For Insurance

Health Auto-Decisioning with ERIC.

Grounded to Your Policy, Correlated Across Medical and Lifestyle Risk, Decisioned the Way Your Best Underwriter Would. Every Time. At Machine Speed.

ERIC
Health Insurance Underwriter
AI Coworker
01 For health carriers Every minute matters

For Global Health Carriers Who Care

Health underwriting is where every minute matters. A family waiting for coverage, a patient beginning treatment or a newborn added to a manual.

1 in 5 Americans face agonizing delays or coverage gridlock for critical, doctor-recommended proactive care (Commonwealth Fund). 41% of those delays lead to a direct, documented decline in patient health outcomes, turning manageable conditions into acute medical crises.

When complex medical histories fall out of standard automation pipelines, backlogs surge. ERIC solves the gridlock.

Millions of Medical Data Points
Interpreted against underwriting guidelines.
Data Privacy
Patient healthcare records and protected health information (PHI) remain fully fortified, processed entirely inside your cloud environment.
02 An empathetic coworker While you protect lives

An Empathetic Coworker That Protects Every Decision. While You Protect Lives!

When unexpected health events strike, families need answers, not delays. ERIC changes the speed of health risk assessment entirely, delivering Zero-Touch processing for even the most intricate non-STP cases, eliminating human decision fatigue. By automating the clinical data crunch, your team can focus on life where it matters most, providing high-empathy human care and specialized support when policyholders need it most. By leveraging advanced agentic AI, ERIC decides complex medical files autonomously, transparently, and instantly.

Manual-Grounded Reasoning
Instantly parses complex ICD-10/ICD-11 diagnostic codes, multi-system chronic conditions, and prescription timelines against your exact underwriting manuals.
Frictionless Co-Pilot
ERIC steps in the moment a case requires deep contextual synthesis, operating seamlessly alongside your clinical teams without requiring a system rip-and-replace.
03 Medical intake to provable decision The journey of a patient file

The Journey of a Patient File

The case arrives as a dense, unstructured medical history. It leaves as a highly compliant, defensible decision, cited line by line - all thanks to ERIC!

Intake and Submission

The case enters the system, and ERIC auto-sorts it!

  • Intelligent Document Handling
  • Document and Quality Assessment
  • Data Extraction
  • Document Classification
  • Document Tagging
  • Corrections
  • Data Validation and Verification
  • Cross-validation across documents
  • Pending Requirement Handling
Verification

Every health fact is grounded against your manual and third-party clinical and identity sources.

  • Verification and Validation
    • Documents and Processes
    • External Integrations
    • KYC Services
  • Third-party Sources
    • Negative News Search
  • Internal Integrations
    • Workflows, Journeys
Underwriting

Decision made. Cited in your UW manual. Logged. Fully replayable.

  • Underwriting Worksheet
  • Automated Decisioning
    • Risk Assessment and Correlation
    • Medical Risk
    • Lifestyle Risk
  • Fraud Detection
    • Document Fraud
  • Pending Requirement
    • Requirement Handling
  • Referral

ERIC decisions the Non-STP cases too. Autonomously, against your health manual, risk rules, and compliance frameworks.

04 Compliant by design Glass-box clarity

Glass-box Clarity for Clinical Integrity and Defensible Decisions

When ERIC approves a diabetic applicant with loading, every line is citable.

That loading wasn’t applied because an algorithm said so. It was applied because ERIC read your UW manual, correlated the HbA1c level against your retained limits, and cited the exact section it acted on. Your underwriter can read it. Your regulator can audit it. The applicant’s broker can query it.

01
Auditable
Every ERIC decision ships with a full audit trail. The decision lineage is the artifact, not a report scrambled together when a regulator asks.
02
Zero bias
In health underwriting, consistency is efficiency + equity. The same application yields the same answer every single time, regardless of when it arrives or who reviews it.
03
Hard grounded
Grounded to your manual and your data. No fabrication or drift. When health is what’s at stake, ERIC doesn’t guess.
For global health carriers

Make Someone’s Access to Medical Attention a Priority

When a case involves a highly complex, interwoven trauma (like a patient balancing severe Type 1 Diabetes compounded by an acute accidental spinal injury and complex rehabilitation needs), your senior underwriters finally have the time they need to review it with deep empathy, clinical nuance, and meticulous care coordination.

Book a 45-minute briefing. Let us show you how ERIC handles end-to-end Health Insurance Underwriting inside your own secure cloud landscape.