Contractor fraud detection after a storm: copied estimates and renamed contractors raised before payment
Contractor clusters raised before payment, not found after it.
See one case, screen by screen ↓It finds contractors who file copied or inflated estimates across many claims after a storm. Contractor Fraud Detection reads every contractor estimate, invoice and direction-to-pay form in the storm footprint, groups the look-alike estimates into clusters, joins business names that are one firm, and matches each cluster to its unpaid claims — so SIU sees the pattern before payment.
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After a hail day, door-to-door roofers, tree crews and remediators sign up homeowners by the hundred. Direction-to-pay forms are signed at the door in the first days, and look-alike estimates follow: the same lines, the same quantities, the same notes — on homes of very different sizes, some outside the damaging hail altogether.
A desk adjuster sees one claim at a time, against the prompt-pay clock, and each estimate is plausible on its own. The pattern only shows across claims — weeks or months later, in a payments audit or an analyst's spreadsheet of contractor names. By then the contractor has changed its business name, the money is paid, and recovery is a lawsuit.
Estimated split for one copied-estimate cluster after a hail storm, by hand and with the solution.
Six agents read every estimate, fingerprint it and join the names; the SIU manager decides.
Hail to 2.75 in fell across Collin County, Texas, on Fri 25 Sep 2026. It is Mon 12 Oct, day 17 after the storm, and a payment run is due tomorrow. Here is what happens, screen by screen, in the working solution.
Gloria opens the solution on the storm: 3,412 property claims in the footprint, 2,906 contractor estimates and invoices read, 1,118 direction-to-pay forms, 612 businesses named. Each bubble is a group of look-alike estimates, sized by homes. Five clusters sit right of the 0.85 similarity line — 97 homes, $1,917,928 not yet paid.
“Over the line: estimates copied, not written. Under it: a company's own template, quantities follow each roof.”
The storm footprint checker tied 214 new claims to the 25 Sep hail. The estimate reader read 188 estimates and 61 direction-to-pay forms, 6,214 lines. The fingerprinter compared them with 2,718 earlier estimates and found a new cluster — Caprock Restoration, 6 homes at 0.89 — and the payment guard found 4 C-07 payments queued for Tue 13 Oct, $92,420, with no acceptance letters sent yet.
“Decide the C-07 holds before the Tue 13 Oct payment run.”
She opens the biggest bubble, C-07. It unfolds into its 40 estimates — 23 from Crestline Storm Restoration LLC, 17 from Northgate Roofing & Exteriors — and the identical lines light up across every sheet. Of 34 lines, 29 are identical in wording and quantity on all 40, 3 are reworded, 2 appear on 2 homes only.
The sheets are coloured by business name, and still light as one.
34.67 SQ of roof is billed on all 40 homes. The aerial measurement reports put those roofs between 21.4 and 39.8 squares, median 27.9. Thirty-six roofs are smaller than billed and four are larger: the quantity was never measured, it was pasted.
“36 roofs smaller than billed · 4 larger — the quantity was never measured.”
Ellen and Mark Ostrowski's estimate, CSR-0927-14 for 1418 Cedar Brake Ln, McKinney, with the copied sentences lit and the typos marked — the same two typos on every estimate, under both business names. The margin notes do the adjuster's arithmetic: 34.67 SQ billed on a roof that measures 23.6 SQ; steep and high-roof charges on a one-storey home of 5/12 pitch; 0.75 in of hail at the address.
The estimate reader keeps every line exactly as written, typos included, and never edits a figure.
Northgate's assumed name was filed in Collin County on Fri 2 Oct — the day after desk adjuster Priya Raman questioned a Crestline estimate billing 34.67 SQ on a 26.0 SQ roof. Five links join the two names, each from a document: the same phone, PO box, bank account on the direction-to-pay forms, estimator J. Vance and rep signature, a 100% stroke match on all 40 forms.
Links only on a value found in a document, never on a similar name.
