Claimant Consent Capture Agent
Capture, validate, and secure claimant consent for compliant, traceable claim workflows
Description
Challenge:
Claims processing often requires access to sensitive claimant data, medical records, or third-party disclosures. Manual consent capture is error-prone, inconsistent, and may result in compliance violations or disputes. Without automated, jurisdiction-specific consent handling, insurers risk unauthorized data usage, regulatory penalties, and delayed claim settlements.
How It Works:
The Claimant Consent Capture Agent centralizes consent management across the claims lifecycle. At FNOL or whenever sensitive data access is required, the agent prompts claimants or nominees with jurisdiction-specific consent forms (HIPAA, GDPR, IRDAI, etc.). Identity is validated via OTP, eKYC, or digital signature before consent is recorded. Captured consents include scope, timestamp, channel, and claimant ID, and are stored in a tamper-proof repository. Downstream workflows are triggered only after verified consent, ensuring legal compliance, transparency, and a complete audit trail.
Benefits:
Achieves 100% traceable consent capture with timestamp and scope
Ensures 95–100% compliance with jurisdiction-specific consent regulations
Reduces disputes over unauthorized data use by 90%+
Decreases claim delays linked to missing/invalid consent by 70–80%
Prevents initiation of downstream workflows without valid consent
Enhances claimant trust with transparent, guided consent interactions
Features
This agent guarantees legally valid, auditable, and automated consent management for all sensitive data interactions within the claims lifecycle.
Features & Capabilities:
Consent Request: Present claimant/nominee with jurisdiction-specific consent form
Identity Validation: Authenticate claimant via OTP, eKYC, or digital signature
Scope Capture: Record consent purpose (medical access, data sharing, settlement approval)
Secure Storage: Log consent metadata including timestamp, channel, scope, and claimant ID
Digital Acknowledgement: Provide claimants with proof of consent
Workflow Enforcement: Trigger downstream workflows only after verified consent
Multi-Jurisdiction Handling: Apply templates and rules based on regional regulation
Guardian/Representative Support: Capture consent for minors or incapacitated claimants
Retry & Escalation Protocols: Handle OTP failures and escalate to manual validation
Operating Blueprint
Knowledge Sources:
Regulatory Consent Templates (HIPAA, GDPR, IRDAI, local rules)
Identity Verification Reference Data (Aadhaar, SSN, Passport, DL)
Policyholder & CRM Database (claimant-policy linkage, demographics)
Consent Requirement Matrix (region-specific mandates)
Historical Consent Logs (past approvals, exceptions, disputes)
Business Rules:
Mandatory Consent: No data access without prior claimant authorization
Identity Validation Requirement: Consent valid only after verified identity
Consent Scope Enforcement: Actions strictly aligned to scope provided
Multi-Jurisdiction Template Handling: Apply region-specific consent forms
Guardian/Representative Consent: Capture for minors/incapacitated claimants
Retry & Escalation Protocols: Max 3 OTP retries; escalate if unsuccessful
Tool Workflow:
Trigger consent request at FNOL or sensitive data use
Present jurisdiction-specific consent form
Validate identity via OTP, eKYC, or digital signature
Capture consent metadata: timestamp, scope, channel, claimant ID
Provide digital acknowledgement copy to claimant
Enable downstream workflows only after verified consent
Maintain secure, tamper-proof audit logs
Badges
Classification
Capabilities
