AI and automation for insurers
We apply AI in insurance where handlers and underwriters lose the most time: reading claim files, checking cover and assembling submissions. Every model output is measured against past cases before release, and the handler or underwriter makes the call.
Where the work gets stuck.
Claim files arrive unstructured
Damage forms, photos, repair quotes, police reports and medical letters land in inboxes and portals. Handlers read everything before they can judge cover, and peaks after storms create long backlogs.
Policy wording is spread over decades
Conditions differ by product, version and intermediary, and old portfolios stay in force for years. Finding which clause applies to a specific policy takes experience that is hard to replace.
Policy administration systems resist change
Core policy and claims platforms are often old or heavily customised. New channels, data exchange with brokers and reporting duties all have to work around them.
How we improve insurance.
Each one is scoped around your systems and rules, and each one keeps a person in charge of the decisions that matter.
Claims intake and document triage
Incoming claims and attachments are classified, key facts extracted and missing documents requested automatically. The claims handler starts from a complete, structured file and makes the cover decision.
Claims handling assistant
An assistant checks the claim against the policy conditions, points to the relevant clauses and drafts the letter to the customer or broker. The handler reviews, adjusts and sends it.
Policy wording search
Conditions, clauses and product changes across all versions become searchable, filtered by product and start date of the policy. Answers cite the exact clause so staff can verify them.
Commercial underwriting submissions
Broker submissions, loss histories and inspection reports are gathered into a summary with risk points and gaps highlighted. The underwriter sets terms and price.
Evals for every release
Closed claims and expert-reviewed answers form a test set that each model, prompt or rule change must pass. Quality becomes a number your claims managers can track release by release.
Broker and policyholder portals
Portals where intermediaries and customers submit claims, upload documents and follow progress, connected to your claims system. Fewer status calls reach the claims team.
Built around the rules.
What we design for from the first week. Your legal and compliance people keep the final word.
Solvency II
Tools that support claims, reserving data or reporting are designed with the governance, data quality and outsourcing controls Solvency II expects. We document our role so your key function holders can assess it.
IDD and fair customer treatment
Customer-facing drafts follow your product governance and duty of care under the Insurance Distribution Directive. Advice and product decisions stay with licensed staff.
DORA
Insurers fall under DORA, so we design for ICT risk management, incident logging and third-party arrangements, including clear exit plans for the software we build and run.
EU AI Act and GDPR
AI used for risk assessment and pricing of individuals in life and health insurance is high-risk under the AI Act. For those uses we design human oversight and logging, and we process personal and health data under GDPR safeguards.
Works with what you run.
If a system has an API, a database, an export or an inbox, we can build on it. These are the ones we meet most.
- Guidewire ClaimCenter and PolicyCenter
- Duck Creek
- Sapiens
- Keylane (Axon, Quinity)
- CCS
- SIVI All Finance Standard (AFD)
- Salesforce
- Microsoft Dynamics 365
- Vecozo (health insurers)
Where to start.
Claims intake for one product line
A build that structures incoming claims for a single product line, such as home contents or travel, and prepares each file for the handler. It proves the connection to your claims system and sets up the eval set future work will reuse.
Talk it throughWhat it includes
- Intake from email and portal uploads
- Extraction and missing-document checks
- Handler review in your claims system
- Eval set from closed claims
Related work.
Guides.
AI readiness checklist: what to answer before your first agent goes live
The questions to answer before your first AI agent handles real work, from process and data to approvals, monitoring and ownership.
10 min read
AI vendor security questionnaire: what to ask before you buy or build
The questions to ask an AI vendor, or your own team, about data, model providers, access, logging, quality, incidents, GDPR and exit, and how to score the answers.
8 min read
Further reading.
LLM evals: how to test AI features before every release
A practical approach to LLM evals: build a test set from real cases, combine code checks with model grading, and block releases that regress.
5 min read
Human-in-the-loop AI agents: design patterns for production
The patterns we use to run AI agents safely in production: approval checkpoints, confidence thresholds, tool permissions, audit trails and fallbacks.
4 min read
How to build a production RAG chatbot: a practical guide
What it takes to turn a promising RAG experiment into a chatbot people trust: ingestion, hybrid search, citations, permissions and evals.
5 min read
Common questions.
No. The software structures the file, checks it against conditions and drafts correspondence, and a claims handler decides on cover and payment. Thresholds for what needs senior review are set by you.
Yes. Guidewire and most modern platforms have APIs we build against. For older or customised systems we use existing interfaces, database views or file exchange, agreed with your IT team.
We build an eval set from closed claims and answers checked by experienced handlers, and every release has to pass it. Results per claim type show where the assistant is reliable and where it should stay in draft mode.
It does not need to be. We use EU-hosted models or run inside your cloud, and we can mask names and policy numbers before text reaches a model.
Yes. We work with SIVI AFD messages and broker portals, so claims and documents from intermediaries enter the same flow as direct claims.