The storm map lays the C-07 homes over the radar-estimated hail. Damaging hail starts at 1.00 in at the address; 12 of the 40 homes saw less — the Ostrowski home 0.75 in, others as little as 0.50 in. The other 28 saw 1.25 in or more.
Reports the hail at the address and time. Never says whether a roof was damaged.
The claims list shows each claim in the cluster: roof measured and billed, hail at the home, payment and prompt-pay date. 31 are unpaid, billed $960,468.40. 9 were paid at actual cash value, $214,380, with $58,740 of depreciation still held — those go to recovery review. Three re-inspections are already in, from Dale Okonkwo.
Gloria signs the hold and sends it to Marcus Hale, catastrophe claims manager, to co-sign — holds on more than 10 claims need him. The 4 queued payments are pulled from Tue 13 Oct, re-inspections are booked with Brazos Field Adjusting for Wed 14 – Fri 16 Oct, and 31 reason letters are drafted to the insureds, not the contractor, to go out on co-signature.
“We are re-inspecting your roof before we decide your claim … Your claim is not denied.”
The week 3 storm fraud brief is drafted for Gloria to sign and send to catastrophe claims leadership, every figure linked to its source. Beside it, a draft referral to the Texas Department of Insurance, Fraud Unit, for Crestline and Northgate: 40 claims, 40 estimates, 40 forms, 5 link documents and 3 re-inspections attached, due Wed 11 Nov, for Theo Lindqvist to complete.
Draft only — no agent sends a letter, a brief or a referral.
The same cluster, seen by the five people who carry it — what their storm looked like before, and what it looks like now.
Six agents read every estimate, fingerprint it and join the names; the SIU manager decides.
Ties every new property claim to the catastrophe event, its date of loss and the radar-estimated hail size at the address, with a 2-mile buffer around the swath.
Reads contractor estimates, invoices and direction-to-pay forms into lines — wording, quantity, unit, price — plus notes, signatures and the contractor's phone, address, remit-to and bank details.
Fingerprints each estimate's wording and line items, scores how alike every pair is, and clusters estimates across the storm.
Links business names that are one contractor by phone, address, bank account, estimator and signature, each with the document it came from.
Finds open claims and queued payments in each cluster and recommends hold and re-inspect, pay, or recovery review, with each claim's prompt-pay date.
Writes the weekly storm fraud brief and drafts fraud unit referrals, every figure cited to its source.
Decides; claims manager co-signs over 10. The agents propose; a named person decides.
The SIU team can ask about a cluster, a contractor, a line on the estimates — or the prompt-pay clock — in plain words. Every answer cites its source.
Why do you say Northgate is Crestline?
Because five values from the documents match, not the names. Every Northgate estimate carries Crestline's phone, (469) 555-0182, and remit-to PO Box 6612, McKinney; the direction-to-pay forms pay the same bank account ··4471; the estimates are prepared by the same J. Vance; and the rep signature is the same image on all 40 forms. Northgate's assumed name was filed on Fri 2 Oct, the day after Priya Raman questioned a Crestline estimate.
Which line gives the copying away?
The quantities. Line 2 bills 38.00 squares of shingles and line 5 212 LF of drip edge on all 40 homes — yet the measurement reports put the roofs between 21.4 and 39.8 squares. Four of the forty roofs are larger than the 34.67 squares billed for tear-off: the number was never measured, it was pasted. Wording alone would not be enough — many roofers share a price list — so the fingerprint looks at wording and quantity together.
Can we hold the 31 without missing the prompt-pay clock?
Yes, if each hold is a re-inspection with a reason letter. Texas gives 15 business days from the items asked for to accept or reject, and 5 business days from acceptance to pay. The 4 payments queued for Tue 13 Oct ($92,420) have no acceptance letter yet, so they can be pulled. The earliest date among the 31 is Wed 14 Oct, on 2 claims; their letters go today.
Is Prestonwood Roof Co copying too?
