Solutions, By function, Quality & Audit

Every file, not a 2% sample

Industry QA samples one to four percent of closed files; a market-conduct exam samples a hundred. Owl reads every file, every time, against your QA scorecard, your unfair-claims framework, your reserve-discipline rules and the