage by up to 25%
Key Capabilities
Real-Time Fraud Scoring
Cross-references policyholder, provider, and claim data against known high-risk indicators.
Network Analysis
Uncovers hidden links among claimants, addresses, or service providers that suggest organized fraud.
Alerts & Escalations
Automatically routes suspicious cases for specialized investigation, helping you act before paying out.
Historical Comparisons
Looks at past claim events to highlight anomalies in usage patterns or claim frequencies.
Highlights at a Glance
What Fiona Solves:
Late fraud detection, post-payment recoveries, and repeated fraudulent claims slipping through.
Return on Investment:
Reduced claims leakage, better fraud deterrence, and stronger regulatory compliance.
Deployment:
Operates standalone or integrates with your existing SIU (Special Investigation Unit) tools via APIs.