CLAIM DOCUMENT CLAIMANT INCIDENT MED. CLINIC ATTORNEY REPAIR SHOP PRIOR ALIAS CARRIER B CARRIER C REF: HUB-SIU-001 TYPE: CLAIM NETWORK · SIU ANALYSIS

Solutions for Insurance Carrier Special Investigation Units

A Staged Collision. An Unrelated Clinic.
A Different Policyholder. The Same Fraud Ring.

Human Expertise. Amplified.

Insurance fraud doesn't operate claim by claim — it operates as coordinated networks of claimants, medical providers, repair shops, and attorneys generating volume across carriers and time. Hubstream connects every claim, every entity, and every prior referral into a single investigation — so your SIU analysts can see the ring behind the suspicious claim, and build the case that stops it.

Built for SIU teams across
Auto Fraud Workers Compensation Healthcare Fraud Property Fraud NICB Coordination DA Referrals

Patterns · 01–06

Sound Familiar?

Every insurance carrier SIU has had these conversations

"A staged collision claim with no witnesses. An unrelated claim six months later naming the same medical clinic. We had no system connecting them."
"We closed the claim as suspicious. The same ring filed forty-two more before we put it together."
"Three claims. Three different policyholders. Same repair shop, same medical provider, same attorney. We caught that in the fifth month."
"The same claimant had used four different names across our system and two other carriers. Our database doesn't resolve aliases."
"We referred one case to the DA. They had no idea we had 30 more connected to the same network."
"Our SIU analysts are talented investigators. They spend half their time doing database lookups instead of investigating."
"A staged collision claim with no witnesses. An unrelated claim six months later naming the same medical clinic. We had no system connecting them."
"We closed the claim as suspicious. The same ring filed forty-two more before we put it together."
"Three claims. Three different policyholders. Same repair shop, same medical provider, same attorney. We caught that in the fifth month."
"The same claimant had used four different names across our system and two other carriers. Our database doesn't resolve aliases."
"We referred one case to the DA. They had no idea we had 30 more connected to the same network."
"Our SIU analysts are talented investigators. They spend half their time doing database lookups instead of investigating."
Connection · Before · After

Forty Claims,
No Pattern

Each claim treated as a separate event — the coordinated network generating all of them stays invisible.

Before Hubstream

Forty Claims,
No Pattern

Auto Claims Medical Bills Repair Shop Records Attorney Filings Prior SIU Referrals NICB Reports

Each claim treated as a separate event — the coordinated network generating all of them stays invisible

After Hubstream

Fraud Ring
Now Mapped

  • Claim A → medical clinic → Claim C (different policyholder)
  • Clinic → attorney filing → 3 prior referrals
  • Claimant alias → 4 identity matches → cross-carrier fraud
  • Prior SIU referral → same repair shop → 2 new claims
  • Fraud ring → mapped and referred for prosecution
Outcomes · 01–04

What You Get

Four things insurance carrier SIUs get from Hubstream — that no individual claims database was designed to deliver.

01 / Claim Network Detection · Fraud Ring Mapping

See the Fraud Ring Behind
the Suspicious Claim.

One suspicious claim is a flag. Ten connected claims are a prosecution.

Organized insurance fraud generates volume — the same medical providers, repair shops, attorneys, and claimant aliases appear across dozens of claims before any individual claim looks suspicious enough to investigate. Hubstream connects your claim data to surface the ring behind the individual claim — so your SIU stops one claim and dismantles the network.

  • Shared provider and attorney network detection
  • Claimant alias and identity matching across claims
  • Coordinated fraud pattern surfaced from claim volume
02 / Entity Resolution · Cross-Claim Identity Matching

One Fraud Actor. Many Claimant
Identities. One Investigation.

Alias cycling is the fraud actor's primary tool. Entity resolution is the counter.

Sophisticated fraud actors cycle through claimant identities, using different names, addresses, and even different policyholders to disguise repeat activity. Hubstream resolves entities across your claim database — matching aliases, shared identifiers, and behavioral patterns — so the same actor can't hide behind a new claim number.

  • Cross-claim alias and identity resolution
  • Shared identifier matching across policyholders
  • Behavioral pattern matching across claim history
03 / Cross-Carrier Intelligence · NICB Coordination

Coordinate Fraud Intelligence
Across Carriers and NICB.

Fraud rings operate across carriers. SIU investigations shouldn't be siloed.

Organized fraud rings don't target one carrier — they spread claim volume across multiple carriers to stay below any single carrier's detection threshold. Hubstream enables controlled intelligence sharing with other carriers, NICB, and law enforcement — so the full scale of the fraud operation becomes visible, and referrals carry the complete network picture.

  • Cross-carrier fraud referral coordination
  • NICB and law enforcement intelligence integration
  • Controlled sharing with source and policy protection
04 / DA Referral Packages · Prosecution Readiness

Build Court-Ready Fraud Cases
for Criminal Referral.

The DA referral that leads to prosecution is built from connected evidence, not a single suspicious claim.

District attorneys need more than a suspicious claim to pursue criminal charges — they need the full network picture: connected claims, entity relationships, financial patterns, and documented fraud history. Hubstream assembles this automatically, so your SIU can refer not just a case but a prosecution-ready package that connects every element of the fraud ring.

  • Multi-claim entity and network evidence package
  • Financial pattern documentation for prosecution
  • Immutable chain of custody across all connected evidence
Case Study · Insurance SIU
Featured Case Study

Insurance SIU / Fraud Ring Investigation

How Canada's NC3 unified investigations and intelligence across agencies on Hubstream.

Canada's National Cybercrime Coordination Centre (NC3) unified investigations and intelligence across agencies on Hubstream — deployed on Microsoft Azure with FTI Consulting. Tips, RFIs, and active cases linked through analysis and visualization across every partner agency, in real time.

"The system was built to serve as an example for national governments in crime tracking and deterrence domains."— Bruce Benson, FTI Consulting
Key Outcomes
  • 01 /Claims from multiple policyholders connected to a single coordinated fraud ring — surfacing network actors that no individual claim review would have identified
  • 02 /Claimant aliases and shared provider relationships resolved automatically — eliminating manual cross-referencing across thousands of claim records
  • 03 /Intelligence shared with law enforcement and NICB with full source protection — enabling coordinated prosecution of the full fraud network, not individual claims
  • 04 /DA referral package assembled with complete entity connections, financial patterns, and claim timeline — resulting in prosecution-ready case from SIU investigation

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Playbooks

Insurance SIU
Workflow Templates

Start with operational frameworks built for insurance carrier SIUs. Download free — no demo required.

  • 01 / Claim Network Detection
  • 02 / Claimant Alias & Identity Resolution
  • 03 / Medical Provider Fraud Analysis
  • 04 / Cross-Carrier Intelligence Coordination
  • 05 / DA Referral Package Assembly
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In Action

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