Fraud Investigation Case Management Platform Built for Insurance Teams
Manage fraud referrals, investigations, workloads, evidence, and outcomes from a single operational platform.
Fraud Referrals Are Increasing. Operational Visibility Isn't.
Investigation teams are managing growing caseloads across disconnected tools — losing referrals, breaching SLAs, and unable to demonstrate outcomes.
Everything Needed to Manage Fraud Investigations
Referral Management
Capture referrals from any source — claims handlers, detection systems, or direct
intake — into a structured, prioritised
queue.
Case Lifecycle Management
Structured investigation stages with mandatory checkpoints, configurable workflows, and automatic SLA tracking at every step.
Investigator Assignment
Assign cases based on capacity,
expertise, and workload. Real-time
visibility prevents overallocation across your team.
Task & Activity Tracking
Structured task plans, deadlines, and ownership tracking against each
case — with a complete activity
timeline.
Evidence Management
Centralise all evidence — documents,
audio, video — with version control,
access permissions, and chain of
custody.
Audit & Compliance
Every action, status change, and decision is automatically logged — making regulatory submissions and legal review straightforward.
Track Every Case From Referral To Resolution
A structured six-stage workflow with SLA enforcement, mandatory checkpoints, and a full audit trail from first referral to final closure.
Referral
✓Intake Form
✓Risk Score
✓Source Log
Assessment
✓Initial Review
✓Classification
✓Assignment
Investigation
Interviews
Field Work
Data Queries
Evidence Review
Doc Analysis
Verification
Linking
Decision
Outcome
SIU Report
Recommendation
Closure
Archiving
Recovery Log
Audit Trail
Complete Visibility Across Your Fraud Operation
Single Source of Truth
All referral data, case history, evidence, and communications unified in one operational system.
Operational Oversight
Real-time visibility for managers across team workloads, bottlenecks, and financial outcomes.
Investigation Consistency
Standardised workflows and SLA enforcement ensure every case is handled correctly, every time.
Audit Readiness
Immutable logs of every action, decision, and piece of evidence for regulatory compliance.
Results That Speak For Themselves
95%
Reduction in Outstanding
Referrals
40%
Faster Claims
Processing
50,000+
Settled
Investigations
£100m+
Fraudulent Claims
Managed
Works With Your Existing Fraud Ecosystem
FraudOps connects with your claims systems, detection platforms, and data sources — no rip-and-replace required.
