🛡️ Agentic Insurance Operations
Governed AI agents for claims, fraud, and underwriting — on your insurance core (Duck Creek / Guidewire) and a governed Databricks Lakehouse. Sovereign by design, human-in-the-loop, and run by your AI Center of Excellence.
Agentic Insurance Operations, End to End
Claims, fraud, underwriting and service delivered as governed agents on your insurance core — the work insurance teams actually do, automated with a human in the loop
Smart Claims Processing
Agent-assisted claims adjudication that triages, validates, and routes claims on your insurance core — with human approval at the gates, not a black box.
- Agentic triage and auto-adjudication for clean claims
- Real-time fraud scoring during intake
- Computer-vision damage assessment
- Intelligent claims routing and prioritisation
- Settlement calculation with human-in-the-loop review
Advanced Fraud Detection
Multi-layer fraud detection on a governed Databricks Lakehouse — ML analysis and network detection that flags for investigation, with every decision explainable.
- Network analysis for organised fraud rings
- Real-time risk scoring during submission
- Pattern recognition across claim types
- Automated investigation workflows
- Explainable scores with full audit trail
Agentic Underwriting
Faster, more consistent underwriting decisions with ML-powered risk assessment and automated policy generation — guardrailed and reviewable.
- Assisted quote generation and approval
- Real-time data integration for risk signals
- Straight-through processing for low-risk applications
- Configurable rule engine with guardrails
- API-first integration with your core
Dynamic Pricing & Risk Assessment
AI-assisted pricing with telematics and alternative data, modelled on a governed Lakehouse for defensible, auditable decisions.
- Telematics-based personalised pricing
- Alternative data integration
- Catastrophe risk modelling
- Competitive positioning analytics
- Portfolio optimisation analytics
Customer Intelligence & Retention
Predictive customer analytics with proactive, governed engagement — churn signals and personalised journeys with a human owning the outreach.
- Customer lifetime value modelling
- Churn prediction with confidence ranges
- Retention campaign support
- Cross-sell opportunity identification
- Personalised customer journeys
Regulatory Compliance & Reporting
Automated regulatory reporting and audit trails aligned to Australian prudential expectations — APRA-aware by design.
- Automated regulatory reporting
- IFRS 17 compliance calculations
- Real-time regulatory limit monitoring
- Comprehensive audit-trail system
- Risk-management dashboards
How We Build — On Your Insurance Core
A governed agentic layer beside your core, never inside it: insurance core (Duck Creek / Guidewire) → governed Databricks Lakehouse → governed agents → sovereign, AU-resident data
The Architecture Spine
Insurance Core Integration
We integrate with your insurance core (Duck Creek / Guidewire) via stable, released APIs — policy, claims and billing stay where they are, never modified.
Databricks Lakehouse
A governed data backbone for insurance agents — sovereign, AU-resident, with lineage and access controls end to end on a Databricks Lakehouse.
Governed Agents
Claims, fraud and underwriting agents run with human-in-the-loop checkpoints and full audit trails — explainable, reviewable, never a black box.
Sovereign & AU-Resident
Data and agents stay in Australia, aligned to prudential expectations — built for APRA-regulated insurers and risk-sensitive buyers.
Trust, Compliance & Standards
The security, sovereignty, and governance posture an insurer's risk and prudential team needs to see
Status is indicative and confirmed per engagement. We are Databricks-based on your insurance core (Duck Creek / Guidewire), vendor-neutral, and not an SAP partner. Certification letters available under NDA.
Where It Earns Its Keep
The outcomes insurance teams target — each tied to a real workflow. Figures are targets confirmed against your baseline, not guarantees.
Claims Processing Efficiency
Agentic triage and adjudication take the manual grind off claims teams.
- Higher auto-adjudication rate for clean claims (target, baselined per engagement)
- Shorter processing time
- Lower operational cost per claim
- More consistent decisions with validation at each gate
Fraud Prevention Impact
Better detection and faster investigation reduce leakage and risk.
