AI for insurance: use cases

01What the industry requires

Three conditions for being able to operate.

Policy payments, claims reports and request follow-up with information that comes only from authorized sources.

Condition

Authorized sources

Coverages, premiums and deadlines only from the insurer's system.
Condition

Complete requests

Claims reports and complaints with all their mandatory data, within the procedure's deadline.
Condition

A human touch when it matters

Escalation to a person in cases of distress or bereavement.

02Use cases

Who acts, under which rules and what gets recorded.

The actions come from the proposed initial Abbi Actions catalog; each implementation confirms which ones are enabled.

Insurance

Policy payments, claims reports and request follow-up with information that comes only from authorized sources.

Marco Each country's data protection law and industry regulation apply, reviewed before every production deployment.

Abbie

Policy payment and renewal

Situation

A policyholder needs to pay or renew their policy and wants to do it on the contact channel they already use.

How it is resolved

Abbie verifies identity and checks the policy status in the insurer's system.
She reports only what the current source says.
She generates the payment link or sends the renewal document.

Abbi Actions: Verify identity · Generate payment link · Send document
Controls: Does not make up coverages, premiums or deadlines · Escalates to a person when the case requires it · Coverage decisions belong to the institution; Abbie informs, records and escalates
Verifiable outcome: The payment or the delivery is recorded with its reference.

Abbie

Reporting and following up on a claim

Situation

A policyholder reports an event or asks about the status of an open claim.

How it is resolved

Abbie records the report with the data the process needs.
She creates the ticket and provides the tracking number.
In later inquiries, she reports the status from the system, not from her memory.

Abbi Actions: Create ticket · Schedule appointment
Controls: Minimal data · Escalation in cases of distress or bereavement · Coverage decisions belong to the institution; Abbie informs, records and escalates
Verifiable outcome: Every report has a ticket and its tracking number.

Caddie

Formal complaint with mandatory requirements

Situation

A complaint must be recorded with all its data and within the deadline set by the procedure.

How it is resolved

Caddie shows the human agent the mandatory data for the complaint.
He alerts when information is missing and blocks incomplete records.
At closing, he leaves the quality evaluation of the interaction for human review.

Abbi Actions: Create ticket · Send document
Controls: Incomplete records blocked · Quality evaluation checked against human review · Coverage decisions belong to the institution; Abbie informs, records and escalates
Verifiable outcome: No complaint is recorded without its mandatory data.

Illustrative examples, not existing deployments. The actions, channels and systems in each case depend on the implementation.

03Agentic use cases

Abbie converses and executes the action in your systems.

End-to-end processes from the agentic use case catalog, with the conversation, each action and the system where it is recorded. Illustrative conversations, not existing deployments; actions, channels and systems depend on each implementation.

Case 01

Policy sales and issuance

Sales
See the process →
Case 02

Automatic policy renewal

Retention
See the process →
Case 06

Emergency and assistance service

Emergencies
See the process →
Case 11

Claim report (first notice of loss)

Claims
See the process →
Case 18

Procedures and case-number follow-up

Service
See the process →
Case 20

Follow-up on quotes and carts

Sales
See the process →
Catalog

The 20 cases

Sales, collections, support, emergencies, logistics, appointments and more.
See the 20 cases →

Illustrative conversations, not existing deployments; actions, channels and systems depend on each implementation.

Case 01Sales

Policy sales and issuance

Applies to Insurance · Assistance services · Extended warranties

Illustrative conversation

ClientI want to insure my car, how much will it cost?
AbbieWith your model and ZIP code, comprehensive coverage comes to $8,450 a year. Shall I issue it?
ClientYes, I'll pay by card.
AbbieDone: I've sent the contract for signature and the payment link to your email.

Abbie does not change rates or coverages: she uses the current ones.

