EIP has launched Virtual TPAi, an AI-driven platform that automates insurance claims processing and decision-making. The system pairs a voice-led AI agent with an existing rules engine, aiming to improve operational efficiency while maintaining regulatory compliance in the insurance sector.
Voice-led automation and operational efficiency
The platform handles up to 20 concurrent conversations around the clock. This capability reduces insurers' reliance on traditional third-party administrators and call center operations. The AI agent conducts human-like conversations, answers policy-related queries, and submits claims on behalf of customers in multiple languages.
Information collected during these interactions passes to the company's rules engine, where the system assesses claims decisions against insurer-defined criteria. This architecture supports AI for Customer Support by reflecting communication channels that customers already use, according to EIP's product leadership.
David Michell Dawson, Director of Product at EIP, said, "What we were building had to be at least as good as, if not better, than the best customer experience already available today. It needed to reflect the communication channels that customers are comfortable with, which heavily influenced our decision to invest significantly more time and money in the complex process of making the Virtual TPAi voice led."
Rules engine and regulatory compliance
Unlike probabilistic AI models, EIP's rules engine provides transparency, auditability, and human oversight. Insurers configure the engine using predefined rules aligned with policy terms. This setup enables the system to approve claims automatically or refer them to human claims handlers for further review.
The platform's human-in-the-loop approach and auditable decision-making process are designed to support compliance requirements, including those introduced under the EU AI Act. This framework allows organizations to adopt AI for Insurance safely within heavily regulated environments.
Ross Sinclair, Chief Executive Officer of EIP, said, "We have developed Virtual TPAi to help insurers and retailers benefit from AI-driven efficiencies while maintaining compliance in a regulated environment. The automation has enabled human agents to focus on more complex claims that require specialist attention. The growth opportunity has been significant because we have addressed the challenge of deploying AI within a regulated framework. We have continued to support the insurance industry's adoption of AI in a responsible and human-led way."
Why this matters for insurance professionals
Insurance professionals must balance the push for operational efficiency with strict regulatory mandates. Virtual TPAi offers a blueprint for automating routine claims and customer queries without sacrificing auditability. Teams can use this model to evaluate how deterministic rules engines, rather than black-box models, might integrate into their own claims workflows to meet compliance standards.
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