Regulation map
Claims decided on time, with reasons.
IRDAI's Protection of Policyholders' Interests Regulations 2024, mapped to elan1 Decide routing and elan1 Pulse turnaround. Free to read, no form.
- Last reviewed
- Access
- Read free · no form
In short
The short answer.
What do IRDAI's policyholder protection regulations ask of AI in claims?
IRDAI's policyholder protection regulations ask for timely and reasoned claim decisions. elan1 maps them to elan1 Decide routing, so a handler confirms anything below your confidence line, and to elan1 Pulse for turnaround.
- Applies to
- Insurers and the claims they decide for policyholders.
Clause by clause
Each duty, and the control that answers it.
| Clause, and what it asks | elan1 control | Mapped to | Claim IDs |
|---|---|---|---|
| Reasoned claim decisionsIRDAI's policyholder protection regulations ask for timely and reasoned claim decisions. | Decide routing: one call reads the claim email and returns line of business, severity, injury and urgency, each with a confidence score. Below your confidence line, a handler confirms. Fraud signals go to a specialist and never deny a claim on their own. |
| |
| Timely claim decisions | Pulse turnaround: every red number leaves with one owner, one action and one date. |
| No claim ID |
Mappings are drafts for your counsel and auditors. They are not certification, legal advice or regulator approval.
By industry
Where this rule shows up.
Banking, Financial Services and Insurance
IRDAI Protection of Policyholders' Interests Regulations 2024
Decide routing, Pulse turnaround.
- elan1 Decide
- elan1 Pulse
Read more
Further reading, and the official text.
Questions
IRDAI, plainly.
Not below your line. Routine claims move as fast as the email that started them; hard ones reach a handler with the evidence attached. Fraud-signal flags go to a specialist and never deny a claim on their own. Any change the claim needs in the claims system still passes elan1 Govern first.
Any change in the claims system passes through elan1 Govern first. Payments above your limit wait for a named approver, and anything outside the rulebook is refused. Every outcome, approved or refused, leaves a signed, hash-chained receipt with the rule and the approver, so the claim file shows who allowed each payment, under which rule and when.
Yes, where it concerns natural persons in life and health insurance. The EU AI Act lists risk assessment and pricing for natural persons in life and health insurance as high-risk in Annex III, and under the Digital Omnibus on AI adopted in 2026, high-risk duties for Annex III systems apply from 2 December 2027. The EU AI Act map covers the duties that follow.
In India by default: AWS Mumbai, three availability zones, no US region. elan1 Run also runs in your data centre or on an appliance. Personal fields are masked before any model call.
No. Mappings are drafts for your counsel and auditors. They are not certification, legal advice or regulator approval. Each row names the clause or duty, what it asks, the elan1 control that answers it and, where one is assigned, the claim ID behind it, so your counsel and auditors can test each mapping against the receipts.
Other maps
The other rules we map.
- Allowed · Approved by Asha R.
- Held for CFO
- Refused · rule 4.2