Model Bulletin on the Use of Artificial Intelligence Systems by Insurers
The model bulletin reminds insurers that AI-supported consumer decisions remain subject to applicable insurance law and describes governance and documentation regulators may request.
What the authority record establishes
The model bulletin reminds insurers that AI-supported consumer decisions remain subject to applicable insurance law and describes governance and documentation regulators may request.
Expectations depend on jurisdictional adoption and applicable insurance law
The exact official title, issuing body, jurisdiction, version or application record, and linked source define the scope of this page. Readers should not transfer the authority's status to a commercial product or infer transaction-, patient-, system-, site-, or organization-specific applicability from this summary.
Why it matters to this market
Underwriting, pricing, claims, fraud, and service technology buyers need inventories, purpose, data, controls, testing, monitoring, third-party oversight, consumer-impact review, and decision records.
Affected operating stages
- Inventory
- Governance
- Data
- Testing
- Monitoring
- Third Parties
- Consumer Decisions
- Documentation
Capabilities to examine
Rating Rules And Premium Calculation
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for rating rules and premium calculation.
Underwriting Intake Triage And Workbench
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for underwriting intake triage and workbench.
Claim Segmentation Assignment And Triage
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for claim segmentation assignment and triage.
Fraud Risk Investigation And Referral Support
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for fraud risk investigation and referral support.
Insurance Data Model Quality And Governance
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for insurance data model quality and governance.
Identity Security Privacy And Operational Controls
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for identity security privacy and operational controls.
Machine-Assisted Extraction Prediction Or Decision Support
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for machine-assisted extraction prediction or decision support.
Audit Trail Reason Code And Decision Reconstruction
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for audit trail reason code and decision reconstruction.
Affected buyer audiences
- AI governance
- claims
- underwriting
- actuarial
- market conduct
- legal
Implementation questions
- Which entities, products, populations, transactions, systems, sites, or jurisdictions are actually within scope?
- What is binding, what is guidance, and what is a technical or consensus standard?
- Which publication, adoption, effective, application, transition, and enforcement dates differ?
- Who owns legal, clinical, quality, regulatory, policy, or operational interpretation?
- How will a source revision affect open work and historical decisions?
Interpretation boundary
The model bulletin is not a universal rule, does not approve a model or product, and does not establish fairness, accuracy, or compliance.