Summarize fraudulent claim detection using agents

task brazil Updated Sep 10, 2026 1 min read mco-summarize-fraudulent-claim-detection.md
Raw file servicenow.com

Automatically detect fraudulent claims by identifying duplicates, similar claim patterns, reused dealer images, mismatched or incomplete supporting documents, usage inconsistencies, and abnormal claim spikes.

Before you begin

Role required: admin

Enable the skill before use. It is inactive by default:

  1. Navigate to All > ServiceNow Otto Admin > Skills.
  2. Select Customer.
  3. Select MCO.
  4. Activate the skill Detect Claim Anomaly.

About this task

The App Anomaly Detection Rule [com.sn_anomaly_detect] framework identifies fraudulent claims. The Agents portal displays fraudulent repair claims submitted from the dealer portal using these rules.

  • Similar claim: Identifies the similar claims submitted for the same customer across multiple assets or vehicles.
  • Duplicate claims: Automatically identifies claims that match previously processed claims for the same vehicle, part, or repair.
  • Image reuse: Detects claims that reference the same picture as a prior submission.
  • Configurable detection parameters: Allows administrators to tune detection sensitivity and time windows to match their operational policies.
  • Product usage mismatch detection: Compares product usage data between the current claim and historical claim records to flag inconsistencies.
  • Dealer claim spike: Surfaces similar claims submitted by the same dealer within a configurable time window.
  • Document mismatch: Detects claims with mismatched or incomplete supporting documents.
  • Threshold based approval: Detects repair claims that exceed threshold limits that have been specified for the causal parts.
  • Inflated claim: Detects if the claim amount is significantly greater than the average claim amount for similar claims.
  • Cross validation: Compares a repair claim's charges against the pre-authorization request or recall campaign it originates from. Claims that fall outside the configured tolerance are flagged for manual review.

Use case 1: Dealer submits repair claim with image.

To submit the report in the Dealer portal, see Submit a repair claim for warranty.

The repair claim appears in the Agents portal with Reject status.

Procedure

  1. Navigate to Workspaces > CRM Workspace > Lists > Repair.

  2. Select the repair claim record that you want to review.

    Note: Choose the record that has the Potential action as Reject/Suggested.

  3. Select Review & approve, to view the claim analysis generated by ServiceNow Otto [Omitted image "icon-ai-sparkle.png"] Alt text:.

Parent Topic:Repair claim

Keywords warranty claim summarization
Search documentation
Search document titles and file paths on the brazil branch