tools
Shift Fraud & Risk
AI software for insurers that detects fraud, prioritizes investigations, analyzes documents, and guides special investigation units.
Shift Fraud & Risk helps insurers identify suspicious claims and policy risks using claims, policy, document, and cross-carrier data. It prioritizes high-risk cases, supports investigations, and provides explainable guidance and next actions.
The product includes document analysis, automated triage, case-task automation, generative summaries, and a domain-specific assistant. Shift presents it as an enterprise solution accessed through its interface or integrated with insurer systems; pricing is not publicly listed and requires a demo.
Features
- Analyzes claims, policies, documents, and external data for fraud indicators
- Automates triage and prioritization of high-risk cases
- Uses cross-carrier insights through the Insurance Data Network
- Extracts and validates invoices, IDs, medical records, and metadata
- Builds investigation plans and automates routine case tasks
- Provides explainable AI reasoning and generative case summaries
- Answers questions about alerts, cases, claims, documents, and policies
- Offers real-time SIU workload and AI-scenario metrics
Use cases
- Detect suspicious claims and policy risks across insurance workflows
- Prioritize high-impact cases for special investigation units
- Review documents and corroborate evidence during investigations
- Generate case briefs, reports, and recommended next actions
- Identify fraud patterns spanning multiple insurance carriers
Pros
Cons
Latest updates
- Insurance Council of Australia, EXL and Shift Launch New Collaboration to Build Insurance Fraud Detection and Investigations Platform
Shift, EXL, and the Insurance Council of Australia launched a collaboration to build a fraud detection and investigations platform.
- Shift Technology Launches Shift Claims to Power Claims Transformation with Agentic AI
Shift launched Shift Claims, an agentic AI solution for claims transformation.
- Shift Provides Tokio Marine & Nichido Fire Insurance with New Generative AI Capabilities for Fraud Detection and Claims Processing Optimization Initiatives
Shift provided Tokio Marine & Nichido Fire Insurance with new generative AI capabilities for fraud detection and claims processing.
Security
- GDPR — “GDPR-compliant by design” source
Pricing
- Prices checked
- 2026-11-06