Insurance Fraud Detection

Action the Halo Effect to uncover fraud, waste, and abuse


Avoid costly fraudulent payments

Daisy’s AI-powered Fraud Detection Solution applies reinforcement learning and fuzzy logic to resolve identities, detect suspicious claims and avoid costly fraudulent payments.

Our solution includes Case Management to ensure Investigators can manage their work from initial suspicion all the way to case closure and recoveries. 

We’re offering


A Fraud Detection Solution that makes an impact

Male insurer using laptop while meeting with elderly female client
With our Fraud Detection Solution, insurers can: 

Identify genuine claims accurately


Reduce the number of false-positives 


Reduce customer frustration and increase trust in the system

Female insurer presenting on company finances while holding tablet
Our solution helps insurers:

Identify all suspicious behavior in their claims data


Proactively eliminate fraud before costly payments are made 


Increase overall profitability as a result

Male insurers collaborating and using laptop
Our Fraud Detection Solution delivers:

An automated investigative process


The elimination of manual effort


The elimination of time-consuming investigative tools (e.g., Microsoft Excel)

Male and female insurers working on laptops while discussing in office
Our Fraud Detection Solution helps insurers:

Uncover previously undetected fraud


Find opportunities to recoup past losses


Maximize profits as a result



Mitigate emerging fraud and risk with Halo-based AI

Identify risk and avoid fraud with the Halo Effect whitepaper

The features that make us unique

Insurance AI Solutions

Alerts for fraudulent activity

Our Fraud Detection Solution actions the Halo Effect to uncover anomalies in claims data, which improves the accuracy of fraud detection. It quickly identifies and alerts investigators to patterns and anomalies that may indicate fraudulent activity, even if it is undetectable by the human eye. Suspicious entities are easy to identify with our Daisy Suspicion Score & Suspicion Index.
Insurance AI Solutions

Cutting-edge AI

Our technology applies reinforcement learning, fuzzy logic, and a proprietary mathematical theory (Theory of Risk™) to resolve identities, detect suspicious claims and avoid costly fraudulent payments, all while automating claims processing. When complex cases require human intervention, investigators receive contextual guidance from Daisy that supports decision-making.
Insurance AI Solutions

End-to-end investigate process

Daisy’s Case Management capabilities accelerate the investigative process by enabling investigators and managers to track and manage high value, high complexity cases and better serve genuine customers.
Insurance AI Solutions

AI made simple

Our patented software runs autonomously, preventing human error in your investigative process. Daisy takes the complexity out of artificial intelligence; we provide plain-language explanations for all our alerts.

Learn more about our tech

Interested in our Fraud Detection Solution?

Get in touch to see how Daisy is transforming the investigative process



Learn more about how we’re identifying the Halo Effect – outliers in high-volume claims data – to minimize fraud, waste and abuse.


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