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Versicherungen, eine Branche, in der Altuon arbeitet

A policy is a promise. Systems keep it.

An insurer sells a document and delivers, years later, a phone call at the worst moment of someone's life. Between the two sit a policy administration core older than most of its operators, a claims process the supervisor reads line by line, and a distribution channel that renews or lapses on the strength of a single conversation. Altuon builds for the moment the promise is tested.

Hands interacting with an illuminated glass surface.

Worum es geht

The regulation follows the policyholder, not the insurer's convenience. In Switzerland, FINMA supervises insurers under the insurance supervision regime and expects every outsourcing arrangement to leave the institution in control of the function it has delegated, with the supervisor's access preserved. In the European Union, Solvency II governs the system of governance, the internal models and the outsourcing of critical functions, and DORA adds operational resilience and third-party risk as supervised duties. In Jordan, the insurance supervisor within the Central Bank oversees conduct, solvency and the arrangements an insurer makes with third parties. In the United States, insurance is regulated state by state, and state insurance regulators' guidance on the use of AI by insurers asks for a written programme covering governance, risk management, testing and the documentation of any model that touches underwriting, pricing or claims. The revised Swiss FADP and the GDPR decide what may be done with policyholder data, and health and claims data sit in their most protected categories.

The cycle is measured in decades and the cores prove it. A policy written thirty years ago is still in force, still accruing, still paying out, and the product rules that govern it live in a system that nobody would build today and nobody may switch off. Every migration has to carry the whole back book, product by product, with the actuaries checking that reserves reconcile and the distribution channel unaware that anything moved. Renewal season does not pause for a cut-over. A modernisation that treats the legacy core as an obstacle rather than as the record of every promise the company has made ends as a reconciliation exercise that runs for years.

The buyer is a committee with a dissenting member. The chief operating officer wants claims triaged in hours rather than days and first notice of loss taken around the clock in the caller's language. The chief actuary and the chief risk officer want to know which model influenced which underwriting decision, on what evidence, and how it would be explained to a policyholder who was declined. Distribution wants renewals answered without a queue and brokers served without a script. Compliance wants the promotion approved before the campaign runs and the outsourcing register complete before the contract is signed. The proposal that satisfies the operator and alarms the actuary does not proceed.

Failure arrives as a complaint before it arrives as a finding. A claims model that quietly treats two similar losses differently, a voice line that promises cover the policy does not provide, a migration that mis-prices a tranche of renewals, an advertisement that states a benefit the supervisor has not seen: each is an ombudsman case, then a supervisory letter, then a headline about an insurer that did not pay. The work has to be designed so that every failure mode is a handover to a claims handler, a blocked release or a rehearsed rollback, and never a policyholder holding a promise the company cannot keep.

Relevante Practices

Regionale Hinweise

Europa und DACH
Swiss and German insurers buy continuity and discretion. Policyholder data stays in Switzerland or the European Union unless a written reason says otherwise; every outsourcing arrangement is mapped to FINMA's expectations or to Solvency II and DORA before it is signed, and the supervisor's access is preserved in the contract. The voice line answers in Swiss German and Hochdeutsch, French and Italian as working languages, and the claims handler who takes the handover reads a record in the same language the caller spoke.
Naher Osten und Nordafrika
Insurers in Jordan and the Gulf are growing under supervisors who expect sovereignty and under policyholders who expect to be answered in their own dialect. Data is held in-country, models work in Arabic as well as English, and the insurance supervisor's expectations on outsourcing and conduct shape the architecture from the first design review. The relationship with the company's leadership is part of the mandate, and Altuon is present in the room rather than on a call.
Nordamerika
US carriers buy velocity under regulators who examine rather than assume. State insurance regulators' guidance on the use of AI asks for a written programme, tested models and documentation an examiner can read; state privacy laws and the insurance-specific data security requirements decide how policyholder data may be used in service and in marketing; and advertising rules differ from one state to the next. The work has to move at the pace of a competitive market and leave a documentary trail that keeps up with it.

Tätigkeitsregionen

Europa und DACH

Sitz

Turin, Italien

Repräsentatives Engagement

Fragen, die uns gestellt werden

Where does policyholder and claims data live, and can it stay in our own data centre?

Where your supervisor and your data protection officer can see it. The data plane is decided per system in the Define phase and recorded in the architecture register: a Swiss region, the European Union, an in-country facility in Jordan or the Gulf, a US region, or your own premises. Speech, language and extraction models run inside that plane; the control plane holds policy, identity and metrics but never policyholder or claims data. Health and claims data are treated as the most protected category under the revised Swiss FADP and the GDPR, and the proposal states which model options fit an on-premises footprint so the residency commitment is costed rather than assumed.

How do you govern a model that influences underwriting or claims decisions?

Every model has a named owner, a documented purpose and risk class, an evaluation set built from the insurer's own cases and scored by its underwriters and adjusters, a monitored baseline and a rollback version. The register records which decisions the model may influence, which it may not touch, and where a person must decide. It is written in the form state insurance regulators' guidance on the use of AI, FINMA's expectations and a Solvency II validation function work from, so the same document serves the actuarial function, the risk committee and the examiner. Where the insurer already has a model-risk framework, the register is mapped to it rather than duplicated beside it.

What may a voice agent do with a claim, and what may it never do?

It may identify the caller to the level the policy requires, take first notice of loss in the structure the claims system expects, answer questions about cover from the policy wording, arrange the next step and hand the call to a claims handler with everything captured. It may not decide liability, quantum or coverage, and it may not describe cover the wording does not contain. Those limits are enforced outside the language model: the model proposes, a policy engine decides what may be executed, and anything beyond written authority becomes a handover with full context. Adversarial testing for social engineering over voice is part of every release gate.

How do you migrate a policy administration core without stopping renewals or unsettling the actuaries?

One product line at a time, behind a compatibility layer, with the old and the new system running together through at least one renewal cycle before the old one is retired. Reserves, premiums and claims are reconciled before and after each tranche, and the reconciliation is signed by the actuarial function rather than by the engineering team. The rollback is rehearsed against production volumes before the first tranche moves. The distribution channel sees the same policy numbers, the same documents and the same renewal dates throughout, and the supervisor sees a change record that matches what happened.

How does the engagement fit into our outsourcing register, and who are your sub-processors?

The obligation register written in the Discover phase lists every requirement the arrangement touches: the insurer's right to audit, the supervisor's access, the location of data, business continuity and exit, and the full sub-processor chain. The proposal names every third party that could touch policyholder data, by role and location, each approved by the insurer before use, with changes notified in advance and a right to object. For a fully on-premises or Swiss-sovereign deployment the list can be reduced to Altuon itself. The agreement carries the terms the insurer needs to include Altuon in its own outsourcing register under FINMA's expectations, Solvency II and DORA.

Who owns what is built, and what happens if we end the engagement or a key person leaves?

The insurer owns the deliverables, the models trained on its data, the evaluation sets and the documentation, and the assignment is written into the agreement rather than promised in a meeting. Exit terms are negotiated at the start: notice periods, the handover of code, data and registers in usable form, and a transition period in which Altuon assists whoever takes over. Every engagement has a named lead and a named deputy, and the registers are kept so that the work is legible to someone who was not present when it was done. That is a supervisory expectation as much as a courtesy, and the insurer should test it before signing.

Bring us the claim that would be hardest to explain.

Whether it is a claims line, an underwriting model, a core migration or a renewal campaign, the Discover phase begins with the promises you have made to policyholders and the obligations you carry to your supervisor, and ends with a register you can put in front of your risk committee. Request a proposal, or book a briefing for the executives who will be asked to sign.