Use Case · Insurance
Detect forged claim documents at intake
Insurance fraud costs the industry over $80 billion annually. Hesper AI detects altered medical records, inflated repair estimates, and fabricated documents before claims are processed.
The fraud landscape in insurance claims
Claims fraud has become increasingly sophisticated. Digital editing tools allow fraudsters to alter medical billing codes, inflate repair estimates, and create entirely synthetic documents that pass visual inspection. Hesper AI operates at the pixel level — detecting the compression artifacts, cloning patterns, and font anomalies that editing leaves behind.
Medical claim fraud
Altered billing codes, inflated treatment costs, and duplicated claims from different providers.
Property & auto fraud
Digitally inflated repair estimates and edited damage assessment photographs.
Policy document fraud
Forged or altered policy schedules, backdated coverage, and fabricated endorsements.
Integration into claims workflow
Add Hesper AI as a step in your claims intake pipeline. Documents are analyzed at submission, and a fraud score is returned alongside your existing claims data — so adjusters have context from the moment they open a case.
Claim submitted with supporting documents
Claimant uploads medical records, estimates, or policy documents through your existing intake flow.
Hesper AI analyzes each document
Each document is sent to /v1/analyze. Multiple documents in a claim are processed concurrently.
Fraud intelligence surfaced to adjusters
Adjusters see a fraud score, flagged regions, and specific findings alongside the claim — before they begin manual review.
High-risk claims routed to SIU
Claims exceeding your fraud threshold are automatically routed to your Special Investigations Unit with full Hesper AI findings attached.
Built for insurers and claims platforms
Hesper AI integrates with your existing claims management system via REST API. No UI changes, no new training for adjusters — just an additional fraud signal surfaced where they already work.