Insurance software from quote to claim
Claims intake, underwriting workbenches, policy administration, broker portals, embedded insurance and health claims adjudication, with the reasons for every decision on record.
What insurance software has to get right
Insurance runs on documents and judgment: broker submissions, claim forms, medical records and policy wordings. Much of the cost sits in people reading those documents and retyping them into old systems.
The builds below read the documents, check them against the policy and put the case in front of a person with the reasons laid out. The person decides, and the decision and its reasons are kept for the regulator and the customer.
Problems we are asked to fix
The problems teams bring to us, the system that fixes each one and the builds that did it.
Claims intake
First notice of loss arrives by email, phone and PDF and is retyped by staff.
Every channel lands in one claim record, with details pulled from the documents and a person behind every decision.
Underwriting workbench
Underwriters spend hours reading broker submissions before quoting.
Submissions read and summarised into the risk details, so the underwriter starts from a draft instead of a PDF.
Policy administration
Product changes take months because the policy admin system is old.
Products, rates and documents defined as configuration, so a change is a release, not a project.
Broker and agent portal
Brokers quote and track policies through emails and calls.
Quotes, applications, policy status and commission in one portal for brokers and agents.
Embedded insurance API
Partners want to sell cover at checkout but there is no API.
An API and partner console to quote, bind and service cover inside a partner's own checkout.
Health claims adjudication
Health claims are adjudicated by hand against complex benefit rules.
Benefit rules applied line by line, with an explanation on every line and a person reviewing the exceptions.
8 kinds of insurance system we have built
Each one links the product build behind it, counted from our case studies.
Insurance products we built
Gratwerk - Commercial Underwriting Workbench from Broker Submission to Quote
Designed and built a clickable underwriting workbench for a Bern-based insurer writing commercial property and liability through brokers: a submission inbox with extraction already done, an underwriter queue with the quote SLA, a submission file enriched with hazard, building and company data, and a workbench that rates the risk, checks every referral rule and shows who may quote.
Kemudi - Broker and Agent Portal for Quotes, Applications and Commission
Designed and built a clickable portal for the agents and brokers of a Malaysian insurance group with a life and a general insurer: a daily to-do list, quick quotes gated by the agent's licence, every case from quote to issued policy, application tracking through underwriting requirements, and commission statements with clawbacks shown before they happen.
Ormeggio - Policy Administration for Italian Motor and Home Insurance
Designed and built a clickable policy administration console for an Italian motor and home insurer: every policy with its versions, coverages, taxes and bonus-malus class, and an endorsement workbench that works out the pro-rata premium per coverage and checks the approver's authority before a change goes through.
Serambi - Embedded Insurance Platform for Micro-Insurance Inside Partner Checkouts
Designed an embedded insurance platform for a Jakarta insurtech broker that places device, parcel, flight delay, personal accident and driver income cover inside partner checkouts, and built its clickable ops console: partners, policy search with the customer's consent record, and a claims queue that checks authority, payee name and screening before any payout.
Qistas - Health Claims Adjudication with an Explanation on Every Line
Designed and built a clickable claims adjudication platform for a Saudi cooperative health insurer: claims arrive through NPHIES, from member reimbursements or on paper, a rules engine decides each line with a trace and a provider explanation in Arabic and English, and only uncertain lines reach a medical reviewer.
Tussock - Customer Self-Service App for Home, Contents, Car and Travel Insurance
Designed and built a clickable self-service app for a New Zealand personal lines insurer: every policy on one home screen, cover in standard or plain language, renewals that explain each reason for a price change, claims with Natural Hazards Commission steps on the timeline, and payments with failed instalments fixed in a tap.
The rules involved
The rules this kind of software usually has to follow. Guidance, not legal advice.
- 01
Conduct and claims handling
Fair treatment, clear documents and claims handled promptly, under rules such as the FCA's ICOBS and Consumer Duty in the UK.
- 02
AI in underwriting and pricing
AI used for risk assessment and pricing in life and health insurance is high-risk under the EU AI Act.
- 03
Data protection
The GDPR and local laws, with health data as a special category and rights around automated decisions.
- 04
Health insurance data
In the US, health plans are HIPAA covered entities. Health claims elsewhere often use national standards built on HL7 FHIR.
- 05
Prudential and product rules
Solvency, product approval and disclosure rules differ by country and line of business.
Framework guides
Rules our insurance builds cite most
- GDPR2
- AML Law 8/20101
- AMLA 20011
- BNM e-KYC1
- BNM Fair Treatment of Financial Consumers1
- BNM Product Transparency and Disclosure1
- Cantonal building insurance1
- CHI Unified Health Insurance Policy1
- CIDRA 20121
Two ways to work with OceanLab
Project build
We design and build the system as one project. It starts with a clickable prototype your team tries before any production code is written. Pay per milestone (outcome-based) or hourly at $30-50/hr, depending on role and seniority.
Embedded engineers
Our engineers join your team on a flexible monthly retainer. Part-time is fine and it runs month to month, with hours that overlap the US, UK and Europe, the Middle East, and Australia and Asia. Outcome-based or $30-50/hr.
Guides and tools
Insurance software questions
Can AI decide insurance claims?
In our builds, AI reads and prepares the claim, and a person makes the decision. That keeps the decision explainable, and it matters under rules on automated decisions and fair treatment.
Do you replace our policy admin system?
Sometimes. Often it is faster to build intake, a workbench or a portal on top of the existing system first, and move products over one at a time.
Which lines of business have you built for?
Our insurance builds cover motor, home, travel, health, commercial and micro-insurance across several countries. Each case study names the line and the rules it was built for.
