AI-powered fraud detection across all claim types

Shift's machine learning models analyze structured and unstructured claims data — including policy details, provider information, and adjuster notes — to assign a fraud risk score to each claim. The models are trained on billions of data points and continuously updated to adapt to emerging fraud patterns.

Business outcome: Fraud teams reduce investigation time by focusing on high-risk claims while minimizing false positives that delay legitimate payouts.

Network fraud ring detection and visualization

Shift automatically identifies connections between claims, providers, claimants, and other entities to uncover organized fraud rings. The platform visualizes these networks, making it easy for investigators to see relationships that would be impossible to detect manually.

Business outcome: Carriers stop multi-claim fraud rings that traditional methods miss, preventing cumulative losses across multiple policies.

Behavioral anomaly detection for subtle fraud signals

Beyond explicit fraud patterns, Shift identifies behavioral anomalies — unusual claim filing patterns, atypical provider referrals, or suspicious timing of medical procedures — that indicate potential fraud even when no known pattern matches.

Business outcome: Detection of previously unknown fraud tactics, giving carriers a proactive defense rather than reactive rule updates.

Integrated case management and investigation workflow

Shift provides a centralized dashboard where fraud investigators can review scored claims, access evidence summaries, and manage investigation workflows. The platform integrates with existing claims management systems to avoid disrupting established processes.

Business outcome: Investigation teams reduce case resolution time by 30-50% through streamlined workflows and automated evidence collection.

Explainable AI for regulatory compliance and adjuster trust

Shift provides clear explanations for why a claim was flagged, including the specific factors contributing to the risk score. This transparency helps adjusters understand and trust the AI's recommendations, and supports compliance with insurance regulations.

Business outcome: Faster adjuster adoption of AI recommendations and stronger audit trails for regulatory reviews.

Enterprise-scale deployment with multi-line support

Shift is designed for carriers operating across property, auto, health, and life insurance lines. The platform handles millions of claims per year and adapts its models to the specific fraud patterns of each line of business and geographic market.

Business outcome: A single fraud detection platform replaces multiple point solutions, reducing vendor complexity and ensuring consistent detection across all lines.

• Detection accuracy at scaleShift's models are trained on hundreds of millions of claims, delivering fraud detection rates that outperform traditional rule-based systems by 3-5x.
• Network fraud ring identificationThe ability to automatically map connections between entities is a genuine differentiator for catching organized fraud that single-claim analysis misses.
• Multi-line and multi-market capabilityShift works across property, auto, health, and life lines in 30+ countries, making it suitable for global carriers with diverse portfolios.
• Explainable AI for regulatory confidenceClear model explanations build adjuster trust and satisfy regulatory requirements for transparency in automated decision-making.

• Enterprise-only pricingShift is not accessible to mid-size or small carriers — the investment and implementation scope require large claims volumes to justify.
• Implementation complexityDeploying Shift requires integration with existing claims systems, data mapping, and model configuration — a multi-month process with dedicated resources.
• No self-serve trialThere is no free trial or demo environment — potential buyers must engage in a sales process to evaluate the platform.
• Professional RealityIf your carrier processes fewer than 50,000 claims annually or lacks a dedicated fraud investigation team, Shift is likely over-engineered and over-priced for your needs.

Auto insurance fraud detection

Auto carriers use Shift to detect staged accidents, inflated repair costs, and fraudulent injury claims. The network analysis capability is particularly effective at identifying rings of providers and claimants working together.

Health insurance provider fraud

Health insurers deploy Shift to flag unusual billing patterns, unnecessary procedures, and provider collusion. The platform's behavioral anomaly detection catches subtle signals that rule-based systems miss.

Property insurance claim verification

Property carriers use Shift to identify inflated damage estimates, fraudulent weather claims, and repeat claimants across multiple policies. The platform integrates with adjuster notes and photos for comprehensive analysis.

Life insurance application fraud

Life insurers apply Shift to detect material misrepresentation on applications, including undisclosed medical conditions or smoking status. The platform flags high-risk applications before policies are issued.

Contact Shift Technology's sales team to schedule an initial discovery call and discuss your carrier's fraud detection needs and claims volume.

Complete a data assessment to map your claims data structure and identify integration points with existing claims management systems.

Participate in a proof-of-concept deployment on a subset of historical claims to validate model accuracy and ROI projections.

Execute the full implementation, including system integration, model configuration, and team training for fraud investigators and adjusters.