Rings hide in clean-looking claims
The same tow operators, assessors and witnesses reappear across collision claims, but each claim passes review on its own.
Industries · Insurance
Insurance fraud detection for claims and SIU teams
The FinCrimes Insurance workspace scores claims, policies, providers and parties across motor, life, medical and property lines. It links the vehicles, providers and people that recur across claims, so special investigations units see organized fraud that looks legitimate one claim at a time.
The challenge
What insurance teams are up against
Life books carry long-tail fraud
Ghost policies, clusters of early deaths and cover far beyond a policyholder’s means can sit in the book for years before a claim exposes them.
Collusive medical billing
Colluding providers bill for treatment never given, patients visit several doctors for the same condition, and some providers bill more hours than a day contains.
SIU referrals without evidence
Investigators receive referrals with a score and little else, then rebuild the evidence by hand before they can act.
Solutions
How Dark Pools helps
Claims scoring before payoutInsurance typologies cover motor, life, medical and property claims, scored in real time before a claim is paid and in batch across the whole book.Ring analysis across claimsEntity resolution links shared VINs, providers, addresses and parties into one network, exposing staged-accident rings, phantom vehicles and provider collusion.Investigation workbench for SIUSLA-driven queues, an evidence trail on every alert, an AI copilot that drafts the investigation narrative, and branded DOCX and PDF investigation reports.Insurance data kept apartThe Insurance workspace is hard-walled and licensed separately from Banking, with isolation enforced on every query and API key and sensitive identifiers held in the PII token vault.
In the field
Scenarios we are built for
InsuranceStaged-accident ring across provincesThe same tow operators, assessors and 'witnesses' keep resurfacing in collision claims across multiple provinces, but each claim looks clean when reviewed on its own.Ring dismantled before payoutInsuranceGhost policies and provider collusionBilling clerks and colluding medical providers write phantom policies and file claims for treatments no patient ever received, quietly bleeding the book for years.Phantom claims surfaced across the book
FAQ
Questions buyers ask
Motor: staged-accident rings, phantom vehicles, multi-claim VINs and inflated claims. Life: ghost policies, early-death clusters and over-insurance. Medical: provider collusion, phantom billing, doctor shopping and impossible billing days. Property: arson patterns, repeat losses and inflated contents claims.
Yes. The real-time scoring API returns a risk score, matched typologies and an approve, review or block recommendation before payout. Batch scoring reviews the existing book, for example in a sweep for ghost policies.
Yes. Banking and Insurance are hard-walled, independently licensed workspaces, and isolation is enforced on every query and API key.
Scores are measured against per-entity and segment baselines, and Rules Studio lets you backtest typology parameters against past claims and your investigators’ verdicts before they go live.
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