Use case · Insurance investigation
Claims investigation with
a defensible audit trail.
Special investigations work moves between three regulators (FCA conduct, ICO data protection, criminal evidential standards), three audiences (claims handler, reinsurer, prosecutor), and three timelines (live claim, retrospective SAR, multi-year recovery). The system underneath has to keep all three of each in sync. CLEARSKY does that as the default operation, not as a reporting layer added afterwards.
The friction
The work, before a structured platform.
-
01
Field investigators run OSINT in their head. The narrative report captures the conclusion. The collection method is recorded in WhatsApp messages and screenshots that do not survive the file.
-
02
SARs arrive months after the collection. Reconstructing what was held about a claimant, on what lawful basis, takes hours per request. Some files cannot be reconstructed at all.
-
03
Reinsurer due diligence asks for source provenance. Claims teams have conclusions. They do not have a machine-readable record of which signal came from which source at which time under which lawful basis.
-
04
Handler-to-SIU handover loses chain. Claims handler escalates. SIU opens its own file. The same facts live in two systems and the relationship between them is a Subject line in an email.
What CLEARSKY changes
Four capabilities mapped to claims work.
-
01 · Proportionality gate
Sensitive collection (social-media scraping, vehicle history, party associates, biometric search) requires a 7-criterion check before the worker will run. Credible, urgent, necessary, least intrusive, proportionate, documented, scoped. The gate issues a time-limited token. Without the token, the collection refuses. The check itself is the evidence the gate was applied.
-
02 · Receipt of Evidence on request
A claimant SARs the insurer. They request a Receipt of Evidence at the subject portal and verify by OTP. The receipt is built from the same audit log your investigators write to, with field-level redaction reasoning where law allows withholding. No parallel workflow.
-
03 · Single object, two surfaces
The same case object sits under both the claims handler and the SIU analyst. Tier-respect by construction means the SIU tier sees what the handler tier does not, but the handler can see that an SIU view exists. No duplicate files. No chain-of-custody breaks at handover.
-
04 · Signed dossier on output
The dossier handed to the claims handler, the reinsurer, or counsel carries an ECDSA signature. The recipient verifies in roughly 200ms at
verify.clearsky.79thunit.co.uk. Provenance becomes a property of the document, not a question for the next meeting.
Concrete shapes
Three illustrative claims.
Hypothetical examples for illustration. Not statements about real insurers or claims.
Motor · staged collision
Suspect crash-for-cash claim. Claimant and second-vehicle driver associate signals from open sources. Vehicle history. Prior claims patterns. Each sensitive collection passes the proportionality gate. Signed dossier handed to claims handler; verifiable by reinsurer.
Property · large-loss fire
Counterparty due diligence on the insured business. Officers, beneficial owners, prior loss history, sanctions exposure. The knowledge graph keeps the same officer object alive across future claims at related entities.
Life · contestability period
Medical history disclosed at underwriting versus lifestyle evidence at claim. Article 9 special-category processing is never opened without an Article 9 condition recorded inline. The proportionality gate enforces this; the receipt, if SAR'd, shows the condition.
Compliance posture
Built around UK insurance regulation.
- FCA Principles for Businesses: Principle 6 (customer interests) and Principle 11 (relations with regulators) require a defensible audit trail. The append-only log is one.
- SIU evidential standards: chain of custody from open-source collection through analyst review to claims-handler decision.
- UK GDPR Article 6(1)(f): legitimate interest with documented Legitimate Interests Assessment per case, captured at the proportionality gate.
- UK GDPR Article 9: special-category data is gated. The platform refuses an Article 9 collection without an Article 9 condition recorded.
- Insurance Fraud Bureau cooperation: the same case object can be exported to IFB-aligned schema where required.
Pricing fit
Which tier suits an SIU function.
Single SIU investigators run Analyst (£49/month) for casework and the verifier. SIU teams of two to five take Team (£399/month) for the shared knowledge graph and tier-scoped collaboration. Insurer-wide deployment with handler-tier and SIU-tier surfaces is Enterprise; talk to us about scope.