Claims
ForMotiv reads how a loss is reported, not just what is reported, and connects it to everything the claimant did from quote to FNOL. Fast-track the honest majority, stop takeover before payout and give SIU the session evidence to act on the rest.
At FNOLbehavior behind the loss report
Before payoutcatch account takeover
For SIUkeystroke-level evidence
Quote-to-claim record
A claim on its own is just a report. With Enterprise Intent, claims and SIU teams see it alongside the policyholder’s behavioral record, from the first quote through bind, servicing and login to FNOL. Add each layer of context and watch the handling change.
SIU & Forensics
The ForMotiv Console is the offline tool fraud, SIU, underwriting and product teams use to work sessions after the fact. ForMotiv Forensics adds the full record: every interaction across the policy, timestamped and stored.
Every interaction on the policy, in one timelineIllustrative
All interactions timestamped and stored, so an investigator sees the claim in the context of everything that came before it.
Early-term claims
The way someone buys a policy often predicts how soon they claim on it. Policies flagged for risky buying behavior file early claims far more often than the rest of the book.
Rating answers edited until the price dropsMileage, garaging ZIP, drivers or prior claims changed after a premium is shown.
Coverage raised right before bind or right afterLimits or new coverage added when a loss may already have happened.
Quote restarted with small changesThe same applicant probing for the answer that gets them through.
Account takeover before payout
An attacker doesn’t need to invent a loss. Through social engineering schemes, they get the policyholder’s credentials, or the policyholder themselves, to redirect the payout. Passwords, one-time codes and knowledge checks can all pass. Behavior is what doesn’t match.
An email or text that looks like it came from the carrier collects the login. The attacker signs in with the real password.
What ForMotiv seesA login from a device and network the policyholder has never used, then a direct path to payout details.
The attacker contacts support as the policyholder to reset the password or change the email on file.
What ForMotiv seesThe next portal session doesn’t behave like any session before it on the account.
The policyholder’s number is moved to the attacker’s phone, so multi-factor checks pass.
What ForMotiv seesAuthentication succeeds, but behavior after login is unfamiliar with the account and moves straight to money.
A fake adjuster or support agent walks the policyholder through changing payout details over the phone.
What ForMotiv seesThe right person with the wrong intent: dictated pacing, pasted bank details and unusual navigation.
Fast-track
When every claim waits in the same queue, genuine customers pay for the few who aren’t. Behavioral context lets you clear the clean claims straight through and spend adjuster and SIU time where the signals are.
Every channel
Claimants report online, in chat, on the phone and through their agents. The behavioral record follows them, so whoever takes the claim sees what the claimant just did.
Signals on the loss report itself: edits to dates and amounts, paste and familiarity.
Chat FNOL with the claimant’s digital history attached, for live agents and AI assistants.
The rep sees the online session that stalled or got flagged before the call connected.
Claims keyed by agents and agencies, read against how the policy was originally sold.
Group benefits & disability
A top U.S. group benefits carrier uses ForMotiv on employee registration and claims, where fraud comes from two directions.
Edits on condition, dates and earnings
Answers that change between claim and follow-up
Compromised employee accounts registered and used to file in quick succession
Shared devices across unrelated employees
FAQ
How does ForMotiv help insurance claims teams?
ForMotiv brings application and account behavior into the claims process and reads behavior in the claim itself, so claims teams can fast-track genuine claims and send risky ones for review before payment.
What claims use cases does ForMotiv cover?
Claims use cases include FNOL fraud, early claims shortly after bind, account takeover before a payout, group benefits claims fraud, and SIU and Forensics investigations.
What are early claims?
Early claims are claims filed shortly after a policy is bound. ForMotiv connects how the policy was bought to the claim that follows, which helps identify policies bought with a loss already in mind.
How does ForMotiv detect account takeover before a claim payout?
ForMotiv flags high-risk behavior after login and ahead of a payout, using behavioral data captured in the session and the rest of the policy's record, so carriers can verify before money moves.
Does ForMotiv slow down genuine claims?
No. Because most claimants behave as expected, carriers can use ForMotiv to move genuine claims faster and focus reviews where the behavior warrants it.
Bring one journey and one goal. We’ll show you the behavioral signals behind it, the decisions they can drive, and how ForMotiv fits into your stack.
Leakage, fraud, conversion or agent oversight, on the line and channel you care about most.
A walkthrough of the signals, features and scores for journeys like yours.
Where the tag goes, what the API returns and which systems act on it.
