Documents
Names, dates, registration and policy details that don’t match across RC, licence, policy and estimate.
Fraud & Red-Flag Intelligence
Find the signals manual review misses.
ClaimHorizon builds a structured evidence trail across documents, images, video, metadata, location, timestamps and claim narratives, then flags inconsistencies for review instead of relying on isolated observations.
Red flags are investigation signals, not proof of fraud.
Scanning evidenceCL-24-30417
Documents
Images
Video
Metadata
Location
Timestamps
Narrative
Sources checked7 / 7
Signals3 for review
DecisionWith reviewer
DocumentsImagesVideoMetadataLocationTimestampsClaim NarrativesPre-Inspection ComparisonReviewer QueueAudit TrailDocumentsImagesVideoMetadataLocationTimestampsClaim NarrativesPre-Inspection ComparisonReviewer QueueAudit Trail
What is red-flag intelligence in insurance claims?
Red-flag intelligence checks every piece of claim evidence against the others (documents, photos, video, metadata, location, timestamps and the claimant’s account) and raises a signal wherever they disagree. In ClaimHorizon, each signal goes to a human reviewer. A red flag is a reason to look closer, not proof of fraud.
Seven sources, plus your pre-inspection record
One evidence trail, checked against itself.
Single observations are easy to explain away. Inconsistencies between sources are what manual review tends to miss.
Images
Damage that looks older than the reported loss, or the same photo appearing on more than one claim.
Video
Gaps or cuts in a walkaround, or angles that avoid a panel.
Metadata
Capture time or device details that don’t fit the reported date of loss.
Location
Photos captured far from the reported accident site or garage.
Timestamps
Loss date close to policy start, or intimation timing that needs a second look.
Narratives
Statements that don’t fit the recorded point and line of impact.
Pre-inspection record
Claimed damage that was already recorded before the policy began.
Examples of the checks that can be configured. Each insurer decides which signals apply and how they are routed.
You are the reviewer
Every signal comes with its evidence.
Pick a flag, compare the evidence, then decide. Dismiss it with a reason, request more information, or escalate it to investigation. Every decision is logged.
Illustrative sample claim. No real customer data.
Photos 4–7 were captured about 18 km from the reported accident site.
Reported siteRing road junction, 14 Oct, 21:10
Photo metadataGarage area, 15 Oct, 11:42
Photos may have been taken at the garage the next day. Ask the surveyor to confirm where the vehicle was inspected.
A front-bumper scratch on this claim was already recorded at pre-inspection.
Pre-inspection (Jul)Front bumper: scratch, minor
Claim estimate (Oct)Front bumper: replace
Check whether the new damage goes beyond what was recorded before the policy began.
Statement says the vehicle was hit from behind; recorded point of impact is front-right.
Owner statement“Hit from behind at the signal”
Spot surveyPoint of impact: front-right
May be a wording error in the statement. Request clarification before escalating.
How it works
From signal to decision, with a person in charge.
-
01
Detect
Evidence from every source is checked against the others as it arrives.
-
02
Explain
Each flag shows the evidence on both sides and why it was raised.
-
03
Route
Flags go to the right reviewer by type, severity and the insurer’s rules.
-
04
Review
The reviewer compares evidence and can ask for more information.
-
05
Decide
Dismiss with a reason, or escalate to investigation. Every step is logged.
The connected advantage
Point tools see one claim. ClaimHorizon sees the whole history.
Because pre-inspection, Spot Setu and claims share one evidence repository, a claim can be checked against what was recorded before the policy began and at the scene.
Pre-inspection · JulyFront bumper scratch recorded
360° video, photo 3, QC-approved
Spot Setu · OctoberPoint of impact: front-right
Geotagged at the reported site
Claim · OctoberEstimate: replace front bumper
Garage estimate, line 1
SignalPossible pre-existing damage
Sent to the surveyor to check the new damage against the July record
Signals, not verdicts.
Red flags are investigation signals, not proof of fraud. Final decisions remain with authorised professionals, subject to policy terms, professional review and applicable regulations. Genuine claims continue through the normal workflow.
FAQs
Red flags, answered.
Motor insurance fraud red flags guideHow does AI detect red flags in motor insurance claims?
ClaimHorizon builds a structured evidence trail across documents, images, video, metadata, location, timestamps and the claim narrative, then checks them against each other. Where they don’t agree, for example a photo taken far from the reported accident site, a red flag is raised for a reviewer to look at.
Is a red flag proof of fraud?
No. A red flag is an investigation signal, not proof of fraud. Every flag is reviewed by a person, and final decisions remain subject to policy terms, professional review and applicable regulations.
What kinds of inconsistencies can be flagged?
Examples include mismatched dates or names across documents, damage that appears older than the reported loss, photo capture times or locations that don’t match the claim, reused images, gaps in a walkaround video, and statements that don’t fit the recorded point of impact.
How does pre-inspection help detect claim inconsistencies?
When a vehicle was pre-inspected with ClaimHorizon, the condition recorded before the policy began can be compared with the damage claimed later. Damage that was already recorded is flagged for review instead of being paid as new.
Who reviews and decides on red flags?
Authorised reviewers, surveyors and investigators. They can dismiss a flag with a reason, request more information, or escalate to investigation. Every action is logged in the audit trail.
Does red-flag intelligence slow down genuine claims?
It is designed not to. Clean claims continue through the normal workflow, while only claims with inconsistencies are routed for extra review.