AI and privilege after United States v. Heppner: what legal teams should know. Read the analysis →
Industries · 08 · Insurance

A claim file holds medical, financial, and investigative data. Then it meets a chatbot.

Adjusters summarize claims. Underwriters assess applications. Special investigations analyze suspicious files. All with AI, all on policyholder and claimant data — and every AI-assisted decision is one a regulator may ask to see. Privilege AI governs AI use across underwriting and claims, with traceability of approvals, exceptions, and sensitive processing.

Data at riskPolicyholder · claimant · investigation · medical & financial docs
ObligationsPrivacy · insurance regulation · AI decision traceability
BuyersCISO · Chief Compliance Officer · Chief Claims Officer
Governed by01 Privilege AI · 02 Watch · 03 Agent
Who buys, and why

Three offices, three reasons.

CISOFinds unsafe AI processing across underwriting and claims.

Prevents leakage of policyholder, claimant, and sensitive investigation data. Enforces security and external-service controls to identify unsafe AI processing across underwriting and claims teams.

03 Agent · 02 Watch
Chief Compliance OfficerKeeps traceability of approvals and exceptions.

Reduces improper use of claimant information and AI decision-related exposure. Supports privacy and insurance regulation while maintaining traceability of approvals, exceptions, and sensitive data processing.

02 Watch · ledger
Chief Claims OfficerAccelerates claims analysis with fewer handling errors.

Protects claim records and confidential medical or financial documentation. Ensures approved AI use in claims workflows to accelerate analysis while reducing information-handling errors.

01 Privilege AI
Threat vectors

Where it happens in a carrier.

Claims · AdjusterSummarizes claim files and drafts determinations with AI.Claimant medical and financial documentation is processed by an unapproved assistant. High risk of privacy complaints, regulatory findings, and AI decision-related exposure.Sponsor: Chief Claims Officer · Decides: CISO / CIO
Underwriting · UnderwriterAssesses applications and risk submissions with AI.Policyholder data and broker submissions are pasted into a consumer AI tool. High risk of unauthorized processing and inconsistent, untraceable decisions.Sponsor: Chief Underwriting Officer · Decides: CISO / CCO
Special Investigations · SIU AnalystAnalyzes suspicious claims and investigation files with AI.Sensitive investigation data and allegations are sent to unapproved AI. Very high risk of litigation complications and confidentiality claims.Sponsor: Head of SIU + GC · Decides: CISO with GC
United States v. Heppner · AI & legal privilege

Distinguish routine claims work from legal advice.

Coverage disputes and anticipated litigation may require counsel-directed analysis, while ordinary claims handling serves a different purpose. Heppner reinforces the value of documenting why AI is being used, who directs it, and how information is handled. Keep the legal purpose clear and have counsel assess protection under the applicable law.

The platform, applied

Approved AI in the claims workflow, with the trail regulators expect.

01 · Privilege AIEvery AI-assisted decision, on the record.

Claims and underwriting work on your own keys, inside matters with retention; every answer records its model, citations, and who was present. Counsel in the session for disputed claims. 0 matters trained on.

Privilege AI
02 · Privilege WatchApprovals, exceptions, sensitive processing.

Detections across Claude, ChatGPT, and the Agent, with the traceability the Chief Compliance Officer maintains for examiners.

Privilege Watch
03 · Privilege AI AgentUnsafe AI processing, identified on the device.

Claimant and policyholder data leaving the workstation for external services, detected across 120+ categories and alerted to the CISO and compliance.

Privilege AI Agent
Insurance regulationPrivacyAI decision traceabilitySOC 2 · ISO 27001