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INSURANCE & HEALTH AI ASSURANCE

Know what your insurance AI can decide, change, disclose, and pay.

Accelerate responsible insurance AI deployment. HAIEC connects every high-consequence decision to business authority, effective permissions, executable actions and evidence, enabling leaders to advance automation with clarity.

HAIEC’s difference: A model test examines the answer. An access review examines the credential. HAIEC examines the consequential action across policy, identity, code and observed evidence.
INSURANCE ACTION SURFACEILLUSTRATIVE MODEL
Claims systemUnderwritingHealth dataPolicy serviceApprove · settle · payClassify · issue · excludeRetrieve · refer · discloseChange · endorse · updateINSURANCE AIAI AGENTTOOLS · AUTHORITYPAYMENT EFFECTRequires separate proof
REQUEST What was asked?AUTHORITY Who allowed it?EVIDENCE What occurred?
Explore this consequence map through the interactive insurance workbench.
THE EXECUTIVE CASE

Scale useful AI. Make the authority and evidence as measurable as the ambition.

Insurance leaders do not need another list of abstract AI risks. They need a decision about what can move into production, what requires a control, and what evidence justifies wider deployment.

CEO / TRANSFORMATION

Shorten the path from AI pilot to deployment decision.

Turn an unresolved governance debate into a named action boundary, a clear evidence request and an accountable release decision.

MEASURE Time from evidence readiness to documented release decision
COO / CLAIMS

Expand automation without handing over unlimited discretion.

Separate recommendations from settlement, denial, policy mutation and payment initiation. Identify which decisions require supervised approval.

MEASURE Target actions with established authority and control evidence
CRO / AUDIT

Make critical AI decisions easier to inspect and defend.

Trace the policy, permission, action and observation behind a finding; keep missing evidence visible instead of treating a checklist as proof.

MEASURE Evidence coverage, unresolved gaps and reviewer effort
CIO / SECURITY

See what agents and vendors can reach, not just what they declare.

Investigate tool paths, identity grants and cross-system consequences. Reassess when code, permissions or operating scope change.

MEASURE Unmediated paths, excess grants and time to remediation

Define your initial baseline during the engagement, then measure control coverage, release readiness and decision-cycle improvement.

EXECUTIVE ECONOMICS / EXPLORE THE UPSIDE

What could evidence-ready automation unlock?

Connect assurance to the operating economics of an insurance workflow. Adjust transaction volume, incremental bounded automation and handling cost to frame a measurable opportunity for your leadership team.

0 pp5 pp
ILLUSTRATIVE ANNUAL HANDLING VALUE$150,000

10,000 additional controlled actions × $15 per action

Make the opportunity measurable.

A HAIEC pilot can establish the eligible workflow, delegated authority evidence, actual handling baseline and incremental control costs before leadership evaluates the commercial case.

Editable scenario, not a HAIEC client result or a savings forecast.
Beyond handling efficiencyOther measurable levers include faster AI release decisions, less audit evidence reconciliation and improved oversight of critical agent actions. Establish separate baselines before combining them.
Build a scoped value case
THE INSURANCE CONSEQUENCE

One AI action can cross five different boundaries.

Insurance decisions can alter contracts, financial obligations, medical journeys and customer trust. Model accuracy and governance policy alone do not establish what connected AI can execute.

Financial

Settlement, premium, payment and payout instructions

Contractual

Policy issuance, exclusions, coverage and beneficiary changes

Health

Medical information, care referrals and clinical escalation

Personal

Identity, consent, disclosures and customer decisions

Operational

Third-party tools, agents, APIs and delegated workflows

01 / ASSURE TODAY

Assurance for the actions that change insurance outcomes.

Explore claims, underwriting, care, servicing and vendor actions. Each example connects the business consequence to a qualified authority question and the evidence needed to resolve it.

LIFE / HEALTH / P&C / CONSEQUENCE PATH

When AI moves from a claim recommendation to a settlement instruction

An assistant evaluates a benefit and prepares an instruction for a downstream payment or claims system. Technical access alone does not establish authority to settle.

ACTION AT STAKEApprove, deny, adjust or initiate a payment
MATERIAL EXPOSURESWrong payee · unsupported denial · unauthorized settlement
THE HAIEC ASSURANCE QUESTION
01 / AUTHORITY

Delegated amount, eligible benefit, policyholder/beneficiary, escalation owner and human approval requirements

02 / EVIDENCE

Claims records, approved authority, tool/code path, payment target, approval witness and target-side result

03 / DECISION VALUE

An inspectable basis for bounded claims automation and remediation

Scenario design example · evidence requirements become the starting point for a scoped customer assessment.
One assurance foundation across insurance workflows: discover the action path, establish authority, evaluate evidence and support a documented decision.
ONE ACTION / MANY QUESTIONS

Accurate claim processing is not the same as authorized settlement.

An AI claims copilot may correctly identify an eligible benefit yet attempt a payment outside its delegated financial authority or to an unverified recipient. HAIEC's consequence-first method asks the additional questions that matter before calling the action supported.

