KAiM Insurance Claim Triage Home · Use cases · Insurance Claim Triage
Status: Live evaluation engine · Demo Data seeded claim · No backend; runs in browser
Flagship use case · 01 of 05 · Insurance · Guided walkthrough

Insurance claim triage under HELM governance

An AI claims assistant has reviewed a single claim and proposes a high-blast-radius 3-action bundle. This page is a guided demo: pick a persona, review the case, submit the AI's proposal to HELM, see the deterministic decision, then take the next-step action that belongs to your role.

How this walkthrough works

Four steps. Each persona sees the same case differently and takes different next-step actions. Try at least two personas to feel the architecture.

1

Pick a persona

Five roles in the same insurance organization. Each has different authority, different views, and different next steps.

2

Review the case

Same claim packet for everyone — but the framing card shows how your role reads the situation.

3

Submit to HELM

The deterministic gate evaluates 6 checks. The eval is the same regardless of persona — HELM is not opinion-based.

4

Take your action

After the decision, your persona panel on the right shows what you can actually do next. The interactive ones expand inline.

Acting asclick a tile to switch role
1 · Persona 2 · Case 3 · HELM 4 · Action
Pick a persona, then review the case below.
Step 3. Hand the AI's bundled proposal to HELM. The eval is identical regardless of which persona you're viewing as — HELM is deterministic.
HELM· Deterministic Evaluation · 6 checks Evaluating…
What's being evaluated: the AI agent's authority to execute this specific 3-action bundle against this specific case, against policy + evidence + harm + regulatory + sacred-line constraints. Result is the same for every persona — what changes is what each persona can do with the decision.
HELM intervention · System worked as designed

No customer-facing action executed

5 of 6 gates triggered. No autonomous denial reached the customer. No regulatory violation incurred. 2 human reviewers assigned. Evidence packet generated. Decision signed and chained.

Per-action disposition

Escalation routing

Evidence packet generated

🔒 Audit Evidence Chain Entry Signed · Immutable
Decision logged. · Switch personas above to see the same decision from another role; their available actions differ.

This is the wedge. Bring us your workflow.

The way KAiM engages is concrete: pick one high-risk AI-assisted workflow you're worried about — claim triage, code review, public claims, refunds, vendor onboarding, something else. We map it to actor / action / authority / policy / evidence / escalation, then show how HELM gates it. No deck. No demo theater. A working session.