Health insurance fraud is one of the fastest-growing threats to the insurance sector. Fraudsters exploit gaps in the system through fake hospitalization claims, inflated billing, non-existent procedures, fabricated disabilities, and collusion with service providers. These activities not only drain resources but also undermine the trust between insurers and policyholders.
CLAIMLAB’s Health Claim Investigation Services are crafted to detect, document, and deter fraudulent or exaggerated claims through fact-based field and digital verification techniques. Our investigations cover a broad range of scenarios: from short-stay hospitalizations to long-term disability claims and accidental injury verification.
We evaluate each claim with clinical, procedural, and documentary scrutiny, ensuring that each submitted record—from bills and prescriptions to lab reports and consultation slips—is genuine, medically justified, and policy-compliant.
Our team works closely with the insurer’s Claims, Underwriting, and SIU (Special Investigative Units) to deliver evidence-backed, legally valid, and actionable reports that uphold the company’s financial and legal interests. Whether you need confirmation of a surgery, test, treatment, or incapacity, we provide ground-truth clarity.