Finance & insurance

Insurance. Buying and claims journeys customers can follow without calling.

Every journey is built to IRDAI’s 2024 rules and the DPDP Act.

We design and build buying and claims journeys, plain-language policy information and AI assistants for life, health and general insurers, insurtechs and intermediaries. The main measure is time from claim to settlement.

Main measure
Time from claim to settlement
Where we work in insurance
  • Life insurance
  • Health insurance
  • General insurance
  • Insurtech & distribution
  • Brokers & aggregators
Rules mapped
8 rules · 6 areas
Disciplines that lead
TechnologyProduct
Frameworks we build to
DPDP Act 2023 — Digital Personal Data Protection Act, 2023PCI DSS v4.0.1 — Payment Card Industry Data Security StandardISO/IEC 27001:2022 — Information security management systemsCERT-In Directions 2022 — Cyber incident reporting directionsEU AI Act — Artificial Intelligence Act (EU) 2024/1689WCAG 2.2 AA — Web Content Accessibility Guidelines
A raindrop-covered blue umbrella held up in the rain against a blurred street
InsuranceCover is judged on the day it rains.

Where the rules biteMap of all forty-one industries

  • Claims Advertising & claims: Often shapes the work
  • Regulator Sector regulator: Shapes most of the work
  • Payments Payments: Often shapes the work
  • Data Personal data: Shapes most of the work
  • Security Security & incidents: Shapes most of the work
  • Access Accessibility: Often shapes the work
  • AI AI governance: Often shapes the work

What is shifting

The buyer reads the fine print first, and judges the claim last.

Cover is compared on screens, sold through marketplaces and tested at the hospital desk. Each shift names what it demands, with a fact you can check.

A smiling family of three sits close together on a sofa at home
Buyers choose cover for the people beside them.
  1. Buyers compare cover online before they speak to an agent.

    What it requiresCover, exclusions and waiting periods compared in plain language before the proposal form.

    EvidenceIRDAI’s 2024 regulations require a Customer Information Sheet with every policy, written in simple words.

  2. Customers judge an insurer by its claims.

    What it requiresClaims journeys that show status, documents needed and time left.

    EvidenceIRDAI’s May 2024 health master circular sets one hour for cashless decisions and three hours for discharge.

  3. Insurance is getting a shared online marketplace.

    What it requiresProducts, documents and service ready for the marketplace as well as your own channels.

    EvidenceIRDAI notified the Bima Sugam insurance electronic marketplace regulations on 20 March 2024.

  4. AI enters underwriting, pricing and claims triage.

    What it requiresModels that are explainable, tested for bias and overseen by people.

    EvidenceThe EU AI Act classes AI used for risk assessment and pricing in life and health insurance as high-risk.

The rulebook

Every screen is a disclosure, every claim has a clock.

IRDAI’s policyholder-protection framework and master circulars, the payment rules, the data law and the cyber guidelines, read for a typical programme. Your compliance team keeps sign-off.

Frameworks we build to

  • DPDP Act 2023 — Digital Personal Data Protection Act, 2023
  • PCI DSS v4.0.1 — Payment Card Industry Data Security Standard
  • ISO/IEC 27001:2022 — Information security management systems
  • CERT-In Directions 2022 — Cyber incident reporting directions
  • EU AI Act — Artificial Intelligence Act (EU) 2024/1689
  • WCAG 2.2 AA — Web Content Accessibility Guidelines

We design and build to these frameworks; this is not a claim of certification.

Advertising & claims

Often shapes the work

  1. Insurance Regulatory and Development Authority of India

    IRDAI rules on insurance advertising

    Insurance advertising must be fair, not misleading and consistent with the policy it describes. The 2021 advertisement regulations were folded into the 2024 framework and its master circulars.

    We designEvery claim in an advertisement or explainer is checked against the policy wording and the CIS before it runs.

    IRDAI · 2024 policyholder-protection framework

Sector regulator

Shapes most of the work

  1. Insurance Regulatory and Development Authority of India

    IRDAI policyholder-protection regulations, 2024

    Every policy comes with a Customer Information Sheet explaining benefits and exclusions in simple words. Life and individual health policies of a year or more get a 30-day free-look period, with refunds within seven days.

    We designThe CIS is a designed screen, shown before purchase and kept with the policy.

    IRDAI policyholder-protection regulations, 2024 (in force 1 April 2024) · master circular of 5 September 2024

  2. Insurance Regulatory and Development Authority of India

    IRDAI master circular on health insurance, 2024

    Cashless authorisation is decided within one hour of the request, and final discharge authorisation within three hours. The insurer bears the cost of any further delay.

