Case Study · Healthcare & Insurance
AI-Powered Medical Underwriting: Automating Insurance Risk Assessment
01 · Client
Meet Our Client
- Client
- Confidential
- Industry
- Healthcare, Insurance
- Market
- Europe
- Technology
- LLM
02 · Challenge
Client's Challenge
Medical underwriting requires information from multiple sources: structured questionnaires, free-text declarations, supporting documents, product-specific eligibility criteria, and expert judgment.
The client needed to digitize this process without reducing complex insurance decisions to an opaque AI response. The new platform had to automate repeatable work, apply underwriting rules consistently, support multiple product variants, and preserve human control wherever a case required interpretation or further investigation.
The solution also needed to protect sensitive personal and medical information and integrate with the client's existing operational environment.
03 · Solution
Our Solution
We built a configurable underwriting platform covering the complete journey from questionnaire completion and document analysis to automated assessment and manual underwriter review.
OCR extracts content from uploaded medical documents, while focused LLM analysis evaluates documents and free-text answers against explicitly defined conditions. A deterministic decision engine combines these findings with the applicant's answers and routes each case to the appropriate outcome.
Alongside the product, we established an AI-native delivery environment in which project knowledge, engineering standards, verification commands, and quality expectations are available directly within the repository. This allowed AI-assisted development to progress through small, testable increments while remaining aligned with the architecture and business process.
04 · Benefits
Client's Benefits
The core platform progressed from initial scaffolding to a complete underwriting workflow in approximately two months. It provides a faster path for straightforward applications and a complete, consistent case view for underwriters handling more complex submissions.
Configurable questionnaires and decision rules make it easier to introduce new insurance products and update existing processes. Automated verification and explicit engineering conventions provide a maintainable foundation for continued development.
Comprehensive testing across individual components, integrations, and complete user journeys has also kept production defects close to zero.
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