SIU case management where the state fraud-bureau report is drafted from the case board, every fact cited
State fraud-bureau reports ready to sign, with no facts re-keyed.
See one case, screen by screen ↓Software a special investigations unit uses to run each fraud case from the referral to the state report: the case file, the evidence, the interviews, the chronology and the fraud bureau referral. SIU Case Management adds six agents that keep the board, the chronology and the evidence index current and draft the state referral from the board, every fact citing its evidence item.
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An SIU investigator works 25 to 40 open cases. For each one they pull the referral, the claim file, the recorded statement, a 150-to-250-page EUO transcript, records checks, photos and their own notes into a case file, then build the chronology by hand. The contradictions that make an owner give-up or a staged loss are found by re-reading, page by page.
Once the SIU manager confirms a reasonable belief, the clock starts: 60 days in California, 30 in Texas. The same facts that are already in the file, the timeline and the summary get typed again into the state fraud bureau's form. A late referral, or one missing dates, subjects and sources, draws questions from the regulator.
Estimated split of about 9 hours by hand against about 1 h 20 min with the solution, from a carrier baseline. Hours, not days.
Six agents keep the board, the chronology and the evidence index, and draft the state report with every fact cited; the investigator decides and signs.
Tyler Brannigan reported his 2023 Ram 1500 stolen from his driveway in Bakersfield. Two days later it was found burned near Tehachapi, 47 miles away. Here is the case in the working solution, screen by screen.
Dana's caseload in the West region shows every case with its line, its stage, how complete its board is and how far its state report clock has run since the determination. Brannigan is on day 17 of 60. Okafor-Lyle, a kitchen fire with $88,400 in contents, is on day 52 with 8 days left. Haskell is waiting for Luis Arambula to approve.
“no clock yet · before determination” — the clock starts only when the SIU manager confirms a reasonable belief.
Claim AU-26-0418873: $51,310 claimed, a $630 rental advance paid. The board holds three subjects, 12 evidence items and 4 interviews. Red strings run from five lines of his recorded statement to the items that contradict them, and a timeline along the bottom places every item from 18 Jul to the determination on 25 Sep. On the right, the California referral already has 19 of its 26 fields filled.
“Filled from the board as the case moved · narrative not drafted yet”
The run log shows every step since Ana Ruiz's referral: the intake agent opened the case with a score of 84 in 41 seconds, the records agent read the prior claims, valuation and trip log, the evidence keeper fingerprinted 16 items as they arrived, and the statement analyst read the EUO on 29 Sep — 27 assertions, 3 answers changed since August.
Every step is on the audit trail, with the time it took.
The recorded statement of 10 Aug, taken by the adjuster with consent, is marked where the record disagrees: “about nine fifteen”, “Two. Both of them are with me.”, “No, it ran perfect.” Each margin note names the contradiction and the item behind it — the trip log, the locksmith invoice, the dealer quote, the sale listing, the phone records.
“Each margin note points at the record that bears on it; nothing is called a lie.”
The chronology lays the night out hour by hour: the truck's trip log, his phone records, the neighbour's canvass and his own account. The truck was driving at 7:52 pm, 47 miles to Highway 58; his phone was near Tehachapi at 8:58 pm; he says he last saw the truck at 9:15. Below, 24 entries, each with its source, put what he said beside what the record shows.
“7:52 pm · 1 h 23 min before he says he last saw it”
The evidence index lists all 16 items: who sent each one, when it was received, every person who handled it, a SHA-256 fingerprint of the file as received, and where the report cites it. Items that contradict a statement are flagged. Two records requests are still open.
“Originals are fingerprinted on arrival and never altered.”
Dana presses one button. The drafter reads the board, maps it to the California referral's 26 fields, takes suspect 2 from the phone records and the canvass, sets the type and five indicators, each with its item, then writes the narrative sentence by sentence. Before it finishes it checks every sentence for a source.
“one fact has no source and is left out: when the transmission first slipped”
25 of the 26 fields are filled; the last is her signature. The narrative carries 41 citations to 16 sources, and one fact is left out and given to Dana as a task — the EUO only says “a while”. Each card on the board now carries a “cited” tab with its number. Point at any citation in the report and a line runs to its card, which lights up.
The drafter fills only from the board. A fact with no evidence item is never written.
Dana signs as the SIU investigator. The signing screen says what she is signing: a suspected fraudulent claim on a completed investigation, with no conclusion of guilt, 16 items and 41 citations, due Tue 24 Nov with 43 days left. She confirms she has read the report and each cited source.
“The referral states a suspected fraudulent claim on a completed investigation; it states no conclusion of guilt.”
The referral moves through four people in order: Dana signs, Gregory Tan reviews the EUO quote on page 91, Luis Arambula approves, Priya Nandakumar files with California. The checks before filing are listed beside it: every sentence cited, 26 of 26 required fields, the due date, and the investigation status stated as complete under 10 CCR §2698.37(d).
The same Brannigan file, seen by the five people who touch it — what their week looked like, and what it looks like now.
Six agents keep the board, the chronology and the evidence index, and draft the state report with every fact cited; the investigator decides and signs.
