AI for insurers and TPAs — settle faster, underwrite sharper, and keep every medical and financial record inside your perimeter
Insurance runs on documents, deadlines and trust, and regulators have put a clock on all three. IRDAI's 2024 master circular gives an insurer one hour to authorise a cashless claim and three hours to clear a discharge; the EU AI Act lists life and health risk assessment and pricing as high-risk. We deploy AI across the policy lifecycle — claims intake and adjudication, pre-authorisation, underwriting submissions, policy servicing, partner distribution and the AI Centre of Excellence that keeps it all governed — on your servers, because a discharge summary is exactly the kind of record a public LLM API should never see.
Where Insurance & TPAs organisations need AI most
The one-hour clock on cashless claims
Pre-authorisation requests arrive as scanned forms, discharge summaries and itemised bills from hospital desks, and an adjudicator has to read all of it, check the tariff and the policy terms, and decide — now inside a regulatory window measured in minutes. AI that extracts the documents, checks completeness against the pre-auth form and matches procedures to the tariff schedule turns the clock from a compliance risk into an engineering target.
Claims leakage and fraud that hides in paperwork
Inflated bills, duplicate submissions, upcoded procedures and provider networks that drift out of the negotiated tariff cost insurers a measurable share of every claims rupee, dollar or euro. Rule engines catch the patterns they were written for. Anomaly detection across documents, providers and claim histories catches the ones nobody wrote a rule for — with an explanation an investigator can act on.
Underwriting submissions nobody can read fast enough
Broker submissions, medical reports, financial statements and loss runs land as unstructured PDFs, and quote turnaround is set by how fast an underwriter can key them in. Structuring the submission is the job for AI; pricing the risk stays with the underwriter — which is also what the EU AI Act's high-risk regime for life and health pricing expects.
Distribution that runs on partners and paper
Bancassurance partners, brokers, NBFCs and affinity programmes each want a co-branded journey, correct product wording and leads that reach the right team. Left to agencies, that becomes dozens of one-off websites with inconsistent disclosures. A managed microsite platform with compliance-approved content blocks launches a new partner in days and propagates a wording change everywhere in hours.
Regulators, auditors and the data question
Health and financial records are special-category data under DPDP, GDPR and HIPAA, and high-risk AI under the EU AI Act carries documentation, logging and human-oversight duties. An insurer cannot send a claim file to a cloud model and hope the contract covers it. Sovereign deployment with a model inventory, an immutable audit trail and a human in the loop is the only architecture that survives both the regulator and the insurer's own audit.
Proven accelerators for Insurance & TPAs
Results we've delivered
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