AMMOR Intelligence Group gives insurance carriers, TPAs, and SIU teams AI-assisted intelligence to surface possible fraud indicators earlier in the workflow. Risk scoring supports review; every final decision stays with your authorized team.
Insurance fraud costs the U.S. an estimated $308 billion annually. Staged accidents, inflated repair estimates, phantom billing, organized fraud rings — the schemes are sophisticated, coordinated, and evolving faster than rules-based detection systems can track.
Your SIU team is overwhelmed. Legacy tools generate false positives that waste investigator hours. Payments go out before red flags surface. And organized rings stay invisible to claim-by-claim review.
AMMOR Intelligence Group was built to solve exactly this.
Staged-accident indicators, inflated repair-estimate signals, prior claim frequency patterns, repair shop risk signals, and geographic coordination indicators for human review.
New policy recency flags, amount elevation analysis, documentation anomalies, contractor and vendor risk profiling.
Repeat injury patterns, inconsistent medical documentation, treatment anomalies, and prior claim frequency on the same claimant.
Phantom billing, duplicate claims, upcoding, provider risk signals, and cross-payer network patterns.
Network graph analysis can connect claimants, providers, attorneys, and repair shops across multiple claims to surface possible coordination for SIU review.
Metadata concerns, readable text and OCR where available, and inconsistencies between submitted documents and reviewer-provided records.
Schedule a 20-minute demo using real claim scenarios from your line of business.
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