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Insurance · Annex III §5(c)

AI Act readiness for insurance firms.

If your firm uses AI in pricing, underwriting, or claims, you're operating under Annex III §5(c) of the EU AI Act and the 2025 EIOPA Opinion on AI Governance. cosantio gives MGAs, brokers, and carriers the workflow, artefacts, and named officer to be audit-defensible in time. Examples here are drawn from the Irish market we know best, but the obligations apply to insurers across the EU, with some country-specific variation.

What governs AI in insurance

Four pieces of regulation. One workflow.

Insurance AI in Ireland and the EU is regulated by more than the AI Act. The four frameworks below overlap. cosantio's Insurance Scorecard maps your firm against all four at once.

01From 2027

EU AI Act, Annex III §5(c)

Source: Regulation (EU) 2024/1689

Classifies AI used for risk assessment and pricing of life and health insurance as high-risk. Triggers obligations on technical documentation, human oversight, accuracy, FRIA, EU registration, and post-market monitoring.

High-risk regime applies02 Dec 2027
02In effect

EIOPA Opinion on AI Governance

Source: EIOPA-BoS-25/360 · August 2025

Sector-specific supervisory expectations on AI governance and risk management, including data governance, record-keeping, fairness, explainability, human oversight, and cyber security, applied on a risk-based, proportionate basis. National competent authorities, including the Central Bank of Ireland, supervise on these terms.

Supervised byCBI · NCA
03In force

Product Oversight & Governance

Source: IDD POG · 2017/2358

If AI is part of product design, pricing, or target market identification, the product must be tested against customer outcomes and value-for-money. Periodic review, distribution monitoring, and intervention triggers are mandatory.

Applies toManufacturers · MGAs
04In force

CBI Insurance Supervisory Framework

Source: Central Bank of Ireland

Sector-specific Irish supervision. Operational resilience under DORA, fitness and probity for AI decision owners, and conduct expectations under the Consumer Protection Code. AI Act compliance does not replace it; it sits alongside.

ThemesDORA · CPC · F&P
Who's in scope

MGAs, brokers, and carriers. Different obligations.

The AI Act treats your firm differently based on whether you develop the AI or use it. That distinction (provider vs deployer) shapes which Article 16 or Article 26 obligations apply.

Typically Provider

MGAs.

Managing General Agents who build or significantly modify pricing models, underwriting algorithms, or claims-triage AI. Acting as provider under Article 25 means full Article 16 obligations.

Key obligation
Full Annex IV technical dossier, EU registration, post-market monitoring, conformity assessment.
Typically Deployer

Brokers.

Insurance intermediaries using third-party pricing engines, quote tools, or claims AI. Acting as deployer under Article 26 means a lighter but still substantive set of obligations.

Key obligation
Human oversight, transparency to customers, use according to instructions, and FRIA where the deployer falls within Article 27 scope.
Both roles

Carriers.

Insurers operating in EU markets, often both providers (in-house pricing and underwriting AI) and deployers (third-party fraud and claims systems). Both obligation sets apply, per AI system.

Key obligation
Per-system classification. One register, multiple roles, separate Annex IV dossiers for each provider-role system.

Article 25 caveat. Modifying a third-party AI system substantially (including changes to its intended purpose) reclassifies the deployer as a provider. A broker that fine-tunes a third-party pricing engine on its own book of business is almost certainly a provider, not a deployer. The Scorecard surfaces this where it applies to your firm.

In-scope AI systems

The systems insurance firms actually run.

Real systems we see across Irish and EU insurance firms. Classifications and obligations below are illustrative; your firm's classification depends on the specific use, not the product name.

