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Insurance

Insurance claims AI

Consent binding, PHI redaction, large-claim dual approval, immutable claims audit.

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What this package does

Compliance guardrails for AI-driven claims processing and underwriting. Binds every data access to a declared claims purpose, redacts medical PHI and personal PII before they reach logs, routes large claims through a dual-approval workflow, and retains an immutable audit record for state insurance commissioner examinations.

Designed for

  • P&C and life insurance carriers
  • Claims management platforms
  • AI-assisted underwriting tools

What's included

  • Consent-purpose binding: claims + underwriting
  • PHI drop for medical claims data
  • Large-claim ceiling with senior-adjuster dual approval
  • Breach alert @ 500 policyholder records
  • Immutable 7-year claims audit

Controls in this bundle

ControlActionParameters
require_roleblockallowed_roles=["adjuster","underwriter","admin"]
mfa_requiredblockmax_age_seconds=900
consent_purpose_bindingblockallowed_purposes=["claims_processing","underwriting","fraud_investigation"]
phi_redactionflagstrategy="drop"
pii_redactionflagstrategy="mask"
txn_amount_ceilingreviewmax_amount_usd=100000
dual_approvalreviewapprover_role="senior_adjuster", min_distinct_approvers=2
breach_thresholdreviewmax_records=500
manual_review_queuereviewreviewer_role="claims_supervisor", sla_hours=24
immutable_logflagretention_days=2555

Profile tiers

Switch profiles in Studio to retune default thresholds across the whole bundle without rewriting any control by hand. This package ships at strict — anything you've already tightened by hand is preserved on switch.

Every control in this package uses identical parameters across all four profiles. Switching profile in Studio has no effect here.

Attestation

The canonical hash of these bundle bytes is sha256:f0531d7ed4c33cd407b45fe75707e198f09f108025e59f2e382add7827811734. The same hash is computed at lock time, at Stripe checkout, and again on the runtime side before any byte is honored.

Want to customize first? Opening this package in Studio prefills the canvas with the 10 controls above. You can add, remove, or retune any of them before you lock the hash and pay.

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