LEGATE: insurance claims, resolved end to end — and fully governed.
A team of AI agents that reads, reasons, decides, and acts on a claim — with every decision logged, grounded, and replayable under the CAIRO Protocol. Billed on resolved outcomes, not seats.
What LEGATE is built to deliver.
Figures from the validated LEGATE demonstration. Production outcomes are tuned to each carrier's policies, quality bar, and the jointly-agreed definition of "resolved".
Claims operations are expensive, slow to scale, and hard to prove.
Carriers carry the cost of large claims teams, struggle to flex when volume spikes after a catastrophe, and face mounting pressure to show — to auditors and regulators — that every automated decision was fair, grounded, and on-policy.
The traditional answer is a BPO: more seats, offshore, billed by headcount. It scales cost linearly and gives you little provenance. The opportunity is to deliver the same outcome — resolved claims at low cost and elastic scale — as governed software with people on the exceptions.
Real LEGATE command center · demonstration data — live throughput, cost per resolution, and spend displaced
One governed agent loop, per claim.
Each claim runs through a disciplined sequence of specialised agents. Governance isn't bolted on at the end — it sits inside every step, and any uncertainty routes to a human.
Intake
Ingest the claim and attachments from the system of record; validate and open a trace.
Retrieve
Semantic retrieval over the carrier's policy and SOP corpus, capturing the exact sections cited.
Reason & decide
A structured, validated determination — approve, deny, request info, or route to human — with rationale and confidence.
Govern
Deterministic guardrails check authority limits, grounding, confidence, fraud and PII. Anything uncertain goes to a person.
Act & record
Write the determination back to the system of record, draft the customer letter, and finalise an append-only, fully-mapped audit record.
Resolution and governance, in one platform.
Specialised agent team
Intake, Policy-Retrieval, Adjudicator, AXON Guardrail and Letter-Writer — each a discrete, governable role.
CAIRO Protocol governance
Every decision logged with sources, scores, rationale and guardrail results — the same governance family as AXON.
Guardrails + human-in-the-loop
Configurable per-carrier thresholds; low confidence, weak grounding, fraud or PII flags route to a reviewer with full context.
Forensic replay
Reconstruct any historical decision deterministically from the immutable, append-only store.
Evidence Pack export
One-click, tamper-evident record mapped to framework citations — for auditors, regulators and SLA disputes.
Outcome metering
Billing-grade counts tied to a jointly-agreed definition of "resolved" — pay per problem solved, not per seat.
Real LEGATE governance view · demonstration data — compliance posture, provenance, and the live action stream
Every decision logged, mapped, and audit-ready.
LEGATE runs on the CAIRO Protocol: full provenance on every determination — retrieve, reason, decide, closure — mapped to the EU AI Act, NIST AI RMF and ISO/IEC 42001.
The audit store is append-only and consistent; guardrail intercepts and human-oversight rates are tracked live; and any historical claim can be replayed exactly as it was decided. It's the difference between claiming your AI behaves and being able to prove it.
- Multi-framework compliance mapping
- Append-only, tamper-evident audit records
- Live guardrail and oversight monitoring
- One-click Evidence Pack for auditors
Run a claims operation — or another high-volume, regulated workflow?
LEGATE is our agentic claims platform, but the pattern — governed agents resolving work end to end — extends to healthcare RCM, BFSI back-office, and beyond. Tell us your workflow.