Insurance
Underwriting, claims adjudication, fraud investigation
Deterministic reasoning across policy language, coverage conditions, loss reports, and fraud typologies — so adjusters and underwriters get a ranked, explainable queue they can defend under examination.
Insurance vertical — waitlist open
Target: H2 2026
Join pilot intake and we will reach out with the first carrier-scale blueprint. Priority goes to teams with a specific line of business (P&C, commercial, reinsurance) and a decision workflow that has to defend itself under regulator review.
Probabilistic AI doesn't survive SIU review.
Adjudication is still a prose problem
Policy language, coverage conditions, endorsements, and loss reports all live in prose. Classical retrieval pulls nearest-neighbor paragraphs and hopes the LLM composes a defensible denial or approval. It does not scale under regulator review.
Fraud intuition is not auditable
Investigator instinct is real expertise — but it is not a chain a regulator can re-trace. Deterministic AI lets investigators move faster without losing the ability to defend every flag in writing.
Capacity is breaking
Claims volume is up. Headcount is flat. Adjusters and underwriters are drowning in reviewable material. The answer is not a probabilistic chatbot — it is a ranked, explainable queue they can sign off on.
Three QAG workflows on the insurance roadmap.
Underwriting QAG
Encode the carrier's underwriting guidelines, reinsurance constraints, and risk appetite in Q-Prime. Apply QAG so coverage conflicts, carve-outs, and appetite mismatches surface as explicit signals before quote.
Claims adjudication QAG
Every claim becomes a reasoning graph: policy → endorsements → loss facts → prior handling. Adjusters see the conflicts (coverage vs. exclusion vs. claim narrative) as HSC signals they can sign or dispute.
Fraud investigation QAG
Investigator-grade narrative generation over the claim graph, constrained to the evidence actually present. Every conclusion is replayable against the facts; every escalation is defensible at SIU review.