Lesson 25 / 26
Case Study: An Insurer's First 12 Months
Plan an AI programme for a mid-sized insurer, from use-case selection to governance and reporting.
A phased plan
Months 1-2 (strategy): leaders choose goals (faster claims, lower support cost). A scoring model ranks ideas: claims-document summarisation and support reply drafting rank high; automatic claim rejection ranks low because it is high-impact on customers. Months 2-4 (foundations): AI policy, risk tiers, inventory, a small review board, approved tools, staff training. Months 4-8 (pilots): two assisted (human-reviewed) pilots with baselines, evaluation sets including Hindi and English slices, PII masking, impact assessments and vendor questionnaires. Months 8-12 (scale and assure): dashboards, quarterly reviews, an incident drill, a regulation tracker, and decisions on build versus buy using three-year TCO. Automatic rejection is deliberately left as "not now" until fairness, appeal routes and regulation are clear.
From strategy to accountable practice
A complete programme links value, ethics, risk, governance and monitoring into one routine.
The programme on one page
Each line maps to a section of this course.
Strategy goals -> use cases -> scoring -> readiness (Sec 1)
Business case ROI/NPV, build vs buy TCO, roles, training (Sec 2)
Ethics principles as questions, stakeholders, fairness slices (Sec 3)
Risk register, tiers, impact assessments (Sec 4)
Governance policy, board, inventory + gates, vendors, evidence (Sec 5)
Regulation tracker, NIST AI RMF mapping, control matrix (Sec 6)
Operations incident runbook + drill, balanced KPIs, quarterly review (Sec 7)Say "not yet" with reasons
Good governance includes the discipline to defer a risky idea and record why, what would need to change, and when to revisit. That is a decision, not a failure.
Quick check: Why was automatic claim rejection ranked low in the case study?
- It is too cheap
- Insurance cannot use AI
- It has high impact on customers and needs fairness and appeal safeguards first
- Scoring models ignore risk
Answer
It has high impact on customers and needs fairness and appeal safeguards first — High-impact decisions about people need stronger safeguards before automation.