Sec 01 · OverviewManaged AI Agent Operations · Insurance
Your insurance AI agents,
run like production systems.
Nestack Agent Care operates the AI agents behind your service and distribution, underwriting, claims, and risk and compliance. We watch every run, from first notice of loss to adjudication support, so an unfair claim decision or a missed sanctions hit is caught before it becomes an unfair, non-compliant, or costly outcome.
- Failure modes catalogued
- 214
- Agent playbooks
- 21
- Enterprise critical SLA
- 30 min
- Continuous agent operations
- 24/7
PlaybooksSection 02
Pick your agent
Choose from 21 insurance agent playbooks to see what each agent does, where it can fail, and how we keep it reliable, compliant, secure, and production-ready.
Score a new claim for severity and complexity, assemble the coverage position and the evidence behind it, and place it with an adjuster licensed and authorised for that claim — who decides.
Open Claims triage & adjudication-support agents7 failure modes
Pull the third-party and internal data an underwriting file needs, reconcile what the sources disagree about, and show every field's origin — the underwriter decides, on evidence that can be cited.
Open Underwriting data-gathering agents7 failure modes
Screen parties against sanctions, PEP and adverse-media sources at onboarding and again before payment, match names and assemble the evidence — an analyst decides, and nothing about a hit reaches the customer.
Open KYC / AML screening assistants7 failure modes
Read the policy as it actually stands — forms, endorsements and effective dates — then draft the answer, the change or the document for the service representative, who confirms anything touching cover.
Open Policy-servicing copilots7 failure modes
Contact policyholders in premium arrears on the script, the cadence and the hours a person set, offer only a pre-approved payment plan, and stop dead on any vulnerability, dispute or cease-contact signal.
Open Collections & negotiation agents7 failure modes
Surface the indicators on a claim or application, link the claims, parties and providers behind them, and hand an SIU investigator an evidence pack — the referral is theirs, and the clock keeps running.
Open Fraud-review assistants7 failure modes
Take first notice of loss on any channel, match it to the policy in force at the date of loss, capture the facts and route it — and state no coverage position.
Open FNOL-intake & routing agents7 failure modes
Pay a narrow, pre-authorised band of low-value claims automatically once every coverage, quantum and screening check clears — the path only ever pays, and everything else goes to a licensed adjuster.
Open Straight-through claims-settlement agents7 failure modes
Read the claim file for recovery potential, name the responsible third party, check the bars and date the limitation period — a recovery handler decides whether to pursue, and the agent demands nothing.
Open Subrogation-identification agents7 failure modes
Read the broker's submission and its attachments, clear it against what you already hold, and triage it against your written appetite — an underwriter decides whether to quote or decline.
Open Submission-intake & appetite-triage agents7 failure modes
Compare the expiring policy with the renewal, or the issued policy with what was quoted, and report every difference with the wording behind it — a broker decides what it means.
Open Renewal-comparison & policy-checking copilots7 failure modes
Match every carrier commission statement line to what the contract says was due, name the shortfalls, overpayments and missing statements, and package the difference — a person approves every adjustment.
Open Commission-reconciliation agents7 failure modes
Suggest the next procedural step on an open claim — the document to request, the deadline approaching — never a value, an offer, a reserve or a denial, which stay the adjuster's.
Open Claims-guidance & next-best-action copilots7 failure modes
Order the evidence a case needs, summarise the medical record with every finding tied to its page, apply the carrier's accelerated-underwriting rules, and hand the underwriter a file they can decide on and explain.
Open Life & annuity underwriting agents7 failure modes
Take the enrolment and eligibility position, intake the disability claim, open the correct regulatory clock, assemble the medical and vocational evidence, and draft the determination and its notice for a qualified reviewer to decide.
Open Group-benefits & disability-claims agents7 failure modes
Keep the AI-systems inventory current — built and bought — hold the governance record each state expects, track when testing is due, and assemble the evidence pack an examiner asks for.
Open AI-governance & market-conduct agents7 failure modes
Assemble the filing and its exhibits against each state's checklist, keep the filing calendar and effective dates straight, draft objection responses with their support attached, and hold every filing for the actuary who signs.
