Insurance Fraud Investigation

The Claimant, the Attorney,
and the Body Shop Didn't Meet by Accident.

Map the Ring. Not Just the Claim.

Insurance fraud is rarely one bad actor filing one bad claim. It's a coordinated network — staged accidents, recruited claimants, complicit medical providers, and attorneys who appear in hundreds of claims across years and jurisdictions. The individual claim is visible. The ring behind it isn't — until the sources connect. Hubstream provides insurance fraud investigators with entity resolution across claimants, providers, attorneys, and body shops, surfacing the full network pattern that individual claim review leaves invisible.

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Built for

Insurance Fraud Divisions State Police Financial Crimes Dept of Financial Services NICB Partners Medicaid Fraud Control Units

28 CFR Part 23 CJIS Compliant SOC 2 Type II

Patterns · 01–08

Sound Familiar?

Every insurance fraud unit has had these conversations

"The attorney, the body shop, and the claimant appeared together in 14 different claims. We found out at trial."

"Workers' comp fraud. Same injury description. Six different claimants. Different employers, same law firm."

"Three clinics billed for the same patient on the same day in different counties. We caught it manually."

"The staged accident ring has 23 participants. Our case management is tracking 4."

"The claimant's attorney has appeared in 90 claims in the past 18 months. Nobody flagged that pattern."

"The same body shop appears in every suspicious auto claim in the county. We know it. We can't prove the connection."

"We have hundreds of suspicious claims. The network connecting them doesn't exist anywhere in our system."

"Our investigators know what they're looking for. The platform can't surface what they don't know to search."

"The attorney, the body shop, and the claimant appeared together in 14 different claims. We found out at trial."

"Workers' comp fraud. Same injury description. Six different claimants. Different employers, same law firm."

"Three clinics billed for the same patient on the same day in different counties. We caught it manually."

"The staged accident ring has 23 participants. Our case management is tracking 4."

"The claimant's attorney has appeared in 90 claims in the past 18 months. Nobody flagged that pattern."

"The same body shop appears in every suspicious auto claim in the county. We know it. We can't prove the connection."

"We have hundreds of suspicious claims. The network connecting them doesn't exist anywhere in our system."

"Our investigators know what they're looking for. The platform can't surface what they don't know to search."

Before · After

FROM INDIVIDUAL CLAIMS
to the FRAUD RING

Reviewing individual claims without connecting the network behind them catches one participant while the ring files the next hundred.

Claim-by-Claim Review

Individual Claims.
No Ring Picture.

Claims reviewed in isolation Claimant, attorney, provider — separate records No cross-claim entity resolution Body shop and provider patterns found manually No link between suspicious claims across jurisdictions Ring structure discovered at prosecution — too late SIU, state police, and DFS data not connected Ring recruits new claimants as fast as cases close

One conviction. The ring files 200 more claims with different names.

→

Hubstream Insurance Fraud Intelligence

The Full Ring.
Attorney. Provider. Body Shop.

Outcomes · 01–04

What Changes After Hubstream

Four outcomes for insurance fraud investigators that claim-by-claim review — and generic case management — can't deliver.

01

Ring Detection

Staged Accident & Injury Ring Mapping — Claimant, Attorney, Provider, Body Shop

Automatically surface when the same attorney, clinic, or body shop appears across multiple claims
Map the full staged accident ring — who recruited whom, who benefited, who coordinated
Identify rings before prosecution — not at trial when it's too late to build the full case

02

Pattern Analysis

Provider & Attorney Billing Pattern Detection Across Claims

Flag providers appearing in an unusual proportion of suspicious or high-value claims
Identify attorneys whose claim population has outsized frequency with the same clinics or body shops
Pattern detection across workers' comp, auto, and health claims in a single investigation picture

03

Cross-Claim Intelligence

Workers' Comp, Auto, and Health Claim Cross-Referencing in One System

Resolve the same claimant appearing under different names, employers, or injury descriptions
Surface when the same individual is simultaneously active in workers' comp and auto claims
Link claimant history across insurers, jurisdictions, and claim types — not siloed by line of business

04

Multi-Agency Sharing

SIU, State Police, DFS & NICB — Connected Intelligence with Controlled Access

Share insurance fraud intelligence across SIU units, state police financial crimes, and DFS
Role-based permissions ensure the right investigators access the right case data
Full audit trails and evidentiary chain of custody — admissible from the first day of investigation

Get Started

Map the Ring.
Not Just the Claim.

From staged accident networks to workers' comp schemes — Hubstream surfaces the full fraud ring that claim-by-claim review leaves invisible.

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See it in action.

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