Insurance
Claims, underwriting, fraud workflowsGovern the moments where insurance losses happen
Insurance AI does not fail in the abstract. It fails when a claim is settled, a quote is changed, or a customer action is taken without the right controls. KLA puts approval thresholds and runtime lineage exactly where those decisions occur.
Operational Bottleneck
The workflow pain
Legal and risk teams do not object to automation in principle. They object to money-moving and customer-affecting decisions that cannot be intercepted, reviewed, or explained.
Block
Block recommendations that exceed authority limits or violate policy checkpoints
Review
Review edge cases, large settlements, and sensitive denials with named approvers
Allow
Allow only the approved action and record the full lineage behind it
Governed examples
- Claims settlement recommendations above delegated authority limits
- Underwriting changes that materially affect pricing or eligibility
- Fraud and SIU escalation workflows triggered by AI-generated risk signals
What reviewers ask for
- Authority band, policy result, and workflow context attached to the action
- Reviewer identity, decision rationale, and exact timestamp
- Signed lineage for outbound claim or underwriting action
