Verticals - P&C

P&C Insurance Integrity

Court-admissible evidence at the moment of detection.

JIL's P&C product is a payment-integrity layer that sits between the carrier's claims platform and the payment rail. It scores proposed claim payments in real time and produces CREB-grade evidence packages for any claim that fails integrity checks - admissible in civil subrogation, NICB referrals, SIU investigations, state insurance fraud bureau filings, DOJ referrals, and reinsurance recovery.

It is not a claims management system, not an SIU case manager, not a recovery vendor, not a reinsurance analytics platform. None of the existing tools (Guidewire ClaimCenter, Duck Creek, Insurity, ISO ClaimSearch) produce court-admissible evidence packages at the moment of detection. That is the wedge.

~$700B
annual US P&C claim payments
$308B
industry fraud estimate (Coalition Against Insurance Fraud)
20
net-new P&C-specific checks
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Architecture - Visual

P&C Insurance Integrity at a glance.

Where the integrity layer sits, what it produces, and how the sealed CREB flows back to the buyer's existing systems.

JIL SOVEREIGN TECHNOLOGIES VERTICAL BRIEF · 01 OF 08 P&C INSURANCE INTEGRITY Pre-settlement fraud detection for auto, property, and specialty lines. Court-ready evidence packages for SIU, subrogation, and litigation. ANNUAL US CLAIMS PAID $700B Personal lines + commercial P&C ESTIMATED ANNUAL FRAUD $308B Coalition Against Insurance Fraud NET-NEW CHECKS 15+ On top of 100+ healthcare primitives FRAUD PATTERNS Staged accidents and rings Damage geometry inconsistency Inflated repair estimates Provider mill bodily injury Catastrophe event opportunism VIN title washing and salvage Cross-carrier duplicate claims JIL APPROACH Pre-Settlement scoring at payment auth Retroactive Proof Audit (24-60mo) VIN and asset intelligence Wallet intelligence on payees CREB evidence at FRE 902(14) KEY BUYERS Tier 1 carriers Progressive, Allstate, State Farm, GEICO, Travelers, Liberty Mutual TPAs Sedgwick, Crawford, Gallagher Bassett State fraud bureaus NICB referrals, civil subrogation DETECTION AND PROOF. NOT RECOVERY. Four-SKU pricing. No percentage of recovery. No contingency. jilsovereign.com RAN · CourtChain · PoCS · Sealed Escrow
Figure - P&C architecture, integration surface, and CREB output
Why this vertical

Where this product earns its place.

The strategic case for P&C as a JIL line of business - what makes the wedge defensible, what makes it economically meaningful, and how it compounds with the rest of the platform.

Court-admissible

Sealed at the moment of detection

Existing tools (Guidewire, Duck Creek, Insurity, ISO ClaimSearch) flag suspicious claims. None produce FRE 902(14) court-admissible evidence at the moment of detection. JIL ships a sealed CREB on every flagged transaction.

Mature integration

Marketplace listings on top three platforms

Pre-Settlement integrates into the claims-platform payment-authorization workflow via Guidewire Marketplace, Duck Creek Anywhere, and equivalent. ~40% of US carriers run Guidewire ClaimCenter; the marketplace path is the standard procurement motion.

Cross-vertical reuse

~95-105 healthcare checks transfer

Identity, duplicate, velocity, network, geographic-temporal, document integrity, sanctions, beneficiary, settlement integrity, and behavioral signals all transfer with minor schema retuning. The wedge is the net-new P&C-specific checks.

No contingency

Detection and proof, not recovery

Pricing carries over from the MCO playbook unchanged - flat-fee scans, subscriptions, per-claim CREB bundles. No percentage-of-recovery, no contingency. JIL is detection and proof; recovery sits with the carrier or its existing partners.

What we build

Net-new checks, sealed evidence.

A representative slice of the P&C-specific check pack. Each one runs in the same five-stage pipeline as the rest of the platform - intake, profile load, parallel checks, verdict, sealed CREB - and ships with a 14-of-20 BFT signature, a CourtChain L1 anchor, and a reproducibility manifest pinning the exact check-logic version.

Check

VIN Integrity

Title washing, salvage rebrand, NMVTIS divergence detection across the title chain. Cross-references state DMV, NICB theft data, and commercial vehicle-history sources.

Check

Staged-Accident Pattern

Claim clustering by VIN, address, attorney, clinic, and time window. Reuses provider-network primitives from healthcare for attorney-clinic ring detection.

Check

Repair Estimate Anomaly

Line-item deviation from CCC ONE, Mitchell, and Audatex baselines for the year-make-model-region. Flags persistent over-estimation patterns by shop.

Check

Damage Narrative Inconsistency

Claimed mechanism of loss versus photo-documented damage geometry. Photo and document forensics including EXIF integrity, prior-loss image reuse, and AI-generated image detection.

Check

Weather and Event Correlation

NOAA verification of claimed hailstorm, hurricane, freeze, or wind event at the coordinate and time of loss. Catastrophe-event opportunism detection.

Check

Provider-Mill Detection (BI)

Bodily-injury treatment-pattern analysis - clinic-attorney pairing, treatment duration versus injury severity, billing-code stacking. Reuses healthcare provider-fraud architecture.

Check

Total-Loss Valuation Drift

Carrier valuation versus market comp from the live used-vehicle market. Surfaces undervaluation disputes alongside fraud-side valuation manipulation.

Check

Premium-Fraud Signal

Garaging-address mismatch, undisclosed driver, vehicle-use misrepresentation. Surfaces the underwriting-side mirror of claim-side fraud.

Buyer profile

Who runs this in production.

The buyer pattern for P&C - who carries the budget, who carries the regulatory exposure, and how the engagement starts. Most first engagements are a Retroactive Proof Audit on a defined lookback window; Pre-Settlement integration follows once the check pack is calibrated to the customer's profile.

Tier 1 personal-lines carriers

Progressive, Allstate, State Farm, GEICO, Travelers, Liberty Mutual, Farmers, Nationwide, USAA. Direct enterprise sales into claims, SIU, and integrity teams.

Large TPAs

Sedgwick, Crawford, Gallagher Bassett. Cross-carrier reach and standardized integration paths. TPA Pre-Settlement integration is a fast lane to scale.

Specialty carriers and MGAs

Specialty lines, MGAs, captive carriers - smaller buyer base but faster procurement cycle than Tier 1 personal-lines.

State and federal enforcement

State insurance fraud bureaus (mandatory reporting in most states), state Attorneys General, NICB, DOJ Insurance Fraud Unit for federal mail/wire-fraud predicates, reinsurance carriers for treaty-claim documentation.

Pricing pattern

Four-SKU model. No percentage. No contingency.

Pricing carries over from the canonical four-SKU model unchanged - Retroactive Scan (flat fee), Retroactive Proof Audit (with credit-back against the next subscription tier), Pre-Settlement Subscription (tiered annual), and per-case CREB bundles (Tier 3 court-ready evidence). Asset Intelligence is the standard fifth SKU where the vertical needs it.

No percentage of recovery. No contingency. No success fees. JIL is detection and proof, not recovery. Recovery sits with the customer or its existing partners (subrogation counsel, recovery vendors, regulators). The structure is what allows JIL to operate as neutral integrity infrastructure across plaintiffs and defendants, payers and payees, regulators and the regulated, on the same case.

Ready to scope a P&C engagement?

Initial briefings are 60 minutes. Retroactive Proof Audit lookback windows, check-pack profile design, and integration runbook are available under NDA. We start where the buyer's procurement gate is shortest.