Aligning intelligence…
Aligning intelligence…
AI Consulting · Automation · Development
Insurance runs on data. Pricing, claims, and fraud all turn on it. We help insurers and brokers in Malta and across Europe settle faster, underwrite sharper, and catch more fraud with AI, and every decision stays fair, explainable, and audit-ready.
Insurance is a data business from end to end: underwriting, pricing, claims, and fraud all depend on it. AI now works across that whole chain. Straightforward claims get triaged and settled faster. Risk signals surface from documents for your underwriters. Anomalous patterns get flagged for fraud teams. Routine policy queries get handled in customer ops. The wins that hold up are the ones where the data is governed and a person stays in the loop, so speed never costs you fairness or a clean audit trail.
The regulatory bar here is specific, not blanket, and it is easy to meet once you design for it. Under the EU AI Act, AI used for risk assessment and pricing of natural persons in life and health insurance is classified high-risk (Annex III). That covers automated underwriting, premium calculation, and acceptance scoring for those lines. The Act's general provisions apply from 2 August 2026, while the high-risk obligations for Annex III systems now apply from 2 December 2027, following the Digital Omnibus simplification package endorsed by Parliament and Council in June 2026. Claims, fraud, and back-office automation usually sit outside that high-risk tier. We keep them there by design, not by assumption.
Governance & compliance
Data law bites hardest in this sector, so we build for it from day one. Health data is special-category under GDPR Article 9, and Article 22 limits decisions made solely by automated means with legal or similarly significant effects. That applies directly to automated underwriting and claims declines. EU rules also bar certain rating factors such as gender, so pricing models have to be tested for proxy discrimination, alongside IDD conduct duties and the Solvency II prudential framework. In Malta the MDIA is the national AI authority under Legal Notice 226 of 2025 and coordinates with the MFSA on high-risk financial-sector AI, while the IDPC supervises data protection.
Classify, route, and fast-track straightforward claims, and escalate the complex or suspect ones to adjusters.
Surface risk signals from documents and data so underwriters price faster, with the reasoning logged and reviewable.
Flag anomalous patterns across claims and policies for investigators to confirm, so nothing gets auto-decided.
Extract structured data from policy wordings, forms, and first-notice-of-loss submissions to cut manual keying.
Resolve common policy and claims queries, route the rest to a person, and keep the service path open.
Build explainable life and health pricing models that meet the high-risk bar, with fairness testing, documentation, and human oversight.
For one specific use, yes. AI used for risk assessment and pricing of natural persons in life and health insurance is listed as high-risk in Annex III. Those obligations now apply from 2 December 2027 following the Digital Omnibus, while the Act's general provisions apply from 2 August 2026. Claims, fraud, and back-office automation typically fall outside that high-risk tier.
Health data is special-category under GDPR Article 9, so it needs an explicit lawful basis and tighter controls. Article 22 also limits decisions made solely by automated means with legal or similarly significant effects, which is why automated underwriting and claims declines need a meaningful human review path.
The MFSA supervises insurers and brokers, while the MDIA is Malta's national AI authority under Legal Notice 226 of 2025 and coordinates with the MFSA on high-risk financial AI; the IDPC oversees data protection. Across the EU the same AI Act, GDPR, IDD, and Solvency II obligations apply.
No. We build AI that supports underwriting and claims judgement rather than replacing it: risk signals surfaced, decisions logged and reviewable, a person in the loop. That is also what the high-risk regime expects, namely meaningful human oversight.
From first strategy to live systems, we cover the full path for insurance teams, no need to hire a full AI team up front.
A five-minute read on where insurance teams like yours stand before committing to a build.