Hesper AI detects and investigates insurance fraud end-to-end - from red flag triage to evidence gathering, statement analysis, and investigation-ready reports. In hours, not weeks.
AI-generated documents, synthetic identities, and coordinated fraud rings are scaling faster than any SIU team can keep up. Most flagged claims simply expire uninvestigated.
$308B+
lost to insurance fraud annually
Coalition Against Insurance Fraud
~10%
of all P&C claims are fraudulent
FBI / NICB
For a mid-size carrier, that's thousands of claims per year.
~75%
of flagged claims are never fully investigated
SIU capacity constraints
They expire. The money is gone.
Most SIU teams have 1 investigator per 200+ cases.
02 How It Works
From detection to resolution
Five autonomous phases. One investigation-ready report. No scroll-jacking - every step is right here.
Step 01 / 05
Suspicious claim detected
Hesper’s detection engine analyzes incoming claims using document forensics, pixel-level analysis, and behavioral signals - flagging suspicious claims instantly. Already have a detection tool? Hesper also ingests flags from FRISS, Shift, Verisk, or manual referrals.
New Claim Flagged
Claim #CLM-2847
Type
Auto Collision
Amount
$47,200
Claimant
James R. Mitchell
Date of Loss
Mar 15, 2024
Risk Score87/100
Document inconsistency detected
Prior claim pattern match
Flagged
Step 02 / 05
AI investigation agent deployed
An AI investigation agent is assigned to the claim automatically. It pulls policy details, claimant history, prior claims data, and begins cross-referencing the claimant’s statements against available evidence.
Agent Active
CLM-2847
Data Sources
Policy Database
Connected
Claims History
Connected
Claimant Statements
Connected
Document Verification
In Progress
Medical Records
Queued
OSINT Sources
Queued
Phase Progress3 / 15
Step 03 / 05
Multi-source evidence analysis
Documents, medical records, social media, public records, and financial data are analyzed in parallel. The agent flags inconsistencies, builds a chronological timeline, and identifies patterns across the claimant’s history.
Evidence Analysis12 sources connected
Mar 15, 2:14 PM
Collision reported to 911
Mar 15, 2:45 PM
Police arrive on scene
Mar 15, 3:30 PM
ER visit (45min unaccounted gap)
Mar 16, 9:00 AM
Claim filed online
Mar 17, 11:22 AM
Social media: gym check-in
Mar 20, 3:00 PM
Same provider network as 3 prior claims
3 anomalies detected across timeline
Step 04 / 05
Investigation report generated
A structured investigation report is generated with findings, evidence references, risk assessment, and recommended actions - ready for your SIU team to review and act on immediately.
Investigation Report
CLM-2847 | Auto Collision
Complete
High Risk - 94/100
Multiple fraud indicators confirmed across evidence sources
Executive Summary
Key Findings (3 items)
Evidence Index (12 sources cited)
Timeline Reconstruction
Statement Analysis
Risk Assessment
Recommendation
Refer to SIU - High confidence of staged collision
Step 05 / 05
Case resolved, audit trail preserved
Every step of the investigation is logged with timestamps and source citations. Full audit trail, regulatory-ready documentation, and explainable AI decisions. From detection to resolution - completely documented.
Audit TrailCase Resolved
10:42 AMPolicy verified against database
10:43 AMPrior claims history pulled (3 found)
10:44 AMClaimant statements loaded
10:51 AMDocument forensics complete
10:58 AMDatabase checks (NICB, ISO, DMV)
11:02 AMOSINT scan complete
11:08 AMStatement cross-reference analysis
11:14 AMInvestigation report generated
11:15 AMCase resolved - referred to SIU
Compliance Checklist
Evidence preserved
Sources cited
Decisions logged
Regulatory compliant
Total investigation time33 min
03 Features
The investigation toolkit
Autonomous evidence collection across every source
Hesper agents pull evidence from claims systems, policy databases, public records, social media, and third-party data sources - building a comprehensive evidence package without manual effort.
Document authenticity verification
Social media & OSINT investigation
Public records search
Prior claims history analysis
Medical record cross-referencing
Evidence Gathering - CLM-47382
Collection Progress19/26 verified
Documents
4
OSINT
2
Records
3
Photos
12
Social
3
Medical
2
3 items flagged for manual review
04 Integrations
Connects to your stack
Purpose-built connectors for the claims ecosystem - we sit alongside your existing tools, not in place of them.
Claims systems
Downstream of your core — no rip-and-replace
GuidewireDuck CreekMajescoClaimCenter+ more
Data & bureau
Every evidence source cited in the final report
NICBISO ClaimSearchLexisNexisNMVTISTransUnion+ more
Detection partners
Pick up where your flagging stops
FRISSShift TechnologyVeriskSalesforce+ more
SOC 2 (in progress)
Zero data retention
GDPR-ready
End-to-end encryption
See It In Action
See Hesper investigate a real claim
We'll walk through an actual investigation on a sample claim - evidence gathering, statement analysis, timeline reconstruction, and the final report.
Hesper connects to your claims management system (Guidewire, Duck Creek, Majesco, or others) via API. When your fraud detection tool flags a claim, Hesper automatically picks it up for investigation. You can also manually refer claims through our dashboard. No rip-and-replace required - we work downstream of your existing tools.
No. Hesper augments your SIU team by handling the investigation legwork - evidence gathering, statement cross-referencing, timeline reconstruction. Your investigators review the structured reports and make final decisions. Think of it as giving each investigator a team of AI research assistants.
Hesper handles property & casualty, auto/motor, workers' compensation, and general liability claims. The investigation agents adapt their workflow to the claim type - an auto collision investigation pulls different evidence sources than a workers' comp claim.
Most investigations complete within 2-4 hours, depending on the complexity and number of evidence sources. Compare that to the 14+ day average for manual SIU investigations. The AI agents work in parallel across all investigation phases.
Each report contains an executive summary, complete evidence package with source documentation, timeline reconstruction, statement analysis with identified inconsistencies, risk scoring with rationale, and actionable recommendations. Reports are exportable as PDF or accessible via API.
We're SOC 2 compliant (certification in progress), maintain zero long-term data retention, and are GDPR-ready. All data is encrypted in transit and at rest. We don't store claim data beyond the active investigation period unless explicitly configured otherwise.
Platform fee of $3-5K per month plus per-investigation usage ($75-150 per claim, depending on complexity). This typically delivers a 10-20x ROI compared to manual investigation costs. We'll walk through the economics in a demo.
Those tools flag suspicious claims - they're fraud detection. Hesper is fraud investigation. We pick up where they stop. When FRISS or Shift flags a claim, Hesper investigates it: gathering evidence, cross-referencing statements, reconstructing timelines, and generating investigation-ready reports. They're complementary, not competitive.
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