From claims triage to Annex III governance, we help insurers put AI to work where the cost sits — and prove it holds up to a regulator.
Insurers use AI to read and triage claims at first notice, spot fraud patterns across claims, analyse policies and endorsements, track regulatory change and serve policyholders without the wait. The value sits in the handling, not the payout: getting each claim to the right desk with the evidence attached. Risk assessment and pricing in life and health insurance is high-risk under the EU AI Act, so those models need documentation, logging and real human oversight.
Life and health pricing with AI is high-risk under the EU AI Act, and the obligations landed on 2 August 2026 — risk management, data governance, technical documentation, logging, human oversight. We build the governance layer around the models you already run.
AI that reads patterns across claims, claimants and repair networks — staged losses, coordinated rings and quiet repeat behaviour — and flags them while the file is still open, with the evidence a special investigations unit can act on.
AI that reads the first notice, the invoices and the adjuster's report, classifies the claim by severity and complexity, and routes it to the right handler on day one — with the reasoning attached.
Continuous monitoring of regulatory changes, internal policy adherence and audit readiness — so your compliance team leads strategy instead of chasing paperw…
Extract obligations, flag risks and track key dates across your entire contract portfolio — without your legal team reading every line.
Extract, classify and act on information from contracts, reports, invoices and forms — at the speed and scale no human team can match.
Build the controls, audit trails and risk framework that turn AI deployments from a liability into a governed, defensible part of your operations.
Continuous regulatory monitoring on Synapse with jurisdiction-aware feeds, control mapping, and audit-ready evidence—built for compliance ownership.
Automate the queries that don't need a human, reduce cost-per-ticket, and protect CSAT — without replacing the agents your customers actually value.
The EU AI Act (Regulation (EU) 2024/1689) lists in Annex III AI systems used for risk assessment and pricing of natural persons in life and health insurance as high-risk. That brings risk management, data governance, technical documentation, decision logging and human oversight that works in the workflow, not only on paper. AI used in hiring and people management is also high-risk. Claims triage, fraud detection or policyholder assistants are not automatically high-risk, but each use should be classified and the reasoning recorded.
With the Digital Omnibus on AI in force since 27 July 2026, most Annex III obligations apply from December 2027, sixteen months later than first planned. The Omnibus does not change AI literacy (Article 4), mandatory since 2 February 2025, or Article 50 transparency, which applies since August 2026. Check the consolidated text on EUR-Lex or the AI Act Service Desk before planning around a date.
The AI Act sits on top of existing insurance rules. Solvency II sets expectations on governance and risk management, the Insurance Distribution Directive (IDD) on product oversight and acting in the customer's interest, DORA on ICT risk and technology providers, and GDPR on personal data, including health data as a special category. This page is orientation, not legal advice: confirm obligations with counsel and official EU sources.
Annex III names risk assessment and pricing of natural persons in life and health insurance, plus AI in hiring and people management. Other uses such as claims triage, document processing or fraud detection are not listed by name, but should still be classified case by case and documented.
A governance layer around them: a documented perimeter of in-scope models, decision logs that let you retrace any outcome, fairness and drift monitoring, technical documentation and an oversight workflow where overrides are recorded. It is usually built around existing models rather than replacing them.
At intake. Reading first notices, invoices and reports, classifying by severity and complexity, and routing to the right handler on day one with the reasoning attached. Simple claims stop queuing behind complex ones and experienced adjusters spend time judging, not retyping.
Rules look at one claim at a time and are learned and worked around. Network analysis links claimants, providers, vehicles and bank details across claims, so it can surface patterns no single file shows, and hand investigators a case with the evidence assembled.
As a deployer you keep duties: use the system as instructed, assign human oversight, keep logs and ensure input data is relevant. If you substantially modify or rebrand the model you may take on provider duties. Put the split of responsibilities in the contract.
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