Sold by: Kriv AI
Kriv AI delivers a 4-week fixed-fee Insurance Claims AI Assessment across Azure, AWS, and GCP. Tri-cloud claims data-flow mapping, model inventory, fair-by-design preliminary disparate-impact review, and gap analysis against the NAIC Model Bulletin on AI (Dec 2023, ~24 state adoptions), Colorado Reg 10-1-1, Colorado SB 24-205, NYDFS Insurance Circular Letter No. 7, Texas TRAIGA HB 149 (eff. Jan 1, 2026), and the NAIC AI Systems Evaluation Tool. Covers FNOL intake, claims triage, reserve-signal scoring, SIU/FWA fraud detection, adjuster-assist narrative drafting, prior-authorization, and adverse-action reasoning across P&C, health payer, life & annuity, and reinsurance. Three tiers ($25K Foundation / $40K Standard / $60K Enterprise) plus optional $10K Extra LOB Deep-Dive. Delivered by Kriv AI — AWS Select + Databricks + Anthropic CPN. Kriv holds no insurance license, performs no actuarial work, and does not provide expert-witness disparate-impact testimony.
Overview
Insurance claims AI is the single most-scrutinized AI surface in US financial services — and no other AWS Marketplace listing delivers a tri-cloud claims-specific assessment in a single SKU.
The NAIC Model Bulletin on AI (Dec 2023) has been adopted in ~24 states with claims adjudication, SIU fraud detection, and triage named as high-risk AI use cases. Colorado Reg 10-1-1 sets algorithmic-discrimination testing obligations. CO SB 24-205 imposes consumer disclosure + bias-testing + impact-assessment duties. NYDFS Circular Letter No. 7 (2024) tells carriers to document + test + govern external consumer data + AI-based underwriting and claims. Texas TRAIGA HB 149 (eff. Jan 1, 2026) layers state AI governance on top. The NAIC AI Systems Evaluation Tool is in 12-state pilot. Class-action complaints and multi-state market-conduct inquiries citing algorithmic claims denial have moved claims AI from "emerging risk" to "active enforcement surface" in 18 months.
Most carriers can't answer in one document — claims AI workloads span Azure (Guidewire ClaimCenter, Duck Creek, payer claims on Fabric + Azure OpenAI), AWS (Textract + Bedrock + SageMaker + Comprehend), and GCP (Vertex AI + Document AI + BigQuery). Big-4 advisory runs $150K–$500K over 3–6 months, single-cloud-shop. Single-cloud Marketplace listings stop at the AWS boundary. Nothing on AWS Marketplace today delivers a fixed-fee, tri-cloud, claims-specific AI assessment with fair-by-design disparate-impact review and NAIC / Colorado / NYDFS / Texas TRAIGA overlay in 4 weeks.
Methodology anchored to Kriv's 03A-Azure-Claims-Intelligence portfolio (FNOL, triage, reserve-signal, SIU, adjuster-assist, adverse-action) and 03B-AWS-Underwriting-Risk portfolio (Textract + Bedrock + SageMaker + CloudTrail), extended with AWS-native controls (Bedrock Guardrails, Textract, Comprehend, CloudTrail, Config, Security Hub, Macie, KMS, S3 Object Lock, Amazon Fraud Detector) and GCP-native controls (Vertex AI, Document AI, DLP API, Chronicle, Security Command Center, BigQuery ML lineage).
4-week structure. Week 1 — Scoping + tri-cloud claims AI inventory (FNOL / coverage / triage / severity / assignment / reserve / SIU / subrogation / litigation-likelihood / adjuster-assist / prior-auth / benefits); PHI data-flow mapping; vendor + reinsurance-AI clause review; prior-DOI / prior-class-action review under NDA. Week 2 — Control mapping per cloud + fair-by-design review (NAIC four pillars + CO Reg 10-1-1 + CO SB 24-205 + NYDFS Circular 7 + TX TRAIGA + NAIC AI Systems Evaluation Tool + NIST AI RMF; Azure + AWS + GCP service-by-service; cross-cloud identity + KMS + audit-log reconciliation; fair-by-design preliminary disparate-impact review across protected + quasi-protected classes — race, color, national origin, sex, age, disability, marital status, ZIP-code-as-proxy, credit-based scoring, language preference). Week 3 — Findings + roadmap (per cloud + cross-cloud + per LOB; Claims AI Governance Committee charter + RACI; model-risk tiering; AUP scaffolding; HITL threshold matrix; adjuster-override logging; adverse-action reasoning template; AI IR Runbook; DOI market-conduct exam readiness checklist). Week 4 — Executive readout + handover.