Inspect the sample claims scenario
SYNTHETIC CASE CLAIMS / SETTLEMENT
01
Claim submittedPolicy, claimant, benefit evidence
02
AI recommends $85,000Recommendation is not execution authority
03
Illustrative $10,000 limitApproval, target, code reach and payment evidence still required
ASSURANCE OUTPUTA source-qualified authority finding and the next action for the insurer's decision owner.
02 / ENABLE TOMORROW

Move from assisted decisions to accountable autonomy.

More automation should come with stronger, not merely longer, evidence. Explore what changes when an insurer expands an agent's delegated action scope.

02 / APPROVAL / RELEASE DESIGN

Introduce execution behind explicit human authority.

The system can prepare and request a change. An appropriately scoped human or policy checkpoint is required before the action is committed.

Approval before action
Assurance evidence to progress
Bind agent, principal and target operation
Verify business-rule and approval requirements
Test exceptions and maintain action evidence
Human-mediated. HAIEC findings inform approval; insurer owners retain release and business decisions.
AI RELEASE ASSURANCE

Turn the next AI deployment gate into a defensible decision.

For a new or restricted agentic workflow, replace open-ended “is it safe?” discussions with a defined operating envelope, a tested action path, named approval ownership and explicit evidence gaps. Approve, limit, remediate or defer on a documented basis.

01Define exposure

Action · target · magnitude · data

02Map authority

Policy · principal · capability

03Evaluate proof

Tests · provenance · missing facts

04Support release

Review · remediation · reassessment

03 / CREATE NEW OPPORTUNITIES

A second opportunity: technical evidence for the emerging AI-risk economy.

Technical consequence evidence can support enterprise AI assurance today and create a foundation for new vendor assurance offerings, portable evidence products and specialist insurance partnerships.

01READY TO SCOPE

Enterprise assurance programs

Give AI release boards, claims leaders and audit teams an evidence-based view of consequential actions. Start with one workflow and expand across approved sources and operating environments.

BUYER / Insurance CIO, COO, CRO & technology
Initial assurance engagement → recurring oversight
02PARTNERSHIP DESIGN

AI Assurance Evidence Record

Explore a portable, versioned technical record of evaluated AI authority, action scope, controls, provenance and change history for procurement and vendor reviews.

BUYER / AI vendors, enterprises, insurers
Potential joint evidence product
03STRATEGIC OPPORTUNITY

AI risk underwriting intelligence

Explore how technical evidence on AI authority, executable exposures and tested controls could inform a licensed insurer’s or reinsurer’s specialist underwriting process.

BUYER / Specialist insurers, reinsurers & partners
Separate insurer partnership and product design
Start with one insurer workflow. Expand into technical evidence services and partnership opportunities as adoption grows.Explore the opportunity
ONE ASSURANCE PLATFORM / INSURANCE CONTEXT

Enterprise governance backed by technical action evidence.

HAIEC brings together AI estate visibility, delegated action integrity, technical controls and review-ready evidence, with insurance workflows as an enterprise operating context.

01

Understand the AI estate

Map AI applications, agents, connected tools, source-capable routes and ownership into one operational picture.

AI Estate and agent inventory
Code-to-action and API reachability
Identity and system constellation
Explore capability
02

Assess authority & security

Compare business decisions, effective access and executable capability. Investigate tool boundaries and application exposures.

Delegated Action Integrity (DAI)
ISAF action-bound methodology
AI AppSec, RAG and MCP isolation
Explore capability
03

Test & establish evidence

Run applicable assurance checks, qualify source evidence and produce inspectable findings for executive, risk and audit reviews.

45-entry assurance control catalog
Selected control tests and findings
Evidence provenance and scope
Explore capability
04

Monitor & govern change

Track important changes in permissions, code, tools and operating scope with source-aware reassessment and monitoring.

Scoped monitoring and review
Evidence lineage and exception ownership
CSM6 lifecycle research alignment
Explore capability
ASSURANCE & GOVERNANCE ALIGNMENTEvidence that supports enterprise governance and assurance reviews.

Align technical evidence with applicable NIST AI RMF, ISO/IEC 42001, ISO/IEC 27001, SOC 2 and insurance supervisory review objectives, while retaining source and decision-owner traceability.

NIST AI RMFISO/IEC 42001ISO/IEC 27001SOC 2 evidenceIAIS principlesInsurance regulators
INSURER GOVERNANCE / CLEAR ACCOUNTABILITY

Add independent technical evidence to the insurer's operating model.

Connect the business owner, model risk, technical assurance, executive approval and ongoing oversight through a shared, review-ready understanding of consequential AI actions.

01Business ownerNames the consequential decision
02Model / risk reviewValidates suitability, fairness and policy
03 / HAIECTechnical assuranceAuthority, code capability and source evidence
04Approval ownerApproves, limits or defers release
05Operations / auditMonitors, investigates and remediates

AIA or another insurer retains business approval and risk ownership. HAIEC delivers the technical evidence that helps those owners make clearer decisions.

