Claims & FNOL

Stop fraudulent claims before they’re paid.

Claims fraud is surging, and much of it starts with a taken-over customer account. ForMotiv continuously analyzes behavior across every session on a policy, from quote and login to the claim itself, so carriers across auto, home, life and employee benefits can stop it in policy admin, at first notice of loss and in SIU investigations.

Policy adminaccount takeover and high-risk changes

FNOL intakesuspicious claims stopped before payout

SIUone behavioral record to investigate

Intake · sample claimsClaim 1
Rear-end collisionWeb · reported by a person

Straight-through

Adjuster

Specialist

SIU

When a claim goes to SIU

The referral arrives with its evidence already attached.

Investigators shouldn’t have to rebuild a session from logs. Every SIU referral from intake carries the intake session behind it and the policyholder’s persistent behavioral record, ready to work in the ForMotiv Console.

SIU referral · sampleReady to review

The full intake sessionBehavioral metadata from every step of the report.

Suspicious and high-risk behaviors, with reasonsEach one in plain language, ready for the case file.

Linked sessionsOther policies and claims connected to this one, without any PII.

The policyholder’s behavioral recordEvery session on the policy, analyzed continuously from the first quote.

End-to-end claims fraud protection

Stop claims fraud before, during and after the report

Taken-over accounts are being used to file fraudulent claims across auto, home, life and employee benefits. ForMotiv analyzes behavior continuously, across every session on the policy, so the risk is visible long before any single answer gives it away.

01 · Policy admin

Before the claim is filed

Every session analyzedQuote, login and servicing sessions, analyzed as they happen and added to one behavioral record.

Account takeoverHigh-risk behavior after login, flagged before it turns into a claim or a payout.

Risk that builds over timePatterns that only emerge across sessions, never in any one of them.

02 · FNOL intake

While the claim is reported

Suspicious behaviorFlagged as the report is being written, in the context of the whole record.

Known fraud behaviorBehavior that matches patterns seen in confirmed fraud.

Who is filingA person, an AI agent or a bot, and whether this device is linked to other policyholders’ claims.

03 · SIU & investigation

After the claim comes in

One behavioral recordEvery session tied to the policy, from the first quote to the claim.

Linked sessionsSearch by device or session to uncover fraud rings across policies and claims.

Ongoing monitoringEvery later session on the claim is analyzed the same way.

At FNOL intake

Catch fraudulent claims as they’re reported, and fast-track the genuine ones

While a claim is being reported, ForMotiv flags suspicious, high-risk and known fraud behavior and checks who or what is filing. Every route arrives in your claims system with its reasons.

Genuine claim

Fast-track it

Reported naturally by a person, on an account with nothing unusual.

Straight-through payment
One thing to check

Send it to an adjuster

Suspicious behavior in the report, flagged with the reason attached.

Adjuster review
Fraud indicators

Refer it to SIU

High-risk or known fraud behavior, or a taken-over account filing the claim.

SIU before any payment
Not a person

Stop it at the door

A bot or AI agent filing, or a device linked to other policyholders’ claims.

Block and investigate

Every intake channel

Losses get reported wherever the customer happens to be

The same continuous behavioral analysis works across every intake channel, including who or what is filing.

Web

Every step of the online report, analyzed as it happens.

Direct digital →
Mobile app

Claims reported in the app, analyzed the same way.

Direct digital →
Chat

Claims reported in conversation, analyzed throughout by the Chat Solution.

Chat Solution →

FAQ

Frequently asked questions

How does ForMotiv help stop claims fraud?

ForMotiv helps carriers stop fraudulent claims at three points: in policy admin, by flagging account takeover and high-risk changes; at first notice of loss, by flagging suspicious, high-risk and known fraud behavior as the claim is reported; and in SIU, with a persistent behavioral record and linked sessions to investigate.

Can ForMotiv stop claims filed from taken-over accounts?

Yes. ForMotiv flags high-risk behavior after login and connects it to the claim that follows, so carriers can stop a fraudulent claim from a taken-over account before it is paid, across auto, home, life and employee benefits.

What does FNOL fraud look like?

FNOL fraud rarely gives itself away in any one answer. It shows up in behavior across the report and the sessions before it, which is why ForMotiv analyzes every session on the policy continuously and flags suspicious, high-risk and known fraud behavior.

Can ForMotiv help SIU at FNOL?

Yes. Claims flagged at FNOL arrive at SIU with the intake session and the policyholder’s persistent behavioral record behind them, including linked sessions that may indicate a fraud ring.

Does ForMotiv slow down claims?

No. Most claims behave as expected, and carriers can use ForMotiv to move those faster while focusing reviews on the claims that warrant it.

Does ForMotiv work for group benefits claims?

Yes. ForMotiv supports group benefits and disability claims as well as property and casualty claims.

Your applications already know more than they say.

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.

01
Pick the use case

Leakage, fraud, conversion or agent oversight, on the line and channel you care about most.

02
See it on a real flow

A walkthrough of the signals, features and scores for journeys like yours.

03
Map the integration

Where the tag goes, what the API returns and which systems act on it.