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Fraud & Risk

Pattern detection across shop behavior, claim sequences, and billing signatures. Explainable — see what drives every score.

Shop risk matrix
Supplement rate × chargeback rate · click a dot to decompose
Austin West · risk decomposition
SHAP-style contribution per factor
Supplement rate vs. peer
+26
Chargeback frequency
+23
Cycle-time variance
+14
Carrier concentration
+8
Post-delivery complaint frequency
+8
Tenure · established shop
-8
Overall risk score63

Detected patterns

highlead time 4d

Component upcoding — rear bumper repairs

Austin West shows unusual over-spec frequency on rear bumper repairs — full replacement claimed where peers typically repair. 73 instances last 60 days, 2.1× peer rate.

mediumlead time 6d

Phantom supplement pattern

Two shops show supplement filings with minimal additional labor hours logged — common marker for rate-shopping behavior. Cross-reference with payroll before escalating.

mediumlead time 9d

Shared-VIN anomaly

Four ROs across three shops reference the same VIN within a 30-day window — possible cross-shop fraud ring or data-entry issue. Flag for manual review.

lowlead time 12d

Off-contract labor rates

Tulsa shows labor rates above the carrier-approved maximum on 8% of State Farm claims — small volume, but a denial-rate driver if left unchecked.