FITS THE OPERATING MODEL

Independent HAIEC, or alongside an enterprise control tower.

Governance workflow and technical consequence evidence can reinforce each other. Both models preserve the insurer's accountability for policies, approvals and remediation.

Insurer AI estateSelected source · identity · API · evidence
HAIEC findings & reportsReview · tests · monitoring where connected
Independent assurance interface

Use HAIEC to investigate eligible action paths, compare authority and review scoped evidence directly. The insurer retains source access decisions, policy authority and remediation ownership.

Coverage depends on actual connected systems and granted evidence access.
EXPLORE HAIEC IN ACTION

Choose a consequential decision. See how assurance works.

Start with the interactive insurance workbench. Explore claims, underwriting, policy changes, health data and connected agents using clear, scenario-based evidence views.

SELF-GUIDED INTERACTIVE EXPERIENCE

From an AI recommendation to an accountable action.

Walk through a claims decision, inspect the authority boundary and explore the evidence that would support a release or remediation decision.

Launch Insurance Workbench
16 illustrative cases · Three autonomy states · Five evidence perspectives
HAIEC / INSURANCEINTERACTIVE WORKBENCH
SELECTED SCENARIOClaims settlement authority
Requested actionSettlement initiation
Delegated authorityApproval checkpoint
Evidence objectiveAction + target trace
ILLUSTRATIVE ASSURANCE CASE
CLIENT PRESENTATION LIBRARY

AIA strategic proposal materials

Two HAIEC-prepared presentations for an AIA-specific executive or technical discussion. Enter the insurance client name to open either presentation.

CLIENT NAME CHECK
EXECUTIVE PROPOSAL · 16 SLIDESAIA Executive Presentation

The business opportunity, measurable executive outcomes, HAIEC's differentiator, a representative workflow and the proposed pilot decision.

STRATEGIC + TECHNICAL MASTER · 55 SLIDESAIA Master Presentation

Insurance scenarios, transparent economics, governance architecture, assurance methodology, pilot execution and strategic expansion options.

AIA-focused proposal materials prepared independently by HAIEC; examples are illustrative and do not imply an AIA evaluation or endorsement.

ENTERPRISE ENGAGEMENT

Start with one AI system and one consequential decision.

Start with an accountable system owner, one consequential decision and a defined evidence objective. HAIEC builds an action-level assurance case and provides an executive decision package.

01 / Define

Select one consequential workflow

Name the business decision, effect, scope, accountable owner and applicable policy.

02 / Connect

Qualify available technical sources

Identify approved code, identity, permissions, workflow, evidence and target-system inputs.

03 / Evaluate

Test relevant action and authority paths

Record bounded findings, control results, uncertainty and evidence gaps where supported.

04 / Decide

Deliver a decision-ready evidence package

Present scoped findings, action-path matrix, control gaps, open questions and prioritized remediation for the insurer’s accountable review.

WHAT LEADERS RECEIVE

Not just findings. A defined decision package.

Each item reflects the evidence actually qualified in scope; unknowns remain explicit.

Action and consequence map Delegated authority matrix Evidence and control coverage Prioritized gap register Source-qualified technical findings Executive decision readout

An initial assessment is commonly scoped for 4–8 weeks after source readiness. Commercial terms and any insurance-specific integrations are defined in the enterprise proposal.

Make the next AI deployment decision more defensible.

Choose a consequential insurance workflow; receive a defined evidence boundary, deliverables, ownership and engagement proposal.

HOW HAIEC WORKS WITH INSURANCE TEAMS

From AI capability to accountable enterprise decisions.

Which insurance workflows can HAIEC help evaluate?

HAIEC can scope consequential AI paths in claims, underwriting, policy servicing, health data, agency, fraud operations and third-party agents. An engagement selects the action, its owner, technical sources and evidence objective.

How does HAIEC differ from model testing and access reviews?

HAIEC connects what an AI system requested, what business policy authorized, what identities were granted, what executable paths exist and what source evidence demonstrates. This action-level comparison supports accountable AI release decisions.

What does an insurance assurance POC deliver?

A scoped consequence map, delegated authority matrix, control/evidence coverage, prioritized exception register, source-qualified findings and an executive readout with recommendations for release, remediation and ongoing review.

Can HAIEC fit our governance and ServiceNow workflows?

HAIEC operates as an independent technical evidence layer alongside an insurer’s existing business, risk, security and audit teams. ServiceNow workflow integration can be scoped as a customer-specific implementation.

How can HAIEC support more autonomous insurance agents?

Assess advisory, supervised and bounded-action designs by comparing decision rights, tool access, effective grants, executable paths, approvals and operational observations. Customer governance teams use that evidence to expand autonomy deliberately.

Industry frameworks and operating context

Explore the insurance supervisory and enterprise governance references that inform our assurance methods.

NAIC — Artificial Intelligence IAIS — AI Supervision ServiceNow — AI Passport