AI for Insurance Risk Intelligence

Spectro AI

AI-Powered Claims Fraud Detection

Reducing fraud leakage through document intelligence. Our AI-powered platform detects digitally manipulated invoices, fake medical bills, inflated repair claims, and AI-generated evidence across motor, health, and travel insurance claims.

Digital analysis use cases and fraud detection examples

The Claims Fraud Problem

Document fraud is the #1 source of claims leakage in Indian general insurance

Motor Claims
6-8%

of claims value

Inflated repair invoices & staged accidents

Travel Claims
10-12%

of claims value

Fake overseas medical bills & duplicates

Health Claims
8-10%

of claims value

Inflated bills & discharge summary fraud

What Spectro AI Flags

Real-world fraud patterns detected across insurance claims with actionable evidence

Health Claims
HIGH RISK
Fraud Pattern: Medicines billed at 3× MRP. Hospital on fraud watchlist.

Ward type mismatch

Bill charges ICU rate; discharge states general ward

Medicine tariff inflation

3 items billed at 2.8-3.2× MRP

Blacklisted hospital

Hospital matches fraud watchlist

Diagnosis mismatch

Procedure inconsistent with diagnosis

Motor Claims
HIGH RISK
Fraud Pattern: Repair invoice inflated from ₹38,000 to ₹90,000. Amount field digitally altered.

Digital manipulation

Metadata tampering indicates digital edit

GST number mismatch

GST doesn't match registered garage

AI generated images

Vehicle damage photos are synthetic

RC cross-check failed

Vehicle model differs from invoice

Travel Claims
HIGH RISK
Fraud Pattern: Fake overseas hospital bill of $4,200. Previously submitted to another insurer.

Metadata mismatch

PDF created 11 days after hospital visit

Duplicate fingerprint

Document matches prior claim

Hospital not found

No online presence or registration

Timeline inconsistency

Return date before discharge date

Spectro AI Capabilities

Comprehensive fraud detection through document intelligence and external database verification

1. Document Intelligence

Digital Tampering

Font anomaly, pixel-level edits, copy-paste trace detection

Metadata Forensics

Editor tool, author identity, modification timestamps

QR / Barcode Scan

Cross-verifies document against embedded source data

AI Image Detection

Identifies AI-generated vehicle or damage photos

Pattern Matching

Flags repeat fraud patterns across past claim submissions

Duplicate Detection

Document fingerprinting — cross-insurer duplicate matching

2. External Database Verification

Live data from Government & third-party sources

GST Verification (GSTIN)
PAN Verification (ITD)
RC / VAHAN Check (VAHAN)
Bank Account (NPCI)
Online Presence (Web)
Hospital Blacklist (Web)
Medicine Tariff (Web)
Doctor Verification (MCI)
...and many more

All checks configurable per insurer · Live external database verification · Fine-tuned to your fraud patterns

How Our AI Analysis Works

Simple 3-step process to detect fraud and verify authenticity

1

Upload & Parse

Securely upload claim documents, invoices, and images. Our system immediately begins extraction and analysis.

2

AI Analysis

Multiple AI models analyze for tampering, verify against databases, and detect fraud patterns.

3

Risk Report

Receive detailed fraud risk assessment with evidence, confidence scores, and actionable recommendations.