Insurance

Pay honest claims faster; catch the networks behind the rest.

Claims fraud and slow claims come from scattered documents, photos and hospital/garage data.

The question it answers

“Which garages and agents appear together in unusual claim patterns?”

What changes: Lower fraud, faster settlement for honest claims.

All seven layers

How ForgeOrbis works for insurance.

  1. 01

    Connect

    Ingest

    Data sources

    • Policy administration
    • Claims system
    • Hospital and garage networks
    • Payments
    • Call centre
  2. 02

    Understand

    Extract

    Facts from unstructured data

    • Claim forms, medical bills, discharge summaries, accident photos
  3. 03

    Unify

    Resolve

    What must be matched

    • Claimants, hospitals, garages and agents with variant names
    • Repeat claimants
  4. 04

    Relate

    Model

    Objects and links (the ontology)

    • Policy
    • Claim
    • Claimant
    • Hospital
    • Garage
    • Agent
    • Payment
    • Document
  5. 05

    Decide

    Ask

    Example question

    “Which garages and agents appear together in unusual claim patterns?”

  6. 06

    Execute

    Act

    Approved actions

    • Flag claim for investigation
    • Request documents
    • Fast-track clean claims
    With approval
  7. 07

    Trust

    Govern

    Trust and compliance

    • Insurance regulator rules
    • Health-data privacy
    • Audit

What a pilot measures

Each pilot measures 2 to 3 KPIs you already track, before and after. We publish no benefit numbers until a customer has measured them.

  • Claim settlement time
  • Fraud detected
  • Loss ratio
  • Investigation hit rate

Who it is for

  • Chief claims officer

Where it stands today

What runs today, and what we are still building.

We would rather tell you up front than discover it in week three. A pilot starts with what runs today.

The platform

  • 01ConnectIngestPartly live
  • 02UnderstandExtractPartly live
  • 03UnifyResolveRoadmap
  • 04RelateModelPartly live
  • 05DecideAskLive
  • 06ExecuteActLive
  • 07TrustGovernPartly live

Still to build for insurance

  • Document extractionLayer 2OCR + layout, forms, tables, scanned records, stamps
  • Video/image extractionLayer 2Object detection/tracking, number plates, drone and CCTV imagery
  • Entity resolution (people/orgs)Layer 3Persons, companies, aliases, phones, addresses, related parties
  • Regulated-data complianceLayer 7Evidence admissibility, financial/health/GMP data rules

Live means shipping in the product today. Partly live means part of the layer ships today and the rest is being built. Roadmap means being built and not available yet. We never show it as available.

Book a pilot

One site, one problem, measured in weeks.

Each pilot measures 2 to 3 KPIs you already track, before and after. We publish no benefit numbers until a customer has measured them.