Case Study
Insurer uncovers nine-figure fraud through claims automation
Results
£100M+
Uncovered fraud worth over £100M
39%
Lifted fraud detection rate by 39%
30+
Stopped 30+ bogus claims daily
Company Profile
Major UK-headquartered FTSE-listed insurance, wealth, and retirement group serving tens of millions of customers across multiple established markets. Multi-line composite carrier covering general insurance, life and pensions, savings and asset management, with deep regulatory and underwriting integration into mature insurance market structures. Operates at exceptional document and claims volumes, where loss-cost integrity and fraud prevention are board-level concerns.
Challenge
Counter-fraud handlers buried in claim documents
Counter-fraud handlers were buried in documents. Each suspicious claim demanded hours of manual sifting through supporting documentation before an investigator could even begin to build a case. Volumes were rising faster than the team could scale.
The risk wasn’t just slow throughput. Every claim that paid out before it was investigated was money the firm couldn’t recover, and every backlog hour was time the team couldn’t get back. The team needed a way to surface fraud indicators automatically, so handlers could spend their time prosecuting cases rather than discovering them.
Solution
Intelligent triage surfaces fraud signals at scale
The firm deployed an automated fraud detection and investigation platform that fed claim documents through intelligent extraction, applied fraud-indicator rules at scale, and surfaced suspect cases to handlers with the evidence already organized. What had taken hours of manual sifting now happened in minutes, guided by confidence scores.
Detection rates moved decisively higher year-over-year, and the team began stopping bogus claims at the boundary rather than chasing payouts after the fact. Handler time shifted from document review to fraud prosecution and customer protection. Daily fraud-prevention savings and the cumulative recovery of fraudulent claim values rapidly justified the rollout.
The same intake-and-investigation discipline now positions the firm for agentic extensions, with fraud workflow data structured cleanly enough that downstream agents can act on indicators directly across more claim types and channels.
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