Open Rate-filing & SERFF workflow agents7 failure modes
Read each outside-counsel invoice against the litigation guidelines for that matter, flag entries that don't match, track spend against reserve, and hold every adjustment for the litigation manager who decides.
Open Legal-bill review & litigation-spend agents7 failure modes
Collect the payroll and sales records an audit needs, reconcile them against what was estimated, apply the governing bureau's classification rules, compute the developed exposure and hold the workpaper for the auditor who concludes.
Open Premium-audit agents (WC & GL exposure)7 failure modes
Verify licence status and lines of authority against the source of record, keep appointments and terminations current in every state, track renewals and CE before they lapse, and prepare filings the licensing officer submits.
Open Producer-licensing & appointments agents7 failure modes
Compare the in-force file against the DMF, work each match into evidence, run the good-faith beneficiary search on a confirmed death, track the dormancy clock by state, and prepare the escheat report.
Open Death-claims, DMF & unclaimed-property agents7 failure modes
Regulatory map
The rules your insurance agents answer to
Every failure mode in the Insurance playbook is mapped to the rule it could breach. These are the 16 regulatory areas we watch, each with its citation.
- 01Unfair claims settlement (US)NAIC Model 900 §4 · Cal. Ins. Code §790.03(h) · 10 CCR §2695.79 failure modes
- 02Unfair discrimination & AI useNAIC AI Model Bulletin (2023) · NY DFS Circular Letter No. 7 (2024) · C.R.S. §10-3-1104.99 failure modes
- 03Health, disability & benefit determinations42 CFR §§422.101(c)(1)(i), 422.566(d) · Cal. Health & Safety Code §1367.01(k) · 29 CFR §2560.503-19 failure modes
- 04AI-system & model-risk governanceNAIC AI Model Bulletin (4 Dec 2023) · Federal Reserve SR 11-79 failure modes
- 05Sanctions & AML screeningOFAC Compliance Commitments Framework · 31 CFR §1010.230 · 31 CFR §1025.320(e)9 failure modes
- 06Misrepresentation & unfair trade practicesNAIC Model 880 §4A(1) · Cal. Ins. Code §790.03 · Tex. Ins. Code §1811.0519 failure modes
Sec 03 · Procedures
Onboard → Observe → Respond → Improve → Verify
We instrument your agents, watch them around the clock, turn incidents into fixes, verify that improvements hold, and deliver a monthly audit-ready scorecard your board or regulator can read.
When an agent misbehaves, nobody improvises — the crew flies the procedure.
Agent incident response
Applies: SEV-1 / SEV-2 / SEV-3
DetectEP-1
An alert, failed evaluation, guardrail event or human reviewer identifies a risky session. The case is acknowledged according to the applicable response target.
ContainEP-2Memory item
For a SEV-1 incident, pause the affected workflow, restrict the risky tool or move the agent into an agreed safe mode before full diagnosis. Containment authority is established during onboarding.
DiagnoseEP-3
Correlate the goal, retrieval, plan, workflow, task, tool, LLM, evaluation and guardrail records; identify the affected slice, classify the failure mode, and locate the earliest critical decision that caused the issue.
RemediateEP-4
Apply the relevant runbook and correct the affected prompt, workflow, tool configuration, data source or guardrail. Link the change to the originating evidence and verify the affected slice through targeted output, step or trajectory evaluations before restoring autonomy.
NotifyEP-5
Notify the client according to the agreed communication target. SEV-1 updates include affected agents, impacted sessions, containment status, probable source and next action.
LearnEP-6
Complete the post-incident review within five business days. Close the incident only after the failure mode, corrective action and verification evidence are recorded, and the relevant evaluation case, guardrail or runbook has been updated.
Nestack Agent Care contains the immediate risk, identifies the failed operational layer, verifies the corrective action, and converts the incident into reusable evidence for future monitoring and evaluation.
AI Agent Care pricing, made simple
Per agent. Per month. Pay only for the AI agents actively running in production.
Agent Care
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