Sub-verticals
Four calling-side shapes; one shared platform.
Underwriting
AI-assisted risk assessment and premium calculation. The agent assesses and calculates; the underwriter issues, declines, or refers. The calling system classifies a policy against the operator's own sum-insured threshold and submits the matching action; a policy submitted as above-threshold is gated behind underwriter approval, alongside decline and referral.
Action classes
Human-approval gating
policy.above_threshold, policy.declined, and underwriter.referred are gated behind underwriter approval; policy.issued (within threshold), risk.assessed, and premium.calculated are recorded for supervisory review.
Primary regulators (maps to)
- EIOPA AI guidance
- FCA Consumer Duty (retail insurance)
- FCA SM&CR
- GDPR Articles 22 and 9
Claims handling
Claim intake, validity assessment, and fraud flagging. The agent assesses and flags; the claims handler authorises payment, denies a claim, or resolves an appeal. The calling system classifies a payment against the operator's own threshold and submits the matching action; a payment submitted as above-threshold is gated behind a claims-handler approval.
Action classes
Human-approval gating
payment.above_threshold, claim.denied, and customer.appeal_outcome are gated behind claims-handler approval; payment.authorised (within threshold), claim.validity_checked, and fraud_flag.raised are recorded for supervisory review.
Primary regulators (maps to)
- FCA Insurance Conduct of Business sourcebook (ICOBS)
- Lloyd's market bulletins on AI
- NAIC AI Model Bulletin
Fraud detection
Multi-policy correlation, network-pattern detection, and customer flagging. This sub-vertical cross-links to the financial-services fraud-monitoring pack where an operator runs both. Customer-impacting actions stay behind a human investigator.
Action classes
Human-approval gating
customer.flagged and case.opened are recorded for investigator review; any customer-impacting action stays behind a human investigator. See the financial-services fraud-monitoring pack for the shared pattern.
Primary regulators (maps to)
- Insurance Fraud Bureau guidance
- FCA Financial Crime Guide
- GDPR (cross-policy correlation)
Distribution and broker-facing AI
Quote generation and recommendation delivery for broker-facing flows. The agent generates and recommends; the broker reviews anything client-facing.
Action classes
Human-approval gating
recommendation.delivered is gated behind broker review for any client-facing recommendation; quote.generated is recorded for supervisory review.
Primary regulators (maps to)
- FCA SM&CR
- FCA Insurance Conduct of Business sourcebook (ICOBS)
- Broker professional indemnity
Adapter coverage
Upstream services Vortalis adapts for this sector.
- Salesforce Financial Services CloudShipping
vortalis_proxy/services/salesforce.py
Salesforce adapter as code. Counterparty certification with the operator's Salesforce org and the carrier systems behind it is the operator's responsibility.
Honest limits
What this sector pack does not do.
Vortalis does not underwrite or bind policy; it governs the AI agent's action.
The platform records what the agent priced, what the policy decided, and what the underwriter approved. The actual binding on the policy administration system and the actual payment instruction happen in the operator's existing infrastructure. Vortalis records the decision and the upstream outcome; it does not underwrite, bind, or pay.
Counterparty certification with each carrier system is the operator's responsibility.
Vortalis ships the Salesforce adapter as code, not as a counterparty-certified production integration. Production certification with each carrier system, claims platform, and payment service sits with the operator. The adapter provides a starting shape; conformance against each counterparty's certification programme is the operator's track.
Fraud-pattern detection accuracy depends on the policy and claim data the operator connects.
The platform governs the agent's fraud-detection actions and records them on the audit chain. The accuracy of any multi-policy correlation or network-pattern detection depends entirely on the completeness and quality of the policy and claim data the operator connects. Vortalis does not warrant detection accuracy; it records what the agent decided and why.
Reinsurance and treaty arrangements remain outside the platform.
The platform governs the primary-insurance agent's actions. Reinsurance placement, treaty arrangements, and the ceding calculations behind them are outside the platform's scope. Vortalis does not model treaty terms or govern reinsurance actions.
The general-purpose honest limits sit at /product/security-architecture; this list is specific to the insurance pack.
Sample scenarios for illustration
How operators put the pack to work.
These are illustrative deployments, not customer references. No named customer testimonials appear here, because the first external engagements are still landing. Each scenario describes a plausible shape of a Vortalis deployment in this sector.
Illustration 1
A UK insurer deploying an underwriting agent on a Salesforce Financial Services Cloud org, governing EIOPA AI guidance and the FCA Consumer Duty through Vortalis. The agent assesses risk against a tokenised view of applicant data, and policy issuance stays behind the underwriter's approval, producing a signed audit trail a supervisor can verify offline.
Illustration 2
A claims operation running a validity-assessment and fraud-flagging agent, governing the FCA ICOBS and the NAIC AI Model Bulletin through Vortalis. The calling system classifies a payment against the operator's own threshold; a payment submitted as above-threshold is gated behind a claims-handler approval, and every fraud_flag.raised action is recorded for supervisory review.
Illustration 3
A broker deploying a quote-and-recommendation agent for client-facing distribution, governing FCA SM&CR and broker professional-indemnity obligations through Vortalis. Every recommendation.delivered action stays behind broker review, and the attribution chain records which authorised person approved it.
Evidence-pack preview
Signed. Offline-verifiable.
A sample EIOPA AI guidance and FCA Consumer Duty evidence pack, showing the structure of a signed, offline-verifiable pack. Signed. Offline-verifiable.
Download the sample insurance evidence pack (PDF)Sample artefact. This is a placeholder evidence pack for layout and review; a real signed, offline-verifiable pack replaces it before launch.
Bring Vortalis to your insurance agents.
Pick the sub-vertical above. Read the integration brief if you would rather start with the engineering detail. Talk to us first if you would rather start with a conversation about your threat model.