Most insurers already hold the data that would flag a suspicious claim somewhere in their claims records. The problem is rarely a lack of data. It is that turning claim records into a prioritised, defensible workload for a special investigations team takes more manual triage than most SIU capacity allows for, and a case built by hand is hard to reconstruct consistently when it is challenged later.
Claim Core is the part of Vantage that does the triage and the workflow for you. You send your claims data in, the platform scores it, and your investigators get a working case queue instead of a spreadsheet of referrals.
Every claim you upload or send through the API is scored, together with any free text held on it, such as adjuster notes, first notice of loss descriptions, emails and call transcripts. Unlike modules that only assess a flagged fraction, every claim is passed to the AI, so nothing is screened out before review. Cases are created automatically once a claim crosses your configured threshold, set to 60 by default and adjustable per tenant. Each case comes back with a risk score from 0 to 100, a risk band of critical, high, medium or low, a confidence level, one or more flags, and a plain English explanation of why it was flagged. An investigator can trigger a re-score on any case at any point and see the score history right on the case page. Scores are decision support for your investigators, not an automated decision: a case is reviewed by your team before any action is taken on it.
A sortable, filterable case queue sits at the centre of Claim Core. Every case can be assigned, re-assigned, moved through statuses such as open, under review and resolved, and set to a priority level. Investigators keep a threaded notes panel on each case, and any note can be marked internal only or left visible in the field work orders, with the author's name and timestamp attached automatically. Every meaningful action on a case, from a status change to a re-score, is logged to a full audit trail that sits alongside the case and travels with it into any export.
When a case is assigned to someone, an email goes out automatically, carrying your organisation's name alongside Vantage module branding, with the case reference, risk score, value at risk and a direct link, so nobody has to check the platform to know work has landed on their desk. Each investigator also gets a personal "My Cases" inbox showing only their open and under review cases, sorted by priority and then by risk score, so the highest value work is always at the top.
Any case can be exported as a PDF in one click, carrying your organisation's name alongside Vantage module branding. The export carries the risk score, identity and confidence details, the value at risk, a full AI explainability breakdown, the evidence table where one exists, a subrogation indicator where the case has been flagged for it, the recovery log, every investigator note, and the complete audit trail. It is built to stand on its own in a legal, audit or regulatory conversation, not just as an internal summary.
Once a recovery is confirmed, whether through subrogation, claim withdrawal or a settlement adjustment, it gets logged against the case with the gross value recovered, giving you a clear, auditable record of what has actually been recovered rather than an estimate reconstructed after the fact.
An administrator can manually trigger a field investigation dispatch directly from any case, sent as a signed, one-time request to whichever field or loss adjuster management system your team already uses, connected through a webhook you configure in settings. The dispatch, its destination and the response status are all recorded in the case's activity log, so there is never any doubt about whether an order actually went out.
Instead of building a report or waiting on an analyst, anyone on your team can ask Claim Core a plain English question about their case data and get an answer straight back. It is built for the claims handlers and SIU staff who actually use the data day to day, not for people comfortable writing queries.
Claim Core includes REST API access as standard, using a bearer token unique to your tenant. You can score a single claim, or send up to 100 in one batch call, directly from your own policy administration or claims management system. A public sandbox with pre-scored demo records and live documentation is available so your technical team can evaluate the API before committing to anything.
Every capability described above is available either way. What changes is how you pay for it.
Both are Claim Core: same scoring, same workflow, same everything above. The only difference is how the bill is worked out.
Claim Core is a cloud-hosted SaaS platform with role-based access, so there is nothing for your team to host or maintain. Data comes in either through the upload manager or the API, sourced from your existing claims management or policy administration exports. Once your application is approved, a new tenant can be provisioned in minutes, with sandbox demo data available immediately so your team can start evaluating the platform before a single real claim is uploaded.
Core Volume and Core Value above are two ways to pay for Claim Core, the same product either way. Claim Score is a different, lighter product: API-only scoring without the case investigation workflow described above, available separately for teams that just want to plug Vantage's risk engine into an existing system.