What Abbie executes

Step	Action	System	Outcome
1	Verifies the customer's identity	CRM	Customer verified
2	Quotes with the current rate	Policy system	Quote with reference number
3	Sends contract for electronic signature	Electronic signature	Contract signed
4	Collects the first premium	Payment gateway	Payment confirmed
5	Issues the policy	Policy system	Policy active
6	Sends policy and receipt by email	Email	Delivered to the customer

Before, without an agent

An advisor quotes; the policy arrives days later
Printed or scanned contract
The payment is reconciled by hand

6 actionsin 5 systems, executed and recorded by Abbie in a single contact [flujo]

3.5×hours of coverage: 168 h/week compared with 48 h for an 8 × 6 shift [calculation]

$8.01 → $0.10USD per contact: agent-assisted compared with self-service [2]

See the case in the catalog →

Case 02Retention

Automatic policy renewal

Applies to Insurance · Memberships · Subscriptions

Illustrative conversation

AbbieHi, I'm Abbie, an AI assistant. Your policy expires on the 30th. Shall we renew it with the same coverage?
ClientYes, but I want to change the payment method.
AbbieDone. Automatic charge to your card ending in 4417. I'm sending you the renewed policy.

Always introduces herself as AI; the customer can ask for a person.

What Abbie executes

Step	Action	System	Outcome
1	Detects policies about to expire	Policy system	List of the day
2	Contacts by voice, WhatsApp or SMS	Messaging	Customer contacted
3	Updates payment method	Payment gateway	Automatic payment active
4	Sends endorsement for signature	Electronic signature	Endorsement signed
5	Renews and issues	Policy system	Policy renewed
6	Sends documents	Email	Delivered

Before, without an agent

Renewal depends on the customer calling
Policies expire without contact
Payment changes by form

6 actionsin 5 systems, executed and recorded by Abbie in a single contact [flujo]

2.15×service minutes per position compared with a human agent [1]

−62 %cost per service minute compared with a human agent [1]

See the case in the catalog →

Case 06Emergencies

Emergency and assistance service

Applies to Roadside assistance · Home · Insurance · Services

Illustrative conversation

ClientI got a flat tire on the highway.
AbbieAre you in a safe place? I'm locating your position and your assistance coverage.
AbbieTow truck assigned. It arrives in 35 minutes; I've sent you the license plate and tracking by SMS.

When there is a risk to life or health, she immediately transfers to a person or to emergency services.

What Abbie executes

Step	Action	System	Outcome
1	Classifies the urgency	Triage rules	Life-threatening risk → 911 / person
2	Validates the coverage	Policy system	Coverage in force
3	Locates the customer	Geolocation	Location confirmed
4	Dispatches the provider	Provider network	Service assigned
5	Shares the arrival time	SMS	ETA sent
6	Opens the file	Assistance system	Reference number recorded

Before, without an agent

Waiting on hold at the critical moment
Dispatch to providers by phone
No tracking for the customer

6 actionsin 6 systems, executed and recorded by Abbie in a single contact [flujo]

3.5×hours of coverage: 168 h/week compared with 48 h for an 8 × 6 shift [calculation]

2.15×service minutes per position compared with a human agent [1]

See the case in the catalog →

Case 11Claims

Claim report (first notice of loss)

Applies to Auto insurance · Home · Medical expenses

Illustrative conversation

ClientSomeone crashed into me, what do I do?
AbbieIs anyone injured? If not, take photos of the damage and upload them here.
AbbieClaim opened. I assigned an adjuster and scheduled the inspection; I've sent you the reference number.

Coverage and payment decisions belong to the insurer.

What Abbie executes

Step	Action	System	Outcome
1	Asks about injuries	Triage rules	Injuries → person
2	Validates policy and coverage	Policy system	Coverage in force
3	Receives photos and data	Digital file	Evidence saved
4	Opens the claim	Claims system	Claim reference number
5	Assigns an adjuster	Claims system	Adjuster assigned
6	Schedules the inspection	Scheduling	Appointment confirmed

Before, without an agent

Long call to capture data
Photos by email or on site
Manual adjuster assignment

6 actionsin 5 systems, executed and recorded by Abbie in a single contact [flujo]

3.5×hours of coverage: 168 h/week compared with 48 h for an 8 × 6 shift [calculation]

2.15×service minutes per position compared with a human agent [1]

See the case in the catalog →

Case 18Service

Procedures and case-number follow-up

Applies to Government · Universities · Notaries · Insurers

Illustrative conversation

ClientHow is my request 2026-4471 going?
AbbieIt is in document review; your proof of address is missing.
ClientI'll send it to you.
AbbieReceived and attached to your case number. I'll let you know when it moves forward.

