InsurTech EIP, a provider of automated insurance claims technology, has unveiled Virtual TPAi, a voice-driven AI tool designed to deliver full end-to-end automation of insurance claims processing and decision-making.
The product centres on a proprietary AI agent that takes on the role traditionally performed by a third-party administrator (TPA), handling customer-facing conversations, answering policy queries and submitting claims. The agent is capable of managing up to 20 simultaneous conversations around the clock, every day of the week, a capacity EIP says is equivalent to roughly 90 human agents, significantly cutting insurers’ dependence on and expenditure associated with TPA providers.
Once a claim is submitted through the voice agent, the information is passed to EIP’s back-end rules engine, which then issues an automated decision, either approving the claim or escalating it to a human handler for review.
The rules engine operates on approximately 80 configurable switches that insurers set themselves in line with their own policy terms, meaning decisions are grounded entirely in those defined parameters rather than probabilistic outputs.
EIP says this approach directly addresses transparency and bias concerns that have surrounded AI-driven claims decisions, offering full auditability and human governance.
EIP describes the rules engine as a well-established method of automated claims decisioning that has been operational for more than a decade. The technology has since been updated and modernised, with the new voice-led AI agent placed on the front end to complete the end-to-end automation pipeline.
The agent supports conversations in multiple languages and is designed to replicate the quality of real human interaction, with EIP stating the experience needed to match or surpass the best customer service already on the market.
EIP CEO Ross Sinclair said, “After almost a year in development, we are delighted to be launching our Virtual TPAi to support insurers and retailers to leverage the efficiencies that AI has to offer in a compliant way. The AI automation frees up human agents’ time so that they can focus on the more complex claims that require their attention.
“The growth potential is huge here because we’ve done the hard work of making sure it works in a regulated environment. We are proud to continue leading the charge on the insurance industry’s adoption of AI in a way that is responsible and human-led, and we look forward to continuing to support clients to transform their operations with our cutting-edge tools.”
EIP director of product David Michell Dawson 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. The sophisticated technology behind it makes it impossible for the AI agent to move outside the guardrails we have imposed.”
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