Three tiers. Foundation $25K (single entity; single LOB; up to 2 clouds; up to 10 use cases) — regional carriers/payers $500M–$2B. Standard $40K (up to 3 entities OR 1 entity tri-cloud; up to 3 LOBs; up to 20 use cases; full state-bulletin overlay; fair-by-design + 1 deep-dive model; 5-jurisdiction state overlay) — mid-size carriers/payers $2B–$5B. Enterprise $60K (multi-entity carrier group OR integrated health payer; full tri-cloud; up to 6 LOBs; up to 40 use cases; full framework stack; fair-by-design + 3 deep-dive models; all-adopted-states overlay; class-action-exposure signal-review memo) — large carriers, top-25 health payers, reinsurers. Optional Extra LOB Deep-Dive $10K each.
Important disclosures. AWS, Azure, GCP infrastructure billed separately. Kriv is not a carrier, reinsurer, MGA, MGU, broker, TPA, claims-handling firm, adjuster, public adjuster, appraiser, umpire, actuarial firm, or law firm; holds no insurance / adjuster / appraiser / legal license; is not a fiduciary. Kriv adjusts no claims; makes no coverage determinations. No actuarial opinion, rate filing, reserving opinion, or loss-development conclusion. Fair-by-design disparate-impact review is preliminary, non-expert, non-legal-opinion, non-actuarial-opinion, not expert-witness testimony. No NAIC / state-bulletin / NIST AI RMF certification exists. No guarantee of DOI exam, class-action, or reinsurer-diligence outcome. Customer retains all data, filings, regulator communications, and operational responsibility. Not legal, regulatory, actuarial, compliance, tax, claims-handling, coverage, or expert-witness advice.
Highlights
- 4-week tri-cloud insurance claims AI assessment — Azure + AWS + GCP — covering NAIC Model Bulletin (~24 states), CO Reg 10-1-1, CO SB 24-205, NYDFS Circular Letter 7, TX TRAIGA HB 149 (eff. Jan 1, 2026), NAIC AI Systems Evaluation Tool, NIST AI RMF. In-scope claims functions: FNOL intake, coverage verification, triage + severity, adjuster assignment, reserve-signal scoring, SIU/FWA, subrogation, litigation-likelihood, adjuster-assist, prior-auth, benefits.
- First-of-kind tri-cloud claims SKU on AWS Marketplace with fair-by-design preliminary disparate-impact review included — explicitly preliminary, non-expert, non-legal, non-actuarial, not expert-witness testimony. Covers race, color, national origin, sex, age, disability, marital status, ZIP-code-as-proxy, credit-based insurance scoring interactions, language preference. Inventory-level for Foundation; +1 deep-dive model for Standard; +3 deep-dive models for Enterprise.
- AWS Select + Databricks + Anthropic CPN — anchored to 03A-Azure-Claims-Intelligence + 03B-AWS-Underwriting-Risk portfolios. Three tiers: Foundation $25K (1 entity, 1 LOB, 2 clouds, 10 use cases) for regional carriers/payers; Standard $40K (tri-cloud, 3 LOBs, 20 use cases, 5-state overlay) for mid-size carriers/payers; Enterprise $60K (carrier group, 6 LOBs, 40 use cases, all-adopted-states overlay, class-action-exposure signal memo) for large carriers, top-25 payers, reinsurers.
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Primary contact. info@kriv.ai · +1-732-433-5564 · https://kriv.ai/support
Response SLA. First response within 2 US business days (Mon–Fri 9 am – 6 pm ET, ex-US federal holidays). Active engagements: named Engagement Lead responds within 4 business hours weekdays.
Onboarding SLA. First customer contact within 2 US business days of buyer inquiry / private-offer acceptance. Kickoff within 2–3 weeks of countersigned SOW.
Escalation. (1) Engagement Lead (named in SOW) → (2) Practice Director (info@kriv.ai ) → (3) CEO Abhinav Dangri (info@kriv.ai ).
Communication. Dedicated Microsoft Teams channel; weekly 60-min video checkpoint; Friday written status. Customer SMEs 3–5 hrs/week (Chief Claims Officer, VP Claims, Chief Actuary, Head of SIU, CIO, Chief Analytics Officer, CCO, GC, Internal Audit). Read-only IAM/RBAC into Azure + AWS + GCP.
Handoff. Word/Excel/PDF in customer secure share; tri-cloud claims data-flow map as .drawio + PNG; gap matrix as Excel; fair-by-design findings as Excel with caveat block; board pack as PowerPoint.
Out of scope. Kriv adjusts no claims, makes no coverage determinations, signs no rate filings, issues no actuarial opinions, provides no expert-witness disparate-impact testimony; fair-by-design review is preliminary signal work only.
Cloud-side billing. AWS, Azure, and GCP infrastructure (assessment tooling, log reads, Config / Security Command Center pulls, audit-log exports, sample Macie/DLP scans, SageMaker Clarify or Vertex AI fairness runs) billed by the respective cloud provider.
Holiday coverage. Closed on US federal holidays; schedule adjusted at SOW execution.