Case study
$180,000 in fraud prevented annually through AI document detection
Facing document fraud rising 15% annually, this regional mutual insurance carrier deployed CheckFile to protect its 2,000 monthly claims.
Context
Industry
Regional mutual carrier, P&C lines (auto, homeowners, commercial)
Volume
2,000 claims processed per month
Tools
Guidewire ClaimCenter, independent adjusters, agent network
Team
12 claims adjusters
The problem
Document fraud was becoming increasingly costly. Claims adjusters, focused on settlement speed, lacked the means to check everything thoroughly.
- Document fraud rising 15% annually on P&C claims
- Altered documents (dates, amounts, photos) undetectable by eye at scale
- Manual verification impossible at volume: 2,000 claims/month
- Settlement delays too long, causing policyholder dissatisfaction
- Fraud cost estimated at $250,000 per year before deployment
The solution
CheckFile.ai analyzes each claim document for anomalies: date inconsistencies, suspicious amounts, altered metadata, retouched documents.
- Automatic metadata and document consistency analysis
- Detection of date inconsistencies between FNOL and supporting documents
- Flagging of abnormal amounts relative to claims history and industry benchmarks
- Risk score per file to prioritize manual reviews by senior adjusters
The results
+23%
more fraud detected
Significant increase in detection rate
-45%
claims processing time
Faster settlements for honest policyholders
$180K
saved per year
Document fraud intercepted before payment
+12 pts
policyholder satisfaction
NPS increase thanks to reduced settlement delays
“We knew fraud was costing us, but we lacked the tools to address it at scale. CheckFile detected fraud patterns no adjuster could have seen. And our legitimate policyholders get paid faster.”
VP of Claims
Regional P&C mutual insurance carrier