taskfloFirst-notice-of-loss triage
Classify severity and route the claim. Suspected fraud and high-value claims go to a handler; the agent cannot settle.
- Read
- Classify
- Route
INSURANCE
Faster claims. Every decision traceable to a rule.
Insurers have much to gain from agents and much to lose from an unexplainable decision. Taskflo is designed for claims and servicing workflows with limits, approvals and evidence built in.
CLAIM REVIEW FILE
- Claim evidence
- Severity routing
- Handler decision
WHY AGENTS STALL HERE
A payout is a decision someone must be able to explain.
A claim is a person’s cover, their records and a decision you may need to explain years later.
Cover and payout decisions must be explainable.
Claims files contain sensitive personal information.
Payout authority must be bounded.
PROCESS STUDIES
From first notice to review, with bounded authority.
Claims documentation review
Check submitted evidence against policy terms and list gaps. The handler decides.
- Evidence
- Policy check
- Handler
Policy servicing
Prepare address, beneficiary and cover-change requests. Apply changes only after verification and required approval.
- Prepare
- Verify
- Approve
Example workflows are illustrative designs, not customer case studies.
The three questions, answered for an insurer.
Where does the data go?
Review your account boundary, model-service terms, region and network paths.
Who can act on our behalf?
Declare tools, owners, limits and approval roles. Keep judgement with the qualified people.
Can we prove what happened?
Review the version, decision record and evidence-retention controls together.
REGULATORY CONTEXT
Life and health pricing is a high-risk use.
Risk assessment and pricing for individuals in life and health insurance are listed in Annex III 5(c), with a fundamental rights impact assessment addressed by Article 27. The Annex III high-risk obligations generally begin on 2 December 2027. A claims-triage workflow needs its own assessment; do not infer classification from the industry alone.
Separate document preparation, routing and the authority to change cover or release money. Define how a handler sees the evidence, when fraud specialists intervene, and what records must survive a complaint. GDPR and supervisory expectations still apply outside an AI Act high-risk listing.
General information, not legal advice. EU AI Act and 2026 amendment. Your legal and professional advisers determine the applicable requirements.
ONE WORKFLOW. A CLEAR NEXT STEP.
Bring us the claims workflow your review rejected.
Tell us about the process, the systems and the people. Let’s work through what it would take to run it.