Pricing enginese.g. life, health, motor pricing
Algorithmic or ML-based determination of premium for new business and renewals. The headline §5(c) use case.
High-risk
Underwriting risk assessmente.g. medical underwriting, property risk
Decisions on whether to accept, decline, or load risk based on automated risk scoring. Includes life expectancy and health scoring.
High-risk
Claims triage & fraud detectione.g. first-notice-of-loss AI
Automated triage of claims into fast-track, standard, or fraud investigation. Affects customer outcomes materially.
High-risk
Distribution & customer chate.g. quote chatbots, channel routing
Customer-facing AI for quote generation, FAQ, and channel routing. Not pricing decisions but customer interaction.
Limited-risk
Internal analytics & reportinge.g. portfolio dashboards, MI
AI used for internal management information, portfolio analysis, or executive reporting. No direct customer effect.
Limited-risk
Sample insurance dossier

What an audit-defensible insurance file looks like.

Excerpt from a sample Annex IV technical dossier for a life-insurance pricing engine. Every finding cites firm-specific evidence; every gap names an owner and a date.

Technical Report · Annex IV (EU) 2024/1689

EU AI Act Conformity · Insurance Pricing

Provider: Sample Broker LtdSector: Insurance · MGA
CSC-2026-0419Issued 13 May 2026
System
PricePilot (v3.2)
Intended purpose
Life insurance pricing engine for Irish broker market
Hardware
AWS EC2 · EU-west-1
Oversight
Underwriter in the loop · mandatory secondary review for declines
01Risk ManagementArt. 9 · 3 questions
Is there a documented risk management system covering the full lifecycle?
Compliant
Cited evidence
Risk Management Framework v2.4 (Q1 2026) covers design, deployment, and post-market phases. Reviewed quarterly by the Risk Committee, chaired by the COO.
Is there a process for post-market risk monitoring?
Action required
Remediation plan
By end of Q3 2026, stand up a monthly data drift monitor with alerting to the Compliance Officer. Owner: A. Murphy (Head of Risk). Aligned with EIOPA Opinion 5.2 on continuous monitoring.
05Human OversightArt. 14 · 3 questions
Can a qualified underwriter override the AI's pricing or decline decision?
Compliant
Cited evidence
All declines and loaded-risk decisions above threshold X are routed to underwriter review. Override rate logged and reviewed monthly. Underwriter holds CII qualification.
Are operators trained on automation bias and explainability?
Compliant
Cited evidence
Quarterly training programme covers automation bias, explanation of model outputs, and how to use SHAP attribution. Attendance log maintained in the AI Literacy Register.
+ 9 more pillars in the full platform dossier · 25 questions across Annex IV
What you'll get

Start with the Scorecard. Go deeper in a demo.

The Scorecard is the same eight questions for every sector, but the result is sector-specific. Insurance firms get EIOPA Opinion alignment, POG mapping, and a §5(c) FRIA readiness check layered on top of the core readiness assessment.

Recommended start

Fast Scorecard.

Free · 3 minutes · no login

Eight plain-English questions. A regulator-grade PDF that scores your firm against every AI Act obligation already in force, with insurance-specific framing throughout.

  • Classification under §5(c), with FRIA trigger flag
  • Status on Article 4, 5, 50, and 11 obligations
  • EIOPA Opinion alignment summary
  • Prioritised action plan with weeks-to-readiness estimate
~3 min · PDF in 5Start the Scorecard
Deep dossier

Deep Dossier.

Demo · 20 minutes · with our team

The full Annex IV workflow inside the platform: 25 questions across 11 pillars per AI system, producing a regulator-grade technical dossier for the Central Bank, EIOPA-aligned auditors, or your carrier. Book a demo to walk through a sample and the insurance-specific features.

  • Annex IV-shaped technical dossier per system
  • Cited evidence and remediation plans per finding
  • Sample pricing-engine pillar map (PricePilot reference)
  • Signed cover sheet for board and regulator use
~20 min · live walkthroughBook a demo
Common questions

Things insurance firms ask us first.

Insurance · §5(c)

Find out where your insurance firm stands.

Eight questions. Three minutes. A regulator-grade PDF with §5(c) classification, EIOPA Opinion alignment, and a prioritised action plan for your firm.