Roosevelt Road Specialty Launches FraudX to Power AI-Driven Insurance Investigations
Updated: Aug 10
Insurance investigations can require experienced professionals to review thousands of pages of medical records, reports, invoices, photographs, statements and other evidence before they can understand what happened and identify issues that deserve additional investigation.
FraudX was built to change that workflow.
Roosevelt Road Specialty has partnered with FraudX to bring AI-powered investigation to its claims operations, giving its team a faster way to analyze complex claim files, surface investigative signals and trace those findings back to the underlying evidence.
Rather than replacing investigators, FraudX helps conduct the first review of the evidence so experienced professionals can focus their attention where it matters most.
Turning Investigative Experience Into AI
Working closely with Roosevelt Road Specialty’s legal and claims experts, the team identified 35 investigative indicators that could signal a need for additional review.
FraudX analyzes claim documentation against those indicators and organizes the results into an investigative risk score that helps Roosevelt Road Specialty prioritize claims for human review.
The distinction is important: the score does not determine whether fraud occurred.
A higher score means the system identified more investigative signals that warrant examination. Investigators then review those signals, examine the supporting evidence and determine what they mean in the context of the claim.
“AI and experienced investigators are a powerful combination,” said Neil Katz, EyeLevel co-founder and COO. “FraudX can review enormous amounts of claim evidence in minutes, surface the signals that deserve attention and show investigators the evidence behind them. The investigator makes the final call.”
Helping Investigators Find What Matters Faster
FraudX is designed to analyze the evidence contained within complex claim files and help investigators identify information that might otherwise require hours or days of manual review.
The platform can help teams:
Reconstruct medical and claim timelines
Identify inconsistencies across records and statements
Surface events that warrant additional review
Identify recurring entities and relationships
Organize investigative signals for human review
Trace findings directly to supporting evidence
Every signal is a starting point for investigation, not a verdict.
FraudX does not determine that a claimant, medical provider, attorney or other party has committed fraud or wrongdoing. Experienced professionals remain responsible for evaluating the evidence and making those determinations.
Bringing AI to Construction Claims
The approach is already being deployed within Roosevelt Road Specialty’s Tradesman Program Managers business, where complex construction claims can involve thousands of pages of documentation and require significant investigative resources.
For Roosevelt Road Specialty, the goal isn't simply to investigate suspicious claims more efficiently. It's also to help legitimate claims move through the process without unnecessary delay.
“We pride ourselves...on quickly resolving legitimate claims to assist an injured worker,” said CEO Daniel Hickey Jr., who noted that fraud can slow the claims process for honest claimants.
By helping investigators prioritize their attention and examine complex evidence faster, FraudX can support both sides of that mission: giving potentially problematic claims the scrutiny they deserve while helping teams identify claims that may require less investigative attention.
AI Investigates. Humans Decide.
The Roosevelt Road Specialty deployment represents a broader shift in how AI can be used in insurance.
The most valuable role for AI isn't making the final decision. It's doing the enormous amount of work required to get investigators to the evidence that matters.
FraudX can analyze thousands of pages, reconstruct events, identify inconsistencies, surface relationships and organize the evidence for review.
Human investigators provide the judgment.
That combination creates a new investigative model: AI conducts the first review. Experienced professionals make the final call.
We're proud to be building that future alongside Roosevelt Road Specialty and Tradesman Program Managers.
Read the full announcement from Insurance Business Review here.
Explore our partners:
Roosevelt Road Specialty – A leading MGU committed to integrity-driven underwriting and proactive fraud prevention.
Tradesman Program Managers - Roosevelt Road’s construction general liability program, focused on protecting contractors and tackling high-risk claims with precision.
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