Stop billions in insurance fraud before claims are paid

Enterprise AI infrastructure that identifies fraud, organized fraud networks, identity abuse, payment anomalies, and hidden risk patterns before losses occur.

Risk Score 94 — Flagged

Detection

Claims data flows through the system instantly

Every claim enters the platform the moment it's filed. The system ingests structured and unstructured data from your claims management system, then begins pattern analysis against historical fraud signatures and emerging network behaviors. No delays. No manual handoffs.

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Intelligence

Algorithms flag what humans cannot see

The AI compares each claim against millions of data points — claimant history, payment patterns, provider networks, geographic anomalies, temporal signals. Synthetic identities, account takeovers, and coordinated rings surface instantly. The platform sees the whole picture.

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Prevention

Every claim gets a fraud risk score before approval

The platform assigns a confidence-weighted risk score to each claim in real time. Your team sees the recommendation — approve, investigate, or deny — before a single dollar moves. Fraud stops at the moment of decision, not months later during recovery.

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94

Capabilities

Three core capabilities

Enterprise-grade AI built to stop fraud at scale.

Organized fraud network detection

Identifies coordinated claim rings before they cost you millions.

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Identity abuse prevention

Stops synthetic identities and account takeovers cold.

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Proactive risk forecasting

Predicts emerging fraud patterns before they materialize.

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The numbers that matter to enterprise insurance leaders

0%+

Detection accuracy

Identifies fraud with precision that rivals manual expert review.

$0M

Prevented losses

Cumulative fraud prevention across deployed enterprise carriers.

60–90

Day deployment

Mission-critical platform live and operational in your environment.

Value

Enterprise outcomes that matter to your board

The platform stops fraud at the moment of claim, eliminates costly recovery cycles, and delivers measurable ROI within months of deployment. Integration is seamless — no system replacement, no operational disruption, no learning curve.

Stop losses before settlement

Real-time detection prevents fraud at the point of claim, not months after payout.

Integrate into existing operations

Connects to Guidewire, Sapiens, and legacy systems via API without disruption.

Board-level visibility and compliance

Executive dashboards quantify fraud prevention ROI and regulatory compliance metrics for governance.

Immediate, measurable impact

Deployment delivers quantifiable fraud prevention results from the moment platform operationalization begins.

Security

Enterprise-grade security and compliance

TUP AI Systems meets the security and compliance standards required by the largest insurance carriers. Your data is protected with the same rigor as mission-critical financial infrastructure.

  • SOC 2 Type II certified with continuous monitoring and audit compliance.
  • End-to-end encryption for data in transit and at rest across all platform components.
  • 99.99% uptime SLA with redundant infrastructure and disaster recovery protocols.
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FAQ

Questions enterprise leaders ask before deployment.

What is the deployment timeline?

Deployment takes 60–90 days from contract to full platform operationalization. This includes data integration, model training on your claims history, and team training. We work with your IT and claims teams to minimize disruption.

How is my claims data handled?

All claims data remains within your secure environment. The platform processes data on-premise or in your private cloud instance. We never store or access raw claims information outside your infrastructure.

Does it integrate with existing systems?

Yes. The platform integrates with major claims management systems including Guidewire, Sapiens, and custom legacy systems via API. Integration is handled by our deployment team as part of the engagement.

What about false positives?

The platform is tuned to your specific claims environment and fraud patterns. False positive rates are typically below 2% after initial model calibration, with continuous refinement based on your claims adjusters' feedback.

Is there ongoing support?

Yes. Enterprise deployments include 24/7 platform support, quarterly model retraining, and dedicated success management. We treat your fraud prevention as mission-critical infrastructure.

Qualified carriers only

This platform is built for serious enterprise deployment.