Data-driven, backend claim analysis, in real-time.
Bulk review claims using data-driven backend analysis via file transfer.
Aggregated results from a data-driven backend analysis to gain case insights
Aggregated results from a data-driven backend analysis to gain case insights
Streamline eligibility validation and fraud detection with industry-leading technology to deliver consistent, defensible claim outcomes.
Book a demo
High-volume claims environments invite fraud, automation abuse, and inaccurate submissions that can distort outcomes and dilute compensation for legitimate class members. Yet efforts to tighten controls risk limiting access for real claimants. Traditional review methods struggle to detect coordinated attacks, synthetic identities, and subtle eligibility issues at scale without imposing restrictive barriers—creating risk for both fairness and defensibility.
We apply a multi-layer claims validation framework that combines expert-system rules with neural-network scoring to determine eligibility and detect fraudulent submissions with scientific precision. Our process evaluates each claim through a multi-factor scoring system and evidence-based signals, producing automated, consistent decisions that withstand scrutiny from courts, administrators, and opposing experts.
The Anti-Fraud Triangle blocks fraud at the form, payment, and analysis stages—before it reaches the fund.
Bulk review claims after the claims period. Securely send claim files to ClaimScore and ClaimScore securely returns result files.
ClaimScore connected directly to digital claim forms and results sent directly to claims or client management systems, in real time.
Evaluate every submission through layered evidence signals to determine eligibility and identify fraudulent activity.
Incorporate external data sources to strengthen validation, confirm details, and surface discrepancies.
Verify claimant identity and contact information to confirm legitimacy and ensure accurate attribution.
Identifies multi-entry fraud patterns, name variations, and shared contact attributes designed to bypass traditional checks.
Detect automation, anomalies, and suspicious behaviors using temporal and structural based signals.
Provide clear, case-ready explanations that document every flag, scoring input, and eligibility decision.
Discover how ClaimScore can safeguard your funds with a practical example, ensuring the class receives their rightful share.
contact@covalynt.com
(973) 259-6120
Pompton Lakes, New Jersey 07442, US
