Insurance
Claims wait for nobody.
Routine claims move as fast as the email that started them. Hard ones reach a handler with the evidence attached. Every change to a claim is checked and recorded.
How can AI agents be used in insurance?
AI agents in insurance read first notice of loss emails, score severity and urgency, flag fraud signals for a specialist and route claims to the right desk. elan1 Decide attaches a calibrated confidence to each answer, so hard cases reach a handler, and elan1 Govern checks every claim change and holds settlements above your limit for a named approver.
Three realities
Every morning, the backlog starts again.
Intake is unstructured.
Claims arrive as emails, photos, PDFs and calls. Someone reads each one before anything moves.
Speed and leakage pull apart.
Fast-track too much and fraud slips through. Review everything and turnaround suffers.
Cover now asks for evidence.
New AI exclusions in liability wordings mean underwriters want proof of human oversight, action by action.
Source: ISO CG 40 47, CG 40 48, CG 35 08
Use cases
Start where the volume sits.
Each one has an owner, a threshold and a person below the line.
Customer and claims operations
- elan1 Decide
First notice of loss triage
One call reads the claim email and returns line of business, severity, injury and urgency, each with a confidence score.
- elan1 Decide
Fraud-signal flags
Signals go to a specialist. They never deny a claim on their own.
- elan1 Decide
- elan1 Govern
Queue assignment
Claims are routed to the right desk. Any change in the claims system passes through elan1 Govern first.
Finance and accounting
- elan1 Govern
Settlement thresholds
Payments above your limit wait for a named approver. Anything outside the rulebook is refused.
Risk and compliance
- elan1 Govern
Evidence for AI-liability cover
An exportable record of every approval and refusal for your underwriter or auditor.
IT operations
- elan1 Run
Document Q&A
Handlers query policy wordings and claim files, seeing only what their role allows. Hosted in India.
Platforms at work
Judgement fast, actions governed.
elan1 Decide
Decision intelligence
Triage, flags and routing, with calibrated confidence.
elan1 Govern
Agent governance and assurance
Every claim change allowed, sent to a person, or refused.
elan1 Run
Sovereign agent infrastructure
Document Q&A and models, in-country.
Illustrative: a motor claim reads 0.88 confidence. Your line is 0.90, so a handler confirms one answer and the claim moves.
Applications
Your systems of record
- Guidewire
- Policy administration
- Claims
- Document store
View as listHide list
- Applications: elan1 Work (not used here), elan1 Decide (applies here), and commerce1, a connected platform at commerce1.ai.
- Governance: elan1 Govern (applies here) allows, asks a person, or refuses every action.
- Runtime: elan1 Run (applies here), the runtime underneath.
- Your systems of record: Guidewire, Policy administration, Claims, Document store. Every change reaches them only through elan1 Govern.
Regulations we map to
Mapped to the rules you report against.
Mappings are drafts for your counsel and auditors. They are not certification, legal advice or regulator approval.
IRDAI information and cyber security guidelines (2023)
Access, logging, incident reporting.
Source: Insurance Regulatory and Development Authority of India, 2023
IRDAI policyholder protection regulations (2024)
Turnaround and reasoned claim decisions.
Source: Insurance Regulatory and Development Authority of India, 2024
DPDP Act 2023
Health and personal data, consent.
Source: Digital Personal Data Protection Act 2023; DPDP Rules 2025
EU AI Act
Life and health pricing and risk assessment are high-risk.
Source: Regulation (EU) 2024/1689, Annex III
NAIC model bulletin on insurers' AI use (US, 2023)
Governance and documentation.
Source: National Association of Insurance Commissioners, December 2023
HIPAA
Access control and audit logs for US health lines.
Source: US Health Insurance Portability and Accountability Act 1996, Security Rule
Facts
Insurance in four figures.
65%
of enterprises report an incident caused by an AI agent.
Source: CSA and Token Security, Apr 2026
6%
fully trust agents with core processes.
Source: Harvard Business Review survey
4 routes
Act, human review, deeper reasoning, hold.
Target, not a measurement.
1 rule
Fail toward a human, never toward an action.
Target, not a measurement.
Third-party figures are quoted from the source named under each one. Design targets describe how elan1 is specified to behave; they are not measurements.
Proof
Stories appear here when they are live.
We publish a customer story only when the work is in production and the customer has signed it off. No invented names, logos or results. Until then, this space is an invitation.
Become a design partner
Bring one real insurance process. Shape what comes next. We configure it with your team, you keep every approval, and the record is there from the first run.
Insights
Related insight
Plain answers on AI that acts, for insurance teams.
Also worth reading
FAQs
AI for insurance claims: common questions
How does AI triage insurance claims?
For first notice of loss, elan1 Decide is designed to read the claim email in one call and return line of business, severity, injury and urgency, each with a confidence score. Claims above your confidence line move; those below it reach a handler with the evidence attached. Fraud signals go to a specialist and never deny a claim alone.
Which insurance regulations does elan1 map to?
elan1 maps insurance work to IRDAI's information and cyber security guidelines (2023), the IRDAI policyholder protection regulations (2024), the DPDP Act 2023, the EU AI Act, the NAIC model bulletin for US insurers and HIPAA for US health lines. The mappings are drafts for your counsel and auditors, not certification, legal advice or regulator approval.
Where is policyholder data processed?
Policyholder data is hosted in AWS Mumbai across 3 availability zones, with no US region. Handlers using document Q&A on elan1 Run see only what their role allows. Health and personal data is handled under DPDP consent and purpose limits, and every change to a claim is checked and recorded.
Who approves insurance claim settlements?
A named person. Settlement payments above your limit wait for an approver in elan1 Govern, and anything outside the rulebook is refused. Every approval and refusal is kept in an exportable record that you can give your underwriter or auditor as evidence of human oversight for AI-liability cover.
How do we start with one claims queue?
Pick one queue, such as motor or health first notice of loss. We run elan1 Decide in shadow on your past claims, show where the confidence line falls and which claims a handler keeps, and leave the cut-over decision with you. It is designed to work with Guidewire, policy administration and your document store.
Bring one claims queue.
We start in shadow on your past claims, show where the confidence line falls, and leave the cut-over decision with you.
Intelligence you can answer for.