No. Prestonwood's 31 estimates share a company template, so the wording is alike, but the quantities follow each roof: shingles from 18.2 to 41.6 squares, drip edge from each eave length. Together they score 0.62, well under the 0.85 line. Theo Lindqvist cleared it on Thu 8 Oct. A firm's template is not a copied estimate.
13 screens from the working solution, on its sample data. Pick one to see it large.
The similarity line, the hail threshold, who may hold and the prompt-pay guard are settings, each change versioned.
| Setting | Default | Choose from |
|---|---|---|
| Similarity line — clusters at or above it are raised to SIU | 0.85 | 0.70 – 0.95 |
| Smallest cluster raised | 5 homes | 3 · 5 · 8 homes |
| Name the same contractor when | 2 links or more | 2 · 3 links or more |
| Damaging hail at the address | 1.00 in | 0.75 · 1.00 · 1.25 in |
| Footprint buffer | 2 miles | 1 · 2 · 5 miles |
| Co-signature for a hold on more than | 10 claims | 5 · 10 · 25 claims |
| Reason letter drafted before each prompt-pay deadline | 3 business days | 2 · 3 · 5 business days |
| Weekly brief to catastrophe claims leadership | Monday 08:00 | Monday 08:00 · Friday 16:00 |
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“demo” = seen in the working solution, on its sample storm data · “target” = the design goal, measured in the live solution · “estimated” = our estimate · “typical” = published figures (NICB presentation to the South Carolina Insurance Rate Review Ad Hoc Committee, Jun 2025 — roofing questionable claims up 90% and tree removal, mold remediation and debris removal up 345%, 2023 to 2024). Regulation is named as context: Texas Insurance Code ch. 542 and §701.051. People, insurers, contractors and homes named on this page are fictional — characters and sample data in the working solution.
It finds contractors who file copied or inflated estimates across many claims after a storm. Contractor Fraud Detection reads every contractor estimate, invoice and direction-to-pay form in the storm footprint, groups the look-alike estimates into clusters, joins business names that are one firm, and matches each cluster to its unpaid claims — so SIU sees the pattern before payment.
It scores wording and quantities together. A roofer's own template with measured quantities scores low — in the working solution, Prestonwood Roof Co's 31 estimates share wording but follow each roof, and score 0.62. The same estimate pasted onto another home scores near 1.00, whatever business name is on top.
Yes. The fingerprint matches on wording and quantities, not names, so a renamed firm's estimates still cluster. The identity linker then joins the names by phone, address, bank account, estimator and signature — each link a value found in a document, and two links or more needed.
No. The payment guard recommends hold and re-inspect, pay, or recovery review for each claim. The SIU manager decides every hold, the catastrophe claims manager co-signs holds on more than 10 claims, and a hold is a re-inspection with a written reason — the letter tells the insured their claim is not denied.
Each claim shows its prompt-pay date, and the reason letter for a hold is drafted 3 business days before it. In the working solution the rules are Texas Insurance Code ch. 542; the lead time is a setting.
It drafts it, with the estimates, forms, link documents and re-inspections attached and the 30-day due date shown. A fraud analyst completes it and a person sends it; no agent sends a letter, a brief or a referral.
Roofing, tree and debris, water and mold, and gutters, fences and windows. It reads estimates, invoices and direction-to-pay and assignment-of-benefits forms, together with aerial roof measurements and weather event data.
The Agentic Solution Engine builds and deploys it from your requirements and documents — your claims manual, your estimate and form formats and the claims from a past storm — and it goes live once every quality gate has passed. We will walk you through it on one of your own storms first.
Referrals in days, not weeks, after first notice, each with its evidence.
1-min demoDocument Fraud DetectionEvery claim document over a set amount tested for edits before it is paid.
1-min demoFraud Network AnalysisOrganized rings seen across claims, not missed one claim at a time.
1-min demoWe'll run Contractor Fraud Detection on the estimates from one of your own past storms.