    We designClaim screens show the hospital and the policyholder each decision and its deadline.

    IRDAI · Master Circular on Health Insurance Business, 29 May 2024

  3. Insurance Regulatory and Development Authority of India

    IRDAI Bima Sugam regulations, 2024

    An insurance electronic marketplace where consumers can buy, service and claim across insurers, free of charge to them.

    We designProduct data and service journeys are built to run through the marketplace and your own channels.

    IRDAI (Bima Sugam – Insurance Electronic Marketplace) Regulations, 20 March 2024

Payments

Often shapes the work

  1. Reserve Bank of India

    RBI e-mandate framework for recurring payments

    Premiums of up to ₹1 lakh can be collected by e-mandate without an extra authentication step. Customers are notified before and after each debit and can opt out easily.

    We designRenewal journeys set up the mandate once and show every upcoming debit before it happens.

    RBI · e-mandate framework; limit raised to ₹1 lakh for insurance premiums, December 2023

Personal data

Shapes most of the work

  1. Ministry of Electronics and IT

    DPDP Act, 2023 and DPDP Rules, 2025

    Health and claims information is collected with consent for each purpose, and withdrawing consent must be as easy as giving it. Breaches are reported to the Data Protection Board.

    We designProposal and claim forms ask only for what each step needs, and consent is logged per purpose.

    DPDP Act, 2023 · DPDP Rules, 2025 (core obligations from 13 May 2027) Official text: DPDP Act, 2023 and DPDP Rules, 2025

Security & incidents

Shapes most of the work

  1. Insurance Regulatory and Development Authority of India

    IRDAI Information and Cyber Security Guidelines, 2023

    Insurers and intermediaries report cyber incidents to CERT-In within six hours, copying IRDAI. They keep ICT logs for 180 days and run regular audits.

    We designPolicyholder portals go live with logging, monitoring and an incident response plan that meets the six-hour deadline.

    IRDAI · Information and Cyber Security Guidelines, 24 April 2023

AI governance

Often shapes the work

  1. European Union

    EU AI Act

    AI used for risk assessment and pricing of individuals in life and health insurance is high-risk (Annex III, 5(c)). For insurers serving EU residents, its obligations apply from 2 December 2027 under the Digital Omnibus.

    We designPricing and underwriting models get documentation, bias testing and human oversight from the first release.

    Regulation (EU) 2024/1689 · Annex III Official text: EU AI Act

Compiled 3 October 2026. Our reading of typical programmes, not legal advice. Rules change; your counsel confirms how each one applies to you.

Challenges

Where insurance loses customers and time.

What comes up first in most insurance conversations, from customer-facing screens to internal operations.

Your customers

  1. Understanding the cover

    Exclusions, waiting periods and sub-limits explained before purchase.

  2. A claim without chasing

    Status, documents and decisions visible at every step.

  3. Renewal without surprises

    Premium changes and portability options explained before renewal.

A person signs one of several printed forms spread across a dark table
Every claim still ends in documents someone has to read.

Your operation

  1. Disclosure on every screen

    Each journey must show what the regulations require, in the order they require it.

  2. Selling through intermediaries

    Agents, banks, brokers and aggregators each describe the same policy differently.

  3. Fraud versus friction

    Checks that catch fraud without making honest claimants wait.

What we build

The disciplines behind a typical insurance programme.

A typical programme here uses each discipline in this mix. Each line says what it builds for the industry and links to the capability behind it.

Leads Core Supports Share of a typical programme, by role · illustrative
  1. Claims and servicing platforms, integration with core systems and audit-ready security.

  2. Buying, renewal and claims journeys with the policyholder disclosures designed in.

  3. 03

    Brand Design

    Core

    Plain-language policy information and one brand across agents, banks and apps.

  4. 04

    AI Design

    Core

    Policyholder and adjuster assistants, tested on your examples, with human approval.

  5. Renewal, cross-sell and service messaging on one consented customer record.

  6. Explainers and campaigns checked against the policy wording.

Programmes

Audit the journey first, then rebuild the claim.

The way in walks every buying and claims journey against the 2024 regulations and ranks the fixes by drop-off and by risk. Lengths are typical, never promised.

The way in

Buying and claims journey audit

We check every buying and claims journey against IRDAI’s 2024 rules and rank the fixes by drop-off and risk.