Reads the adjuster’s referral and the claim file, opens the case, names the subjects and scores the claim’s indicators.
Reads records checks, prior claims, lender histories, dealer and locksmith records, trip logs and phone records produced, and drafts requests for what is missing.
Reads recorded statements and EUO transcripts, extracts each assertion with page and line, and flags contradictions and changed answers against the board.
Builds the case chronology from every item on the board, with his account beside the record wherever they differ.
Fingerprints each file on arrival, indexes it, pins it to the board and logs who has handled it.
Maps the board to the state fraud bureau’s form and writes the narrative, each fact with a numbered citation to its evidence item.
Decides and signs; manager approves, coordinator files. The agents propose; a named person decides.
The investigator can ask about the board, the statements, the clock or the report. Answers come back with the evidence numbers, and the cards they rest on light up.
Why is this called an owner give-up?
Four facts point the same way, each pinned on the board: the truck left home at 7:52 pm under its own key and was switched off at 9:07 pm where it burned, ignition and column intact; a third key was cut 17 days before; it was listed for $49,500 three weeks before, after a $6,480 transmission quote; and the loan was three payments behind, $52,310 owed against a value of $46,850. The finding is Dana’s. The report says “suspected” and states no conclusion.
What changed between his statement and the EUO?
Three answers changed between 10 Aug and 22 Sep. Keys: “two” (3:03), then three, “a spare for my wife” (63:22). Transmission: “ran perfect” (3:16), then “slipping a little” (57:05). Sale: “never” (4:02), then “just to see what it’s worth” (41:15).
When is the California report due?
Tue 24 Nov 2026. California allows 60 days from the determination, and Luis Arambula confirmed the determination on Fri 25 Sep. Today is day 17; 43 days are left, and you will be warned at day 46. Sources: Cal. Ins. Code §1872.4 · 10 CCR §2698.37(c).
Draft the California report from the board
Drafting now. I fill the seven open fields and write the narrative from the board; every sentence carries the number of its source, and any fact without one is left out and given to you as a task.
13 screens from the working solution, on its sample data. Pick one to see it large.
Clocks, approvers and what the agents may never do are settings, versioned and on the audit trail.
| Setting | Default | Choose from |
|---|---|---|
| Report clock starts at | Determination date | Determination date · Referral to SIU |
| Warn before the state limit | 14 days | 7 to 30 days · the manager is told at half this |
| Clock where the statute says “promptly” | 30 days | 21 · 30 · 45 days |
| Counsel review before filing a report that quotes an EUO | On | On · Off |
| Second approver on every bureau referral | SIU manager | SIU manager · SIU director |
| Open a case automatically at referral score | 70 | 40 to 95 · below it, the SIU manager decides |
| Agents may contact insureds, witnesses or providers, or file a report | Never | Investigators do all contact · the coordinator files |
| Keep the case file after the case closes | 7 years | 5 · 7 · 10 years |
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 case · “target” = the design goal, measured in the live solution · “estimated” = Botminds estimate from a carrier baseline · “typical” = published statute: Cal. Ins. Code §1872.4 and 10 CCR §2698.37 (California, 60 days from the determination), Tex. Ins. Code §701.052 (Texas, 30 days). People, companies and claims named on this page, including Halden Mutual, are fictional — characters and sample data in the working solution.
Software a special investigations unit uses to run each fraud case from the referral to the state report: the case file, the evidence, the interviews, the chronology and the fraud bureau referral. SIU Case Management adds six agents that keep the board, the chronology and the evidence index current and draft the state referral from the board, every fact citing its evidence item.
The statement analyst reads each recorded statement and EUO transcript, extracts every assertion with page and line, and checks it against the evidence on the board. A contradiction is shown as “contradicted by” with its source, and answers that changed between the statement and the EUO are shown side by side. It never calls a person a liar.
No. The investigator decides the finding and the SIU manager confirms the determination. The report states a suspected fraudulent claim and no conclusion of guilt, and the claim decision stays with the adjuster.
Every case runs on the clock of the state the claim is in, from the determination date: 60 days in California, 30 in Texas, and the SIU’s own 30 days where the statute says “promptly” or sets no period, as in New York and Florida. The investigator and coordinator are warned 14 days before the limit, and the manager at half that.
No. Agents never file. The investigator signs, claims counsel reviews any EUO quote, the SIU manager approves, and the fraud reporting coordinator files with the state.
The intake agent reads each referral and claim file and scores the claim’s indicators from 0 to 100. It never scores the person and never uses a protected characteristic. At 70 a case opens automatically; below it, the referral waits for the SIU manager.
Yes. Agents draft and organise; people decide. Investigators do all contact with insureds, witnesses and providers, records are requested only when the investigator asks, and every agent step and every person’s action is on the audit trail.
The Agentic Solution Engine builds and deploys it from your requirements and documents — your referral guidelines, state forms and a sample of closed SIU files — and it goes live once every quality gate has passed. We will walk you through it on your own cases 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 SIU Case Management on a sample of your own closed SIU files.