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
A long list of good AI use cases is not an AI strategy. At ARU, we wanted a platform that could support meaningful operational improvements across the business, rather than adding a different point solution for every task.
That is one of the reasons we selected SimplAI. We are already working with their team to build agentic workflows around statement of values processing, loss runs, and underwriting audit. Their team brings genuine insurance domain expertise to the work, which means we can spend less time explaining the fundamentals of insurance workflows and more time solving the operational problems within them.
SimplAI has approached the relationship as a strategic partner, combining that industry knowledge with an impressive ability to build and iterate quickly. We are excited about what we are building together and the broader opportunity to thoughtfully apply agentic AI across different areas of our operations at ARU.
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.
As a sovereign big data technology provider, Saal's DigiXT platform is trusted by enterprises and government entities to manage, govern, and get value from their data at scale. DigiXT has a wide ecosystem of technology partners, and SimplAI's agentic AI platform is now integrated into it, giving our customers another option for building Agentic solutions on their data.
The engagement has been collaborative and constructive throughout. The SimplAI team has been responsive, capable, and open to feedback, which made the integration smooth. We look forward to continuing this partnership.