Package
Sprint · Fixed fee
Typical length
2–3 weeks
It sets
Time from claim to settlement, as a baseline
  • Product experience audit
  • Technical & code audit

What you get

  • A disclosure-gap register against the 2024 regulations
  • A fix list ranked by drop-off and by risk
  • A claim-status design that removes the need to call
Start here
  1. 02Milestone · 4–9 months

    Claims experience rebuild

    Claim intimation, documents, decisions and settlement redesigned as one visible journey, integrated with your claims systems.

    MeasureTime from claim to settlement

    Services: Complete UX & UI design · Custom CRM or operations platform · System integration

    Enquire about Claims experience rebuild
  2. 03Project · 6–10 weeks

    Policy information in plain language

    The CIS, product pages and renewal notices rewritten so buyers understand the cover before they pay.

    MeasureFree-look cancellations

    Services: UX writing & content design · Verbal identity & tone of voice

    Enquire about Policy information in plain language
  3. 04Project · 8–12 weeks

    Policyholder and adjuster assistant

    An assistant that answers only from your policy wordings, with an evaluation set and automatic checks.

    MeasureClaims complete at first submission

    Services: AI knowledge assistant · AI assistant experience design

    Enquire about Policyholder and adjuster assistant

How success is measured

Main measureTime from claim to settlement

  • Time from claim to settlement
  • Quote-to-policy conversion
  • Free-look cancellations
  • Complaints per 10,000 policies

AI, under the rules

AI gathers and summarises, a person decides every claim.

Each use case has an owner, an evaluation set and a log; no model accepts or rejects a claim.

Use case 01

Claims document assistant

Measured byClaims complete at first submission

Tested forOWASP LLM01 · Prompt injection

agent / claims-document-assistant Guarded
  1. TaskTells a claimant which documents the claim needs and checks uploads for completeness.
  2. CheckNever decides admissibility; anything unclear goes to an adjuster.
  3. ApproverAn adjuster decides every claim.
  4. LogDocuments requested, checks run and hand-offs.

Goes live only with its evaluation set, automatic checks and a named owner

Use case 02

Policy-wording assistant

Measured byAnswer accuracy on an agreed evaluation set

Tested forOWASP LLM09 · Misinformation

agent / policy-wording-assistant Guarded
  1. TaskAnswers questions about a policy from its own wording and CIS.
  2. CheckCites the clause it relies on and never promises cover.
  3. ApproverThe service team reviews flagged answers every day.
  4. LogQuestion, clause cited and answer.

Goes live only with its evaluation set, automatic checks and a named owner

Use case 03

Adjuster file summary

Measured byTime to first decision

Tested forOWASP LLM02 · Sensitive information disclosure

agent / adjuster-file-summary Guarded
  1. TaskSummarises a claim file for the adjuster, with the timeline and what is missing.
  2. CheckEvery line links to its source document, and it never recommends rejection.
  3. ApproverThe adjuster reads the file and decides.
  4. LogThe summary and its sources.

Goes live only with its evaluation set, automatic checks and a named owner

Work and insights

Case studies stay private until a client approves them.

No insurance client is named or described without written approval. Here is what we have written that bears on the industry.

A typical programme · composite

A health insurer redesigned its cashless claims journey around the one-hour and three-hour deadlines, so hospitals and policyholders see each decision as it is made.

Anonymised and illustrative: the shape a programme takes, never a named client.

Questions

What product, claims and compliance leads ask us first.

Something else on your mind? Ask us directly

Q.01Do you work with intermediaries as well as insurers?

Yes: brokers, corporate agents, web aggregators and insurtechs, alongside insurers. Each gets journeys built to the rules that apply to it.

Q.02Can you build our claims platform?

Yes. We design and build claims journeys and the platforms behind them, integrated with your policy administration and core systems.

Q.03How do you keep marketing consistent with the policy?

We check every claim in an advertisement or explainer against the policy wording and the CIS before it runs.

Q.04Will AI decide claims?

No. AI collects, checks and summarises; a person decides every claim and every rejection.

Tell us what you need built.

You will speak to a lead who would run the work, and get a straight answer on fit.

Book a call

Three ways to start

  1. 01About 2 minutes

    A quick question

    You get A reply from a named lead

  2. 02About 8 minutesRecommended

    A project brief

    You get Options and a first scope after one call

  3. 03About 15 minutes

    A formal RFQ or RFP

    You get Receipt confirmed and a named bid lead

Every engagement starts with a written scope and a quote agreed before work begins. How each package is priced