Insurtech EIP launches AI-powered claims automation tool

Insurtech EIP has launched Virtual TPAi, a new artificial intelligence (AI) tool designed to automate insurance claims processing and decision making from first notification of loss through to settlement.

The system uses a proprietary voice-led AI agent that performs many of the functions traditionally handled by third-party administrators (TPAs) and call centres.

Customers can ask questions about their policies and submit claims through human-like conversations in multiple languages.

According to EIP, the AI agent can manage up to 20 conversations simultaneously, 24 hours a day, seven days a week, reducing insurers’ reliance on outsourced claims handling services.

Information gathered during claims conversations is fed into EIP’s rules engine, which applies insurer-defined criteria to either approve a claim automatically or refer it for human review.

Ross Sinclair, chief executive at EIP, said: “The growth potential is huge here because we’ve done the hard work of making sure it works in a regulated environment.

“We are proud to continue leading the charge on the insurance industry’s adoption of AI in a way that is responsible and human-led.”

’Sophisticated technology’

The insurtech said the rules engine provides transparency and auditability because decisions are based on insurer-configured policy rules rather than probabilistic AI models.

The platform uses around 80 configurable rules, allowing insurers to determine how claims are assessed and processed.

EIP noted that the rules engine has been used for more than a decade and has now been integrated with the new AI front-end to deliver end-to-end automation.

David Michell Dawson, director of product at EIP, said the company had invested heavily in creating a voice-led system capable of delivering a customer experience comparable to, or better than, existing service models.

He added that safeguards had been built into the technology. He explained: “The sophisticated technology behind it makes it impossible for the AI agent to move outside the guardrails we have imposed.”

Under the system, insurers remain accountable for claims decisions, with human handlers able to review, override or approve outcomes where required.