Business Need
Heritage Insurance needed a modern, auditable, mobile-first system to verify medical claims in the field and combat fraudulent payouts. Their existing process relied heavily on emails, phone calls, and paper notes, making field evidence unreliable and investigations slow. They wanted a unified digital platform that could capture field activities with full traceability and help investigators close cases faster—while maintaining regulatory compliance and data integrity.
Field verification relied on unstructured communication such as calls, emails, and handwritten notes, creating audit blind spots.
No reliable mechanism to validate onsite visits, allowing fraudulent or poorly documented claims to slip through.
Media files and documents were scattered across systems, complicating audits and slowing down investigations.
Legacy SQL Server workloads became difficult to scale and lacked modern reporting and operational clarity.
Manual processes increased turnaround time and led to inconsistencies in fraud detection and case management.
Faramond built a full-featured Oracle APEX–based mobile investigation application deployed securely on Oracle Cloud Infrastructure (OCI). The solution introduced complete digital traceability—from field visit to case closure—and replaced multiple legacy tools with a single, governed investigation platform.
Mobile geotagged check-in and check-out with automatic GPS capture for every field visit.
Structured, guided checklists aligned to different claim types and investigation workflows.
Integrated media capture including photos, documents, videos, and signatures, all metadata driven.
Fraud indicators and red-flag rules built into case screens, enabling smarter decisioning
SLA-based workflows for escalations, reviews, and approvals.
Supervisor console for monitoring investigator performance, workload balancing, and audit trails.
Centralized evidence repository stored in Oracle Object Storage with secure access controls.
Real-time dashboards with TAT tracking, productivity analytics, case outcomes, fraud detection trends, and geo heatmaps.
Faramond followed a structured delivery model aligned to Oracle best practices:
Discovery & Experience Design: Investigation process mapping, workflow design, fraud indicators, SLAs, metadata structures.
OCI Landing Zone Setup: Secure tenancy, Object Storage buckets, network setup, and integration channels.
SQL Server Migration: Legacy data cleansing, transformation, and migration to Oracle Database on OCI.
APEX Build: Mobile-friendly field app, supervisor console, validations, forms, workflows, and audit trails.
Pilot → Tune → Scale: Gradual rollout to 300+ investigators across multiple regions.
Runbook, Hardening & Monitoring: Performance tuning, security policies, user management, and operational support.
Faster Decisions: Field evidence now reaches supervisors in minutes, not days.
Fraud Reduction: GPS-stamped visits and metadata-driven proofs significantly lowered fraudulent submissions.
Operational Clarity: A single, governed system of record with complete auditability and traceability.
Higher Productivity: Investigators complete more cases per day due to streamlined workflows.
Improved Compliance: Secure evidence management and structured data strengthened audit readiness.
Mobile/Web App built on Oracle APEX (OCI)
Oracle Database for transactional and historical investigation data
Oracle Object Storage for media and evidence
Audit & Reporting Layer with dashboards, fraud analytics, and SLA tracking
Optional Integration APIs for downstream claim processing
Security Framework: IAM policies, fine-grained access, encryption, and role-based controls
