Every policy is different
A generic answer about coverage is worse than no answer. The response has to come from this customer's wording, not the brochure.
Insurance
Policy servicing that reads the actual policy
Renewals, claims status, first notice of loss and policy questions answered from your own wordings and endorsements, with citations and a gate that stops an unsupported answer.
- Retention configurable per data class
- Immutable audit with integrity proofs
- Insurance vertical pack included
Illustrative interface. Flow steps and settings are sample configuration, not a performance claim. The screen shows an OptiML flow designer canvas for first-notice-of-loss intake: the call or message arrives on voice, WhatsApp or web, the policy and cover are verified through an API node, incident details are extracted, documents are uploaded and read, and the flow branches so that injury or total-loss claims route straight to an adjuster while standard claims are created and acknowledged with a reference. Alongside it, rows show that answers are cited to the policy wording, recordings are encrypted with consent captured, and retention follows the claims data class.
The problem in your world
Insurance is the industry where a generic answer is worse than none, the volume arrives in a six-week wall, and the record of the conversation is itself a regulated artefact.
Renewal season is a wall
Volume triples for six weeks and then collapses. Staffing for the peak is expensive; staffing for the average loses the renewal.
Claims calls are emotional
The customer who just had an accident does not want a menu tree, and the interaction is remembered for years.
The claims file is a regulated record
Retention, access and jurisdiction for a claims recording are written by your regulator and audited by your reinsurer. They are not a setting your vendor gets to choose.
From renewal to first notice of loss
Six insurance workloads and the mechanism behind each.
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Policy servicing
Coverage, premium, endorsement and status questions answered from the customer's own policy documents, with the clause cited.
See knowledge & grounding -
Renewal campaigns
Multi-touch outbound across voice, WhatsApp and email with send-time optimisation, timed to lapse dates rather than to a calendar.
See outbound & dialer -
FNOL intake
Structured first-notice-of-loss capture with entity extraction, document upload, automatic claim creation and priority routing on severity.
See the flow designer -
Claims status
Self-service status checks through workflow API calls into your claims system, with proactive updates when the status changes.
See automation & workflows -
Agent and broker support
A separate agent with broker-scoped knowledge for commission, submission and underwriting queries.
See the agent builder -
Peak-season absorption
AI carries the renewal-season volume spike; humans handle exceptions and complex cases.
See workforce management
Capabilities that matter here
Six capabilities that decide whether an insurance deployment survives contact with a real claims file. All six are part of the platform.
Per-agent knowledge scoping
Each agent answers from the knowledge it is scoped to — this customer's wording, the broker library, the claims manual — and nothing else.
Agent & flow builderDocument ingestion and OCR
Policy wordings, endorsements and scanned schedules ingested, chunked, embedded and indexed, then answered with the clause cited.
Knowledge & groundingOutbound journeys
Multi-touch renewal sequences across voice, WhatsApp and email, timed to the lapse date and held to consent and calling windows.
Outbound & dialerWorkflow API nodes
Read and write the policy administration and claims systems mid-conversation, with 100+ nodes and a code node when the logic outgrows the palette.
Automation & workflowsSentiment-based escalation
A distressed claimant is escalated on sentiment, not on hold time, and reaches a human with the incident already captured.
Ticketing & casesQuality scoring
Every interaction scored on 15 dimensions, including whether the mandatory disclosure was read and the cover explained correctly.
Quality managementBring one policy wording and one hard question
We ground an agent in the document and ask it something a claims handler would have to look up. You see the clause it cited and the score it passed.
Built for the regulated record
A claims recording outlives the conversation by years. These are the controls that decide where it sits, who can read it and how long it stays.
Recordings with consent capture
Encrypted recordings with consent capture, so the claims call is evidence rather than an exposure.
Immutable audit
Immutable audit with integrity proofs, so the trail you hand the reinsurer can be shown not to have changed.
PII and PHI redaction
PII and PHI detection and redaction, applied to transcripts, logs, exports and the analytics store alike.
Retention per data class
Retention configurable per data class, so a claims recording keeps the retention the regulator wrote instead of the one the platform defaults to.
GDPR
DPDP
16+ compliance packs, including regional insurance rules
Customer-managed data residency, on Enterprise
Customer-managed data residency is an Enterprise option: your database and recording storage in your own cloud account, under keys you hold and revoke. The platform itself runs in OptiML Cloud. This option moves your data, not the software.
Who processes it in between. Model, speech-to-text and speech synthesis providers are named sub-processors. Choose which ones you use, restrict them to a region, or bring your own key and your own contract, in which case they become your sub-processors and leave our register entirely.
Availability. Customer-managed data residency is an option on the Enterprise plan, scoped per engagement. Reference architecture and shared-responsibility matrix available under NDA.
Insurance vertical pack included. The insurance vertical pack ships pre-built agents, knowledge structure, compliance templates and workflows, all activated in one click.
A worked scenario, while the case study is in approval
A motor and health insurer, renewals and claims on one line
Two agents share the platform and not the knowledge. The servicing agent is scoped to the caller's own policy documents and endorsements, so a coverage question is answered with the clause cited and the groundedness gate stops anything the wording does not support. The broker agent is scoped to the commission and submission library instead, and never sees a policyholder's file.
Renewals run as a journey rather than a blast: voice, WhatsApp and email touches timed to each lapse date, with consent and calling windows enforced by the dialer. First notice of loss runs on the flow canvas: policy verified through an API node, incident details extracted, photographs uploaded and read, injury and total-loss cases routed straight to an adjuster. Recordings are encrypted with consent captured, and retention follows the claims data class rather than a platform default. Configuration and mechanism are what this describes; outcome numbers belong to a named customer, and we do not have written approval for one yet.
- Answers scoped to this customer's wording
- Groundedness gate before the answer is spoken
- Broker knowledge kept separate from policyholder files
- Renewal touches timed to lapse dates
- FNOL captured, documented and routed on severity
- Claims retention set by data class, not by default
We publish outcome figures only with the customer's written approval, so this slot stays empty until one is signed off. In the meantime the mechanism above is the honest version.
Related solutions
Three sectors that share the same shape of problem: a document that decides the answer, and a record that outlives the conversation.
Banking & Financial Services
Self-service, compliant collections and KYC, with grounded policy answers and immutable audit behind them.
Banking & financial servicesHealthcare
Appointment scheduling, intake and triage with PHI detection and redaction across every surface that stores text.
HealthcareReal Estate
Instant enquiry response, qualification against your criteria and site visits booked while the interest is live.
Real estateYour conversation data can live in your own cloud account, under keys you hold. Enterprise plan.
The platform itself runs in OptiML Cloud. This option moves your data, not the software — and the trust centre names every row that stays with us, including PII-redacted operational telemetry and a bounded message-queue window.
The platform underneath
Everything on this page is the OptiML CX Platform configured for Insurance, not a separate product. These are the modules it leans on.
Book a working session
Ask it something only your wording answers
Bring a policy wording, a claims call recording or a renewal script from your own operation. We will ground an agent in it and run it live on the call — not a canned demo.
- 30 minutes
- A working agent grounded in your content
- No slide deck unless you want one
Book a demo
30 minutes, on your own content. No slide deck unless you want one.
or reach us directly
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