The Problem We Were Brought In To Solve
$4.2B US P&C insurer losing $34M annually to staged accidents and medical provider rings. SIU catching only 28% of fraud — after payment.
How Revino Delivered
Pre-payment fraud scoring: social network analysis for provider rings, billing anomaly detection, claimant history cross-referencing, narrative red flag extraction.
Measurable Business Impact
✓Fraud detection rate: 28%→71% of fraudulent claims
✓Pre-payment blocks: $12.4M in Year 1
✓Investigator productivity: +2.8×
✓False positive rate: 4.2% (minimal friction)
✓State DOI compliance automated
PythonGraph Neural NetworksLightGBMAWSPostgreSQL
KEY METRICS
3.4×
Detection rate
$12.4M
Fraud blocked
2.8×
Investigator capacity
4.2%
False positive rate
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Fraud -43% | $8.2M recovered Year 1 | False declines -62%
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