FraudCheck 360 returns a clear verdict, a trust score, and full evidence in seconds, without a single document leaving Salesforce.
Automated document-fraud detection for insurance, built natively in Salesforce under the Einstein Trust Layer. It turns hours of manual review into seconds, and never auto-rejects a borderline case.
A clear answer in seconds, with the evidence attached.
Built on Salesforce + MuleSoft, inside your own org
Loss estimates, invoices, receipts, proof-of-loss forms, financial statements, and IDs all come from the customer. Altered figures, pasted logos, and re-typed text are hard to catch by eye and getting better. Accept a forgery and you approve a bad claim or policy; reject a genuine one and you lose a good customer. Both mistakes are expensive.
Minutes per document, and reviewers tire and miss details under volume.
Altered amounts and pasted logos increasingly slip past the human eye.
A bad claim, policy, or account approved on false proof is expensive.
Reject a genuine document and you lose a good customer and damage trust.
$308.6B
Estimated annual cost of insurance fraud in the U.S.
Coalition Against Insurance Fraud
48%
Falsified documents are the most common form of AI-related insurance fraud
2026 carrier survey, Claims Journal
100K+
Questionable claims reviewed by the NICB each year
National Insurance Crime Bureau
FraudCheck 360 turns hours of manual review into seconds, and never auto-rejects a borderline case.
Upload a document and the system reads it, runs a tailored set of fraud rules plus an AI visual check, and returns a clear answer in seconds. Your team handles far more volume with the same headcount.
Clear cases are decided automatically; only genuinely uncertain ones become Review and go to a person, with the reasons attached. Good customers are never auto-rejected on a borderline case.
Every check, including the AI, runs inside your Salesforce org under the Einstein Trust Layer. No external API calls, no data sharing, and your existing record and field security is honored.
Documents checked in seconds, not minutes, so your team clears far more volume.
A tailored rule set plus AI vision catches figures that don't add up, altered text, pasted logos, and re-typed fonts.
Every verdict carries a trust score, the exact reasons, and a map to the problem on the page.
Each check is saved to the customer record with full evidence and a shareable PDF report.
All AI runs in the Einstein Trust Layer. No external services, no data ever leaves Salesforce.
Rules, point weights, and thresholds are changed by your team in Setup, with no developer needed.
Stand up coverage fast with AI-generated rules, encode the rules your team already trusts, or combine both. The rule set is dynamic, and you adjust either path in Salesforce Setup with no developer.
AI derives the fraud rules from what a genuine document should look like, including branding, figures, expected wording, and visual integrity. You get working coverage quickly, without authoring rules by hand.
Already have fraud criteria, watchlists, or underwriting checks? Encode them directly as configurable rules with your own weights and thresholds, so the system enforces the policies your team already trusts.
MuleSoft Document AI extracts the header, key fields, line items, and totals from the document.
Tests a tailored rule set: branding, figures, wording, dates, and internal consistency.
Inspects the image for pasted logos, font changes between cells, and uneven spacing.
Sets the trust score, applies the verdict, and writes a plain-language reason.
Trust score 85–100
Looks genuine; all checks passed. Accept and continue your normal process.
Trust score 55–84
Borderline, with no clear tampering. A person checks it, with the reasons attached.
Trust score below 55
Clear signs of tampering. Reject or escalate; the evidence is shown.
FraudCheck 360 is added on top of your existing org without changing its other apps or automation. All AI reasoning runs inside your org under the Einstein Trust Layer; MuleSoft handles only secure document extraction. No external LLM keys, no data leaves the platform.
All LLM calls route through the Einstein Trust Layer via the Models API and Prompt Builder; MuleSoft IDP extraction is likewise Trust-Layer governed. Rules, weights, and thresholds live in Custom Metadata, tuned in Setup with no deploy.
Document extraction
A CloudHub 2.0 app reads the file via Intelligent Document Processing and returns normalized JSON. Salesforce reaches it through a Named Credential with OAuth, with no secrets in code.
Governed AI
AI Vision (prompt template) and the AI Summary (Models API) run governed, with PII masking, zero retention, toxicity scanning, and audit. The org holds no LLM key and makes no direct external callout.
Resilient by design
If a live AI call can't run, the layer falls back to a deterministic forensic check that still catches tampering. The check never fails outright, and your record and field security is always honored.