Why "audit-bearing"
Regulators have moved from observing AI to examining it. The tools marketed to claims teams were mostly built before that shift — they produce an answer but not the defensible record of how the answer was reached. "Audit-bearing" is the bar that closes that gap: the work has to carry its own proof.
The five questions
1
What slice of claims work are we evaluating? Separate the audit-bearing slice (coverage, denials, fair-handling, fraud) from supporting tasks — the governance bar is materially higher for decisions that affect outcomes.
2
What evidence does this tool produce per decision? Model documentation, decision provenance, bias monitoring, an NAIC-aligned record — as an artifact you can hand to an examiner, not a promise.
3
Who controls the governance? Is it embedded in a core-system vendor's black box, or a layer you control and can inspect independently of your core-system roadmap?
4
How does it work with our claims manual and state rules? Generic AI doesn't satisfy state-specific UCSPA and prompt-payment requirements — the tool has to reason against your guidelines and the relevant state's law.
5
What's our remediation path? When something goes wrong, can you inspect, correct, override, and document it — the way the NAIC bulletin's remediation expectations require?
Velerian builds to this standard: every decision ships with its reasoning, citations, and evidence trail, and a qualified person signs off. Read the full white paper, or see what's in an evidence trail.