Read the business request
Sign in to save your workRead the request as a governance practitioner. Your task is to test whether the case for ClaimReview AI is supported by evidence, not to validate the solution.
“The Board is pleased with fraud savings, but complaints and an internal fairness concern have reached us. Give us an assurance view and a recommendation.”
ClaimReview AI scores every home and motor claim for fraud likelihood. Claims above 0.70 go to the Special Investigations Unit (SIU) queue instead of normal handling; payment is held until an investigator clears them.
When someone makes an insurance claim, a computer estimates how likely it is to be fraud. High scores are sent to investigators and the payout waits. If the computer wrongly suspects honest people, they wait weeks without knowing why.
- Six evidence documents
- Five fictional claimants
- Simulated fraud scores
- A sample of SIU cases to test
- Detect more fraudulent claims
- Reduce investigator workload on low-risk claims
- Pay genuine claims faster
- Lower the claims cost ratio
Your first challenge
Write your opening questions before you look at the evidence.
Think about purpose, data, affected people, evidence, accountability and the human role…
Answers save automatically and sync to your account when you are signed in.
Every organisation, person and figure is fictional. Do not enter real personal, customer or patient information.