Summarize fraudulent claim detection using agents

  • Release version: Australia
  • Updated March 12, 2026
  • 1 minute to read

    • Automatically detect fraudulent claims by identifying duplicates, similar claim patterns, reused dealer images, mismatched or incomplete supporting documents, usage inconsistencies, and abnormal claim spikes.

    Before you begin

    Role required: admin

    Enable the skill before use. It is inactive by default:
    1. Navigate to All > Now Assist Admin > Skills.
    2. Select Customer.
    3. Select MCO.
    4. Activate the skill Detect Claim Anomaly.

    About this task

    The App Anomaly Detection Rule [com.sn_anomaly_detect] y framework is used to identify the fraudulent claims. The Agents portal displays the fraudulent repair claims submitted from the dealer portal using the [com.sn_anomaly_detect] based rules:
    • Similar claims
    • Duplicate claims
    • Image reuse
    • Usage mismatch detection
    • Dealer claim spike
    • Document mismatch

    Use case 1: Dealer submits repair claim with image.

    To submit the report in the Dealer portal, see Submit a repair claim for warranty.

    The repair claim appears in the Agents portal with Reject status.

    Procedure

    1. Navigate to Workspaces > CSM/FSM Configurable Workspace > Lists > Repair.
    2. Select the repair claim record that you want to review.
      Note:
      Choose the record that has the Potential action as Reject/Suggested.
    3. Select Review & approve, to view the claim analysis generated by Now Assist .