Shift Technology

Shift Technology uses AI to detect insurance fraud and automate claims decisions across the policy lifecycle.

Overview

Shift builds machine-learning models that score claims and submissions for fraud signals, drawing on behavioral, network and document analysis rather than simple rules. Its FORCE platform helps claims teams prioritize investigations on the cases most likely to be fraudulent.

Beyond fraud, Shift applies AI to underwriting risk and document processing, aiming for end-to-end decision support for insurers. The company works with hundreds of insurers globally and reports materially higher fraud detection rates at lower review volumes, which is exactly the ROI equation fraud teams need.

Insurance fraud is adversarial: patterns evolve as schemes adapt to detection, which is why static rule engines decay in performance over time. Shift’s machine-learning approach treats fraud detection as a continuously retrained classification problem, layered with network analysis that exposes organized rings rather than isolated claims. Investigators receive scored worklists with the evidence behind each score, so review effort concentrates where expected recovery is highest. Beyond claims, the same analytical foundation supports underwriting risk and document verification, giving insurers a consistent decision layer across the policy lifecycle. The practical outcome is higher detection at lower review volume — the combination that makes fraud programs economically sustainable.

The measurable outcome is a sharper investigation funnel: fewer cases reviewed, more confirmed fraud per review, and a detection capability that improves as new schemes appear rather than decaying between rule updates.

The winners in this category combine domain data depth with workflow integration, improving decision quality while producing the documentation trail that risk, compliance and audit functions require.

Key Features

• Machine-learning fraud scoring for claims and submissions
• Network analysis exposing organized fraud rings
• Document and image analysis for inconsistent evidence
• Underwriting risk assessment capabilities
• Explainable alerts designed for investigator workflows
• Global footprint across P&C and health insurers

Pricing

Shift is licensed through enterprise agreements scoped to lines of business and claim volumes.

Who Is It For

Insurance claims and special investigations units that want to focus human review on the riskiest cases.

FAQ

Is Shift Technology free to use?

No free tier; engagement begins with carrier scoping and proof-of-value analysis.

Does Shift Technology offer an API?

Yes — Shift integrates with claims and policy platforms through standard APIs.

How does Shift Technology compare to alternatives?

Compared with rules-based fraud engines, Shift adapts to new fraud patterns statistically, at the cost of needing quality historical data to tune models.