Point of viewAI in insurance

Fair and explainable AI in underwriting: make the reasons part of the workflow

AI can take the re-keying out of underwriting and sharpen risk selection. In regulated lines it will be judged on whether every flag and recommendation can be explained, tested for fairness and overridden by an underwriter.

6 min read By · Point of view

Key takeaways

  • The EU AI Act lists AI used for risk assessment and pricing in life and health insurance as high-risk1.
  • The quickest wins are in submission intake and guideline checks, not in automated decisions.
  • Explanations, segment tests and override logs should be produced by the workflow itself.
  • Underwriters keep authority; agents prepare the file and show their reasoning.

Underwriters spend much of their day re-keying submissions, chasing missing information and checking guidelines. AI can remove most of that. It can also influence who gets cover and at what price, which is why regulators are paying attention. The EU AI Act classifies AI systems used for risk assessment and pricing in life and health insurance as high-risk, with requirements for risk management, data governance, transparency and human oversight1.

Start where the risk is low and the time saved is high

  • Submission intake: document AI extracts the risk data and lists what is missing.
  • Guideline checks: each flag shows the rule and the evidence.
  • Referral packs: a draft recommendation with reasons for the senior underwriter.

None of these decides whether to offer cover. Each makes the underwriter faster and the decision better evidenced.

Make explanation cheap

Fairness and explainability become a drag when they are a separate review at the end. When reason codes, data lineage, segment-level outcome tests and override logs are generated as part of the workflow, they become evidence for the regulator and feedback for the model.

For executives

What this means for your bank

  1. Inventory AI used in underwriting and pricing, and classify it against applicable regulation.
  2. Prioritise intake and guideline automation over automated decisions.
  3. Log every override and test outcomes by segment.
Put it to work

How SCIKIQ can help

Underwriting & Pricing services.

Learn more

Data governance, privacy and AI governance for insurers.

Learn more

Agent governance: autonomy levels, approvals and evaluations.

See governance & controls

Sources

  1. 1

Figures are drawn from the cited public sources. Opinions labelled “SCIKIQ point of view” are our own.

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