Omega — Insurance Fraud Intelligence Hub

Detect fraud, validate claims, and gain visibility across policyholders, hospitals, and claims — powered by voice + data intelligence.

Why Insurance Fraud Remains Unsolved

Traditional methods fail to address the complex, evolving nature of insurance fraud in today's digital landscape.

Manual Process Bottlenecks

Slow, human-dependent verification leads to delays and missed fraud patterns.

Impact

  • 5–7 day processing
  • 30% cases missed
  • ₹4,000 Cr losses
  • 3× manual workload

Lack of ICD Mapping

No automated correlation between claims and medical diagnosis codes.

ICD Impact

  • No ICD validation
  • Mismatched procedures
  • Poor traceability

No Voice–Hospital Correlation

Call center data exists in silos, disconnected from claim verification.

Disconnected Data

  • Unlinked voice logs
  • No NLP ↔ ICD match
  • Low traceability

Language Complexity

Multi-lingual claims create verification challenges and fraud opportunities.

Multilingual Risk

  • Miscommunication
  • 11+ languages
  • No AI checks

Introducing Omega — Intelligence at Every Step

Our comprehensive solution addresses fraud detection from every angle.

AI Voice Verification

Advanced voice analysis detects stress and verifies identity.

Details

  • 98.7% matching accuracy
  • 15+ stress indicators
  • Realtime during calls

Real-Time Risk Scoring

200+ indicators evaluated in milliseconds.

Highlights

  • <500ms scoring
  • Historical patterns
  • Pre-auth & post-claim

Hospital Fraud Mapping

Provider pattern tracking & geo-risk intelligence.

Capabilities

  • 30k+ profiles
  • Blacklist/watchlist
  • Regional clustering

ICD Pattern Detection

Diagnosis ↔ treatment alignment & misuse detection.

Insights

  • Upcoding flags
  • WHO/IRDA mapping

Audit Trails & Logs

Every step captured for compliance and review.

Features

  • Timestamped steps
  • Escalation metadata

Automated Workflows

Risk-based routing reduces manual load by 40%.

Capabilities

  • Auto escalation
  • Smart handoffs

How Omega Works

A seamless flow from claim intake to resolution with intelligent fraud detection at every step.

Claim Intake

Automated ingestion from TPAs, hospitals, and policyholders

Data Mapping

Correlation across policies, providers, and historical claims

Voice Verification

AI-powered call analysis & authentication

Risk Assessment

Real-time scoring against 200+ indicators

Resolution

Auto-approve or flag for investigation

Fraud triggers identified at each stage

Built for Global Support

Optimized for the world’s most-used languages.

English
Chinese (Mandarin)
Hindi
Spanish
French
Arabic (MSA)
Bengali
Portuguese
Russian
Urdu
Indonesian
German
Japanese
Turkish
Vietnamese
Korean
Italian
Tamil
Telugu
Marathi
Punjabi

Proven Results from Early Deployments

Quantifiable impact across insurance providers and TPAs.

0

Seconds to Score

Detection latency

0

Faster Closures

Legit claim processing

0

Fraud Detected

Voice + data correlation

0

Rejection Accuracy

Pattern identification

Enterprise-Grade Deployment

Comprehensive support through implementation and beyond.

On-site Resource

Dedicated specialist for first 90 days

Client Success

Strategic reviews & playbooks

Tech Lead Access

Direct escalation for critical needs

Webinars

Monthly training

Dashboards

Custom analytics

Agent costs

Included bundles

Language packs

Regional coverage