Fraud Detection Agent
Our AI agent analyzes invoices, vendor data, and claim patterns in real-time to detect and flag fraudulent activity, stopping claims leakage before it happens.
How SimplAI Detects & Prevents Claims Fraud
Analyze Invoices for Fraud Indicators
- Detects upcoding and unbundling of services
- Flags phantom services or duplicate billing
- Alerts SIU teams to billing anomalies
Vet Vendors & Identify Collusion
- Checks for shared addresses, directors, or bank info
- Identifies newly created or high-risk vendors
- Maps hidden relationships between providers and claimants
Uncover Anomalies with Behavioral Analysis
- Flags abnormal claim frequency or severity
- Identifies billing patterns outside normal benchmarks
- Scores claims for fraud risk in real-time
Automate Investigations & Link Analysis
- Auto-generates investigation summary reports
- Provides link-analysis graphs of fraud rings
- Prioritizes high-probability fraud cases for review
Ready to Stop Fraud Before It Hits Your Bottom Line?
Stop paying fraudulent claims. Deploy the SimplAI Fraud agent in weeks and see an immediate reduction in claims leakage and a massive boost to your SIU team's efficiency.
Built for SIU & Claims Integrity Teams
Adapts to your processes. Handles investigations end-to-end. Works 24/7.
Scales Like Software
Analyzes millions of invoices and data points daily with consistent accuracy.
Built for Fraud Investigation
Trained on vendor fraud tactics, invoice anomalies, collusion patterns, and investigative guidelines.
Integrated With Your Stack
Works with Guidewire, Duck Creek, FRISS, Shift, and other core claims and fraud systems.
Compliant by Design
Logs every investigative step with a full audit trail for regulatory and legal review.
Instant Leakage Reduction
Go live in 4 weeks and see measurable improvements in fraud detection and reduced false positives.
Trusted by Industry Leaders
SimplAI has fundamentally changed how we approach AI adoption inside the organization. Instead of running isolated experiments with different models and tools, we now have a unified platform to build, orchestrate, and govern AI agents across multiple business workflows.
What stood out for us was the platform's ability to handle enterprise requirements - security, governance, and observability - while still allowing teams to rapidly prototype and deploy AI solutions. SimplAI helped us move from fragmented AI initiatives to a scalable AI operating model
We chose SimplAI for its agentic operating system and enterprise-grade reliability. Today, we run multiple agents across GTM, operations, and customer support — all on a platform that scales and deploys securely on private clouds. The support from the team has been exceptional.
SimplAI has fundamentally changed how we approach AI adoption inside the organization. Instead of running isolated experiments with different models and tools, we now have a unified platform to build, orchestrate, and govern AI agents across multiple business workflows.
What stood out for us was the platform's ability to handle enterprise requirements - security, governance, and observability - while still allowing teams to rapidly prototype and deploy AI solutions. SimplAI helped us move from fragmented AI initiatives to a scalable AI operating model
SimplAI is helping us address customer challenges at scale using AI, without the need to build an in-house AI engineering team. Even before going live in production, SimplAI has shown its value through its robust capabilities and consistent support for our goals. Their responsive and dedicated approach has made them a reliable partner in advancing our AI initiatives.
Secure infrastructure alone is not enough. Enterprises need the full stack — governed AI agents running inside a deployment model that never compromises their security posture. Pairing Zeblok’s Ai-MicroCloud with SimplAI’s orchestration layer means enterprises no longer have to choose between capability and control. Furthermore, our ability to offload to Flash memory means significant reduction in GPUs when managing user context.
With SimplAI, Lawyered isn't just embracing AI, we're redefining the legal landscape. By seamlessly integrating cutting-edge technology with our mission to democratize legal access, we're not only streamlining processes but also ensuring data security and privacy. SimplAI isn't just a platform, it's a catalyst for innovation.
