Cygnet

Home insurance claims · Claims officer: Priya Raman

Reset demo

This is the system Cygnet Insurance uses to pay out home insurance claims. Priya reads each claim and decides whether to pay it.

She also has an AI assistant. It can look at a claim, pay it, refuse it, or ask the customer for more paperwork — and it can do all of that on its own.

Priya is allowed to pay a claim up to $5,000 by herself. Anything bigger is supposed to be checked by someone else first.

$5,000.00 Most Priya can pay on her own

There are 42 claims waiting, worth $75,421.31 altogether. The assistant has not touched any of them yet, and 1 is too big for Priya to pay on her own (over $5,000.00).

All names, claims and references below are made up

Claims

The one claim that is too big for Priya to approve is shown first. The approved rule holds the assistant to Priya's limit it.

$12,840.00 Sofia Lindgren Subsidence Too big for Priya to approve clm_0007 not looked at yet
$481.11 Marguerite Arden Storm damage clm_0001 not looked at yet
$1,108.46 Chidi Okwu Accidental damage clm_0002 not looked at yet
$415.00 Halina Wróblewska Accidental damage clm_0003 not looked at yet
$1,612.28 Rémy Battiste Subsidence clm_0004 not looked at yet
$824.45 Tomas Iversen Fire clm_0005 not looked at yet
$456.56 Ngozi Adeyemi Escape of water clm_0006 not looked at yet
$845.88 Dev Ramachandran Accidental damage clm_0008 not looked at yet
$1,610.57 Beatriz Salgado Theft clm_0009 not looked at yet
$181.40 Yusuf Demirel Subsidence clm_0010 not looked at yet
$2,193.77 Fiona Kavanagh Fire clm_0011 not looked at yet
$1,114.88 Kenji Watanabe Escape of water clm_0012 not looked at yet
$603.63 Amara Bello Storm damage clm_0013 not looked at yet
$623.18 Lucas Ferreira Accidental damage clm_0014 not looked at yet
$1,210.65 Ingrid Halvorsen Theft clm_0015 not looked at yet
$2,112.68 Omar Haddad Subsidence clm_0016 not looked at yet
$257.63 Bronwyn Teague Fire clm_0017 not looked at yet
$2,775.26 Mateo Guzmán Escape of water clm_0018 not looked at yet
$1,405.31 Anneke Visser Storm damage clm_0019 not looked at yet
$750.70 Rajiv Menon Accidental damage clm_0020 not looked at yet
$842.77 Clara Mbeki Theft clm_0021 not looked at yet
$1,575.42 Stefan Novak Subsidence clm_0022 not looked at yet
$2,614.79 Leilani Fetu Fire clm_0023 not looked at yet
$333.86 Hugo Marchetti Escape of water clm_0024 not looked at yet
$3,356.75 Zainab Farouk Storm damage clm_0025 not looked at yet
$1,695.74 Peter Ashcombe Accidental damage clm_0026 not looked at yet
$897.77 Mei-Ling Chow Theft clm_0027 not looked at yet
$1,062.36 Diarmuid Nolan Subsidence clm_0028 not looked at yet
$1,940.19 Talia Ben-Ari Fire clm_0029 not looked at yet
$3,116.90 Kwame Asante Escape of water clm_0030 not looked at yet
$410.09 Rosalind Petch Storm damage clm_0031 not looked at yet
$3,938.24 Andrei Lupu Accidental damage clm_0032 not looked at yet
$1,986.17 Sanne de Vries Theft clm_0033 not looked at yet
$1,044.84 Emeka Nwosu Subsidence clm_0034 not looked at yet
$1,281.95 Carys Llewellyn Fire clm_0035 not looked at yet
$2,304.96 Juan Pablo Reyes Escape of water clm_0036 not looked at yet
$3,619.01 Astrid Kallio Storm damage clm_0037 not looked at yet
$486.32 Nadia Rahimi Accidental damage clm_0038 not looked at yet
$4,519.73 Callum Struan Theft clm_0039 not looked at yet
$2,276.60 Wanjiru Kamau Subsidence clm_0040 not looked at yet
$1,191.91 Elias Thornbury Fire clm_0041 not looked at yet
$1,501.54 Isabela Cardoso Escape of water clm_0042 not looked at yet

Trying out a new rule first

Done

Before letting the rule stop anything, the approved rule was run over all 42 claims already on file. 1 would be held for a second approver, and not one of them was settled, paid or refused to find that out. That is the question every rollout asks first — “what does this do to last month?” — and it now has an answer.

  1. 1You have past claims to test against
  2. 2Run the new rule over them
  3. 3Look at what it would have done
  4. 4Switch the rule on for real

What the assistant has done

The assistant has not done anything yet. Ask it something to see what happens.

Each row is one thing the assistant did, and the reason it gave. Which rule allowed it is now recorded in Safety checks, alongside the signed policy version it came from.

Safety checks enforcing Open ›

Safety checks

Loaded
Is anything checking the assistant? Yes

Every action is checked against the approved rules before it happens, and if a rule says no, it does not happen.

Where the check happens Gateway::execute → /app/rails/bundle

Everything the assistant does — every claim it looks at, pays or refuses — passes through this one piece of code. 0 actions gone through it so far. The check was added in this one place, and it covers everything.

The three answers, filled in
  • decisionblank
  • reason_codeblank
  • rule_idblank

Every action already comes back with room for three answers: was it allowed, why, and under which rule.

Three ways this can work
  • Nothing is checkedavailable The assistant does whatever it decides to do.
  • Checked, but nothing is stoppedavailable Every action is checked against the rules and the answer written down, but the assistant still goes ahead. This is how you find out what a rule would do before you trust it.
  • Checked, and stoppednow Every action is checked against the rules, and if a rule says no, it does not happen.
Decisions made

The rules are loaded and nothing has been put to them yet. Ask the assistant to settle a claim.

Assistant azure · gpt-4o

Ask it to look at a claim, pay one, or refuse one. It will do whatever you ask, to any claim, without checking with anybody.