Solutions/Cross-claim patterns

Related claims, handled together.

Claims are handled one at a time, so the same claimant, provider, attorney, or location on several claims rarely gets noticed. Isomer™ Graph connects them on one claim graph across your book, and Isomer Signals flags the pattern.

Built onIsomer Graph · Isomer Signals

One claim at a time misses the pattern.

When a claim is roundtabled, the claims related to the same event or the same parties should be in the room too. In most claims operations, they aren’t, because nothing connects them.

Start from a party

Pick a claimant, provider, attorney, or insured and see every claim they appear on, across lines of business.

Start from an event

Gather the claims that come from one incident, location, or common cause, so they’re discussed together.

Let the pattern find you

Signals flags a provider and attorney pairing on unrelated claims, or prior incidents at the same location, as claims arrive.

Patterns that span claims.

Example signalWhat it catchesTypical severity
Multi-claimant common causeSeveral claims that trace to one incident or causeHigh
Medical–legal referral patternThe same provider and attorney pairing across unrelated claimsHigh
Organized fraud / RICO exposureSigns of a coordinated scheme across claims, parties, or providersHigh

Examples from the 90+ detectors in the signal library.

Keyword search can’t tell who is who.

Connecting claims means knowing that the claimant on one file is the witness on another, and that two addresses belong to the same provider. The claim graph records each party by role, with the source of every fact, so a connection can be checked back to the documents.

See the patterns on your book.

In our workshop, your team builds synthetic claims modeled on your book and sees Isomer connect them. A pilot then finds the patterns on your own claims.