Find the Fraud, Not the Claimant
Most personal injury claims are exactly what they appear to be. A small number are organized: the same networks, the same enablers, and the same playbook, moving across dozens of claims and more than one insurer. Those are the claims worth finding, and they are the ones blanket review is worst at catching.
How insurers use open-source intelligence to identify organized claims fraud, and settle genuine claims faster.
Series description
This analyst-led series shows how open-source intelligence identifies the networks behind personal injury and claims fraud. It is built for insurance fraud, special investigation unit (SIU), and claims teams who need to concentrate scrutiny where it is warranted.
Product line
Fivecast ONYX turns publicly and commercially available data into network intelligence, helping insurers focus investigation on organized fraud instead of spreading suspicion across the whole book.
What does this series cover?
- How organized fraud networks operate across multiple claims, providers, and insurers
- The professional enablers that make repeat fraud possible
- Which indicators justify escalating a claim, and which do not
- Corroborating evidence from publicly available sources, applied proportionately
- Analyst workflows that concentrate effort on organized fraud and clear genuine claims faster
Register for the full analysis series
Register to access analyst-led case studies, repeatable workflows, and network analysis techniques drawn from real organized claims fraud investigations.
FEATURED INSIGHT
One organized network can surface across dozens of claims that look unrelated. Assessed one at a time, each is plausible. Connected, the pattern is obvious, and preventable.
WHY DOES IT MATTER?
Organized claims fraud is paid for by every honest policyholder. It is also the hardest kind to see, because each claim is built to look ordinary on its own. Open-source intelligence connects them, so investigation concentrates where fraud is deliberate and organized, and genuine claims are settled sooner.
HOW THIS STAYS PROPORTIONATE
Intelligence should narrow scrutiny, not widen it. Fivecast is engineered for targeted, defensible investigation: source tagging on every finding, a fully automated audit trail, and AI that supports analyst judgment rather than replacing it. Findings are evidence for an analyst to assess. They are never an automated decision about a person.
WHAT WILL YOU ACCESS?
- Analyst-led case studies on organized personal injury and claims fraud
- Repeatable OSINT workflows that prioritize claims by fraud indicators, not by claimant profile
- Network analysis techniques that expose rings, repeat actors, and professional enablers
- Corroboration checks that resolve a claim quickly in either direction
- Guidance on proportionate, defensible, and auditable evidence for investigations
WHO IS IT FOR?
Built for insurance fraud, special investigations, and claims teams responsible for organized claims fraud. Most useful for investigators and analysts who need to concentrate effort on deliberate fraud while genuine claims move through faster.
Frequently asked questions
What is organized claims fraud?
Organized claims fraud is deliberate, repeated fraud carried out across multiple claims, usually involving networks of claimants, providers, and representatives working to a pattern.
Does this mean investigating every claimant?
No. The purpose is the opposite. Open-source intelligence narrows attention to the claims that carry genuine fraud indicators, so the majority of claims proceed without additional scrutiny.
How does OSINT identify organized fraud?
It surfaces publicly and commercially available signals, including links between claimants, providers, and representatives, that connect claims which appear unrelated when assessed in isolation.
Is this fair to genuine claimants?
Focused investigation works in their favor. When organized fraud is separated out early, legitimate claims are settled faster, and the cost of fraud is not passed on through premiums.
How does Fivecast keep evidence defensible?
Fivecast applies source tagging and a fully automated audit trail, so findings stay accurate, consistent, and defensible. Findings support analyst judgment. They do not automate decisions about individuals.