Current official information only; always identifies herself as AI.

What Abbie executes

Step	Action	System	Outcome
1	Verifies the applicant's identity	Registry / CRM	Applicant verified
2	Checks the case status	Procedures system	Current status
3	Receives missing documents	Digital file	Document attached
4	Schedules an appointment if required	Scheduling	Appointment confirmed
5	Notifies every status change	SMS / email	Citizen notified
6	Records the interaction	Procedures system	Interaction audited

Before, without an agent

A line or a call to find out the status
Documents delivered at the counter
No notice of changes

6 actionsin 5 systems, executed and recorded by Abbie in a single contact [flujo]

80 %of common cases resolved without human intervention (2029 projection) [3]

$8.01 → $0.10USD per contact: agent-assisted compared with self-service [2]

See the case in the catalog →

Case 20Sales

Follow-up on quotes and carts

Applies to E-commerce · Insurance · Dealers · Automotive

Illustrative conversation

AbbieI'm Abbie, an AI assistant. You left a quote for medical expenses insurance unfinished. Can I help you complete it?
ClientI had questions about the deductible.
AbbieThe deductible is $15,000 under your plan. Here is the link to purchase at the same price.

Only contacts people who gave consent and during permitted hours.

What Abbie executes

Step	Action	System	Outcome
1	Detects open quotes	CRM / e-commerce	Prioritized list
2	Contacts with consent	Messaging / voice	Customer contacted
3	Answers questions with approved sources	Approved documents	Question answered
4	Sends purchase link	Payment gateway	Link sent
5	Confirms the payment	Payment gateway	Sale closed
6	Updates the opportunity	CRM	Opportunity won

Before, without an agent

Quotes no one follows up on
Salespeople with no time for follow-up
Questions unanswered after hours

6 actionsin 5 systems, executed and recorded by Abbie in a single contact [flujo]

3.5×hours of coverage: 168 h/week compared with 48 h for an 8 × 6 shift [calculation]

−62 %cost per service minute compared with a human agent [1]

See the case in the catalog →

04Compliance by design

Standards we follow for your industry.

We don't adapt to regulation afterwards; we build from it. We design the solution following these models and reference frameworks.

Insurance industry: Each country's industry regulations, reviewed before every production deployment.
Payments: PCI DSS requirements for handling payment data.
AI management and risk: ISO/IEC 42001 and the NIST AI Risk Management Framework, with the EU AI Act as a reference.
Personal data protection: GDPR (European Union), LFPDPPP (Mexico), LGPD (Brazil), Law 1581 (Colombia), Law 81 (Panama) and the equivalent regulations of each country where we operate.

We follow these standards in building our products and services. When a client requires it, we make the corresponding documentation available.

05Which offer fits

Start with one process, grow with data.

Product A

Abbie

Talks with your customers and acts in your systems, within her mandate.
Meet Abbie →
Product B

Caddie

Guides the human agent and blocks critical steps. The human agent decides.
Meet Caddie →
Product C

Abbi Actions

Operations with a verifiable outcome and an audit log.
Explore the actions →
Service F

Process consulting

Diagnosis and a design ready to implement in your operations.
Let's design the process →

Illustrative cases, not existing deployments.

AI that is accountable, in insurance.

Three conditions for being able to operate.

Authorized sources

Complete requests

A human touch when it matters

Who acts, under which rules and what gets recorded.

Insurance

Policy payment and renewal

Reporting and following up on a claim

Formal complaint with mandatory requirements

Abbie converses and executes the action in your systems.

Policy sales and issuance

Automatic policy renewal

Emergency and assistance service

Claim report (first notice of loss)

Procedures and case-number follow-up

Follow-up on quotes and carts

The 20 cases

Policy sales and issuance

Automatic policy renewal

Emergency and assistance service

Claim report (first notice of loss)

Procedures and case-number follow-up

Follow-up on quotes and carts

Standards we follow for your industry.

Start with one process, grow with data.

Abbie

Caddie

Abbi Actions

Process consulting

Tell us which process you want to improve.