Claims
Fraud
Agentic AI

Fraud or Claim? Making Agentic AI work for the Investigator

Fraud and SIU teams don't have a data problem. They have a time problem.

Every alert lands with dozens of fields, flags and linked records — but no story. Before an investigator can even begin to judge a case, they have to read across scattered data points, chase down further evidence, and piece together a narrative by hand. The decision itself is often quick once the full picture is in front of them. Getting to that picture is the real bottleneck.

That's the gap this webinar is about: what "agentic AI" actually means for fraud investigation — not as a buzzword, and not as a replacement for human judgment, but as a way to close the distance between an alert landing and a decision being made.

What we'll cover

Over three connected segments, we'll walk through how agentic AI is showing up in real fraud and SIU workflows today:

  • From Alert to Answer — how a plain-language, domain-aware summary of an alert, paired with an agent that autonomously gathers and cross-references supporting evidence, can turn minutes of reading into seconds of orientation — freeing investigators to spend their time on judgment, not data-hunting.

  • Close the Coverage Gap Yourself — how SIU teams can go from "we suspect there's a blind spot" to a working detection scenario without waiting on a data scientist or a vendor request, using an agent that helps them explore their own claims data and tune detection scenarios directly.

  • Agentic Doesn't Mean Unsupervised — the question every insurer, regulator and consumer is asking right now: does "agentic" mean losing human control? We'll make the case for agents as case-preparers, not deciders — with the accountable human and the audit trail firmly intact.

We'll close with an open Q&A, so bring your hardest questions about where this technology is heading and where the guardrails need to sit.

Why it matters

This isn't a theoretical discussion. It's built on live product development in alert summarisation, agentic triage, and self-serve detection tuning — and on a genuine industry tension: how do you get the speed and consistency benefits of automation without handing over adjudication?

If you work in fraud, SIU, claims, or insurance technology, this session is designed to give you a concrete, practical view of where agentic AI helps today, where the human absolutely has to stay in the loop, and how to think about adopting these capabilities responsibly.

Speakers

Neil Wood
Neil Wood
Head of Fraud
Markerstudy
Nick Rawlings
Nick Rawlings
Executive Director and Strategy & Enterprise Transformation
Covea Insurance
George Robbins
George Robbins
Head of UK, Ire & Nordics
Shift Technology
Yannis
Yiannis Kotoulas
Editor
Insurance Times
Moderator