Where Fraud Cases Get Lost: The Cost of Handoffs Between Claims, SIU and Legal
Every fraud case handoff between claims, SIU and legal loses context and duplicates intel work. Here is where cases stall, and how one case record fixes it.
Every fraud case handoff between claims, SIU and legal loses context and duplicates intel work. Here is where cases stall, and how one case record fixes it.
Most SIU case management tracks cases, not the people working them. Here’s why that blind spot concentrates backlog and burnout on a few investigators, and what workload visibility actually fixes.
Detection fills the queue; fraud referral conversion decides how much you actually save. Where counter-fraud savings leak between referral and outcome, and how to close the gap.
How long should a fraud investigation take? Realistic SLA ranges by case type, what delay costs under Consumer Duty, and how to hit deadlines without cutting corners.
A unified fraud investigation workbench brings the whole case onto one surface. What that changes for case visibility, consistency and investigator capacity.
Detection keeps filling the queue; the fraud alert backlog is where savings leak. Why more fraud alerts don’t mean more savings — and how to clear it.
Human-in-the-loop AI in fraud investigation means AI handles retrieval and drafting while a named investigator makes every material decision. What regulators and investigators both need, and why full autonomy stays rare.
Fraud detection and investigation management are different jobs. Detection finds the suspicious claim; investigation management turns it into a worked outcome. Why the gap costs money, and how to close it.
There is a question worth asking about how most insurance fraud investigations actually run day to day. An investigator receives a referral, opens the case, and then does something that has become so routine it…
98,400 fraud claims detected across the UK in 2024. Up 12% on the year before. £1.16 billion in fraudulent claims identified, according to the ABI’s November 2025 report. By any measure, detection is working. So why is…