- Reduced fraud leakage (target, baselined against your book)
- Fewer false positives on tuned models
- Faster investigation resolution
- Explainable scoring for every flagged claim
Financial Performance
Sharper pricing and tighter operations target a healthier loss ratio.
- Improved loss ratios (target, confirmed per engagement)
- More accurate premium pricing
- Faster underwriting decisions
- Lower administrative cost
Customer Experience
Faster service and proactive engagement support retention.
- Improved customer retention (target)
- Higher customer satisfaction
- Faster quote-to-policy conversion
- Better cross-sell relevance
Risk Management
Stronger risk assessment and governed reporting reduce exposure.
- More accurate risk prediction
- Reduced catastrophe exposure
- Automated regulatory compliance evidence
- Faster risk-adjustment processes
Phased Implementation
A governed, phased onboarding on your insurance core — sovereignty and prudential alignment first, never a risky big-bang
Foundation & Governance
Phase 1: stand up the security, sovereignty, and governance foundation — Privacy Act 1988 / APPs and APRA (CPS 230 / CPS 234) alignment from day one.
- Privacy Act 1988 / APPs alignment
- APRA CPS 230 / CPS 234 governance setup
- Data governance and audit-trail implementation
- Insurance core (Duck Creek / Guidewire) connectivity
- Role-based access and permissions
Data Integration & Lakehouse
Phase 2: build the governed Databricks Lakehouse, data pipelines, and core analytics models — sovereign and AU-resident.
- Databricks Lakehouse architecture
- Core ML model development and training
- Real-time streaming pipeline setup
- Initial fraud-detection deployment
- Lineage and access controls end to end
Agent Build & Guardrails
Phase 3: configure claims, fraud, pricing and customer agents with approval flows and human-in-the-loop checkpoints.
- Advanced fraud-detection models
- Dynamic pricing engine
- Customer churn prediction models
- Computer-vision damage assessment
- Guardrails and agent validation
Real-Time Processing & Automation
Phase 4: real-time decision engines, automated workflows, and regulatory compliance reporting.
- Real-time underwriting engine
- Automated claims-processing workflows
- Regulatory reporting automation
- Performance monitoring and alerting
- Business intelligence dashboards
Testing, Training & Go-Live
Phase 5: comprehensive testing, staff training, and change management for a seamless go-live with hypercare.
- End-to-end system testing
- User acceptance testing
- Staff training and certification
- Change management support
- Go-live readiness and hypercare
Optimise & Extend
Ongoing: continuous optimisation, model retraining, new agent use-cases, and managed support.
- Model performance monitoring
- Continuous system optimisation
- Regular model retraining
- New agent use-cases
- Ongoing platform enhancements
Who It's For
Built first for the Australian insurers where governance and sovereignty matter most
AU insurers on Duck Creek / Guidewire
Insurers running a modern insurance core who want governed agentic AI integrated via stable APIs — never a risky modification of the core.
Claims & fraud teams wanting agentic automation
Claims and SIU leaders who want agentic triage, adjudication, and explainable fraud detection — with a human in the loop, not a black box.
Sovereignty- & APRA-governance-first buyers
Regulated insurers that need Australian data residency, Privacy Act / APP alignment, APRA CPS 230 / 234 governance, and audit trails on every agent.
Aligned to Australia's Whole-of-Government Cloud posture and Hosting Certification Framework for sovereign workloads.
Built and Run by Your AI Center of Excellence
This platform runs on five CoE capabilities — strategy, people, agents, data, and governance. We design, deploy, and govern a clean-core-safe agentic layer that keeps your data sovereign in Australia and every agent auditable and cost-controlled.
Bring Agentic AI to Your Insurance Core
Book a walkthrough with an insurance specialist — we'll map your claims, fraud and underwriting workflows and show where governed agents take the load on your Duck Creek / Guidewire core.