Insurance Fraud Alert

Type: Information Object

Status: Planned
Industry Sector: Insurance
Sensitivity Level: Restricted
Personal Information: Sensitive PII

Description:
A signal indicating that an insurance claim, policy or related transaction may require review for potential fraud.

Accessed by Application(s):

• Claims Management System

 Yes

Attributes

Order	Name	Description	Type	Cardinality	Example value
1	Alert ID	Unique identifier for the insurance fraud alert	GUID	Mandatory
2	Related Claim ID	Reference to the insurance claim related to the alert	Reference	Optional
3	Related Policy ID	Reference to the insurance policy related to the alert	Reference	Optional
4	Alert Type	Category of suspected insurance fraud	String	Mandatory
5	Alert Status	Lifecycle state of the fraud alert	String	Mandatory
6	Alert Score	Risk score or priority assigned to the alert	Decimal	Optional
7	Detection Source	System, rule or person that raised the alert	String	Mandatory
8	Investigation Outcome	Outcome recorded after investigation		Optional

 Yes
 
 Planned
 Sensitive PII
 Restricted
 Insurance
 A signal indicating that an insurance claim, policy or related transaction may require review for potential fraud.

✏️ Edit

"Text" is not in the list (String, Integer, Boolean, Date, Date & Time, GUID, Enumeration, Decimal, Binary, Reference) of allowed values for the "Attribute Type" property.