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Insurance

Insurers apply AI to decisions that directly affect whether people are covered, what they pay and whether a claim is paid, decisions that attract conduct, fairness and regulatory attention. Gamut gives underwriting, actuarial, claims and risk teams a shared way to govern these models and prove they operate fairly and effectively.

AI systems typically in scope

Section titled “AI systems typically in scope”
  • Underwriting and risk-selection models.
  • Pricing and rating models, including dynamic and personalised pricing.
  • Claims triage, severity prediction and automated settlement.
  • Fraud detection across applications and claims.
  • Customer-facing GenAI for quotes, servicing and claims intake.

Governance drivers

Section titled “Governance drivers”
  • Fairness and non-discrimination. Evidence that pricing and underwriting do not produce unfair or proxy-discriminatory outcomes.
  • EU AI Act. Risk-based obligations where AI materially affects access to insurance.
  • Conduct and treating customers fairly. Documented oversight of automated decisions.
  • Actuarial and model governance. Validation, monitoring and documented assumptions.

Use cases

Section titled “Use cases”

Prove an underwriting model is fair and validated

Section titled “Prove an underwriting model is fair and validated”

The scenario: a risk-selection model decides who is offered cover and on what terms.

How Gamut solves it: register and model-card the model, tier it through intake, route to GTSAF and the EU AI Act, and capture fairness, validation and monitoring evidence with control tests recording operating effectiveness.

Govern automated claims decisions

Section titled “Govern automated claims decisions”

The scenario: a model triages or auto-settles claims with limited human review.

How Gamut solves it: intake captures the human-oversight model and automated-decision flag; the resulting tier routes deeper controls, and any oversight gap becomes a tracked finding with remediation.

Demonstrate fraud-model assurance to reinsurers and auditors

Section titled “Demonstrate fraud-model assurance to reinsurers and auditors”

How Gamut solves it: a workpaper pack traces each control conclusion to its evidence, giving reinsurers, auditors and regulators a defensible package.

Quick start

Section titled “Quick start”
  1. Register the model in AI System Records with a model card.
  2. Run intake, flag personal data, automated decisions and human oversight, and confirm the tier.
  3. Route to GTSAF and EU AI Act.
  4. Capture fairness, validation and monitoring evidence in the Evidence Tracker and Testing Centre.
  5. Track gaps on the Remediation Roadmap.
  6. Produce assurance and board reports from reporting.

Frameworks that apply

Section titled “Frameworks that apply”

GTSAF, EU AI Act, NIST AI RMF, ISO/IEC 42001, and ISO/IEC 42005 for impact assessment.

Next

Section titled “Next”