AI and automation for financial service providers and insurers

Questions and answers

What can AI do for an insurer or financial service provider?

Datawonder uses AI for the groundwork that is now done by hand: taking and entering claims, answering policy questions with a reference to the terms, checking submitted documents and compiling reports from your source systems. The decision stays with a person. What the system did can be traced in a log.

Can AI take and enter a claim?

Yes. A voice agent or a smart form asks the questions that belong to a claim, follows up when something is missing and delivers the claim complete into your system. Missing documents are requested automatically. Whether a loss is covered is assessed by a staff member: AI does the intake and data entry, not the decision.

Can AI answer customers' policy questions?

Yes, with a reference to the terms the answer comes from. Datawonder builds assistants that take their answers from your own policy terms and documents and name the source, so a staff member or customer can check what it says. A ruling on a specific claim or on coverage is not part of that. That stays with a staff member.

How do I automate the submission of documents by clients?

With a chain that sends reminders, checks incoming documents and requests missing documents by itself. Datawonder builds such a chain with n8n, for example, and connects it to your mailbox, portal or case management system, if that has an API. That way your team does not have to chase documents itself at every deadline.

Can software recognise fraud before the money is gone?

Software can recognise patterns that point to fraud and warn before a payment goes out. Datawonder has built an anti-fraud application for this, as its own work and not commissioned. It shows how such a check works. For your organisation it is tuned to your own processes and data.

Is AI in insurance or lending high risk under the EU AI Act?

Sometimes, yes. AI that assesses the creditworthiness of individuals or sets risks and premiums for life and health insurance counts as high risk. AI that only detects fraud does not. For high-risk systems the obligations apply from 2 December 2027. Datawonder determines per system which category it falls into and what then needs to be arranged.

Does DORA apply to my organisation or software?

DORA has applied since 17 January 2025 to financial institutions such as banks, insurers and investment firms, and it also sets requirements for their ICT service providers. If you supply software to such an institution, you often deal with it through contract requirements. Datawonder uses the applicability scan for European software regulation to work out whether and how DORA applies to you.

How does AI stay verifiable for an accountant or regulator?

By recording what the system did. Everything Datawonder builds leaves a trail: who did something, when and on the basis of which source. Answers from an AI assistant come with source references and decisions stay with a staff member. That way you can explain afterwards how an outcome came about.

Further reading