Context: False positives in fraud control are rarely caused by bad data in Insurance. They occur when decisions are triggered without sufficient context, at the wrong point in the customer journey.

Challenges: Rules fire without understanding intent, and transactions are stopped first and reviewed later. Responsibility is split across risk, operations, and customer teams, and by the time a transaction is cleared, trust is already damaged and revenue is already lost.

Solution: The Fraud Decision Guidance Agent, an AI agent built using Microsoft Copilot Studio, intervenes when activity looks risky but inconclusive, evaluating behavior, context, and history together to guide a deliberate choice — approve, challenge, or escalate — only when warranted.

Impact: Insurers adopting this approach see false positives fall as customers transact without friction and analysts focus on genuine risk, with outcomes improving because decisions are made with timing and intent rather than reflex.