Intelligence at Enterprise Scale
Turning complex data into actionable intelligence across every system, claim, and transaction.
Claim 14291
High risk
92
Risk score
Claim 14274
Review
64
Risk score
Claim 14258
Low risk
18
Risk score
The problem
False positives are overwhelming SIU teams.
Legitimate claims are escalated too often, creating backlogs that delay real fraud detection and drain investigator time.
SIU investigators are stuck triaging volume instead of focusing on high-risk behavior. Generic scoring models and opaque rules increase false escalations, slowing both claims handling and fraud response.
- Manual queues grow faster than teams can clear them.
- Opaque rules create mistrust and rework for investigators.
- Low-risk claims get delayed, hurting customer experience.
False positives dominate queues
3 in 4
Escalations can be low-risk claims when triage lacks explainability.
Illustrative benchmark — refine with carrier data.
The solution
Explainable claims triage built for SIU workflows.
Zephyr blends AI scoring with transparent reasoning so investigators get fewer, higher-quality escalations.
Pre-SIU claim ranking
Automatically prioritize claims before they reach investigators, so only the highest-risk cases enter the SIU queue.
Plain-English explanations
Every score includes clear, audit-ready reasoning that investigators can trust and defend.
Lower false positive escalations
Reduce unnecessary handoffs and keep legitimate claims moving without delays.
Focused fraud investigations
Keep senior analysts on real fraud patterns instead of triaging noise.
Explainability layer
Clear reasoning for every decision.
Each score comes with the top contributing factors, confidence bands, and audit trails that map directly to SIU policies.
Top drivers
- Prior claim timing outside expected cadence
- Vehicle damage pattern inconsistent with report
- Policy change within 7 days of incident
How it works
A simple workflow that integrates fast.
Designed to fit seamlessly into existing claims systems with minimal disruption.
Ingest claims signals
Zephyr connects to core claims data, policy context, and third-party signals.
Explainable risk scoring
Claims are ranked with transparent drivers so SIU teams see why each score was assigned.
Route with confidence
Only high-risk claims reach investigators while low-risk cases move forward automatically.
Workflow visualization
From intake to SIU routing in minutes.
Zephyr scores every claim, explains the drivers, and routes high-risk cases directly into SIU queues with audit-ready summaries.
Value proposition
Outcomes SIU leaders can measure.
Zephyr delivers real operational impact while keeping decisions transparent and defensible.
Illustrative false-positive reduction
30–45%
Benchmarks vary by carrier and data maturity.
Illustrative investigator hours saved
10+ hrs/week
Per investigator, based on streamlined triage.
Illustrative queue time improvement
2–3 days
Typical reduction in low-risk escalation delays.
Illustrative benchmarks — validate with your data.
Contact
Ready to reduce false positives?
Get a tailored walkthrough of Zephyr's explainable claims triage and see how it integrates with your SIU workflows.