Auto claims investigation, fully automated
Auto fraud costs insurers $29 billion annually. Staged collisions, phantom passengers, and body shop collusion require investigation resources most carriers don't have. Hesper AI investigates every auto claim in hours.
Common auto claims fraud schemes
Auto fraud ranges from individual exaggeration to sophisticated rings involving drivers, attorneys, medical providers, and body shops working in coordination. Hesper investigates every flagged claim against all four schemes simultaneously.
Staged accidents
Organized rings orchestrate collisions with predetermined participants and pre-arranged witnesses. Hesper AI cross-references participant histories, analyzes accident scene photos for staging indicators, and maps connections between drivers, passengers, attorneys, and medical providers.
Phantom passengers
Claimants add non-existent passengers to increase injury payouts. Hesper AI verifies passenger identities against DMV records, cross-references medical treatment timelines, and detects patterns of the same individuals appearing across multiple unrelated accidents.
Inflated injury claims
Minor accidents with exaggerated medical treatment. Hesper AI analyzes medical records for altered billing codes, detects inconsistencies between reported injuries and accident severity, and flags treatment patterns that exceed norms for the type of collision.
Repair shop collusion
Body shops inflate repair estimates or bill for work not performed. Hesper AI detects altered amounts in repair invoices, maps relationships between claimants and specific shops, and cross-references repair costs against regional benchmarks and OEM parts databases.
Manual workflow vs. Hesper
Every phase compresses. The cumulative effect is the difference between a two-week investigator assignment and a same-day decision.
How Hesper AI investigates an auto claim
Every auto claim runs through a structured investigation pipeline. Phases run in parallel where dependencies allow - the full sequence completes inside a few hours.
Document and photo ingestion
~3 minAccident photos, police reports, medical records, repair estimates, and rental receipts are ingested simultaneously. Each document is analyzed across 200+ fraud signals at the pixel level before any text extraction.
Vehicle and identity verification
~8 minVehicle VINs are checked against NMVTIS for title history, salvage records, and prior damage. Driver and passenger identities are verified against DMV records and cross-referenced with prior claims in ISO ClaimSearch and NICB.
Medical treatment validation
~14 minMedical records are analyzed for altered billing codes, fabricated treatment dates, and inflated charges. Treatment timelines are cross-referenced with the accident date and injury severity to detect patterns inconsistent with the reported impact.
Network and ring analysis
~10 minHesper AI maps connections between all parties - drivers, passengers, witnesses, attorneys, medical providers, body shops. Shared service providers across multiple claims are flagged as potential organized fraud indicators.
Investigation report and resolution
~12 minA complete investigation report is generated with evidence citations, network diagrams, risk scores, and recommended actions. Denial justifications and referral packages are prepared for SIU review or law enforcement referral.
Annual auto insurance fraud in the US
Per Coalition Against Insurance Fraud
Of auto injury claims involve fraud
Higher than P&C average
Hesper AI investigation time per claim
Vs. 14+ days manually
Fraud signals analyzed per document
Pixel-level plus text-level
Go deeper on auto claims fraud
Research, technical deep-dives, and playbooks from the Hesper AI team.
See Hesper investigate your auto claims
We'll run a sample investigation on your real flagged claims and show you the evidence package and report it produces.