Insurers verify claimant identity and documents instantly, helping catch fraudulent claims earlier in the process.

On this page

An insurance provider was seeing a rise in claims filed using mismatched or altered identity documents, where the claimant's submitted details didn't line up with the original policyholder on record. Catching this required manual cross-checking that slowed down claims for genuine customers too.

The Challenge

No automated way to confirm a claimant's identity matched the original policyholder
Fraudulent claims were often only caught after payout, when recovery is far harder
Genuine claimants faced the same slow manual review as suspicious ones

Insurance Claims Fraud Detection: an insurance claim folder inspected by a magnifying glass, with a car and a shield in the background

The Solution

Veriqos Technologies' identity verification APIs confirm claimant PAN and Aadhaar details against the policy record automatically when a claim is filed, flagging mismatches for review before any payout is processed.

The Results

The insurer now catches identity mismatches at first submission instead of after payout, while genuine claimants with matching records move through the process without added delay.

Matching claimants to the policy record

The core of insurance claims fraud detection here is a simple comparison: does the person filing the claim match the policyholder on record? Checking PAN and Aadhaar details at the moment a claim is filed answers that question before any money moves, when stopping a fraudulent claim is easiest.

Genuine claimants should not pay for the controls. When matching details pass automatically, their claims move straight on, and reviewers spend their time only on the mismatches that genuinely need investigation.

Keeping the result of each check with the claim file also gives the insurer clear evidence if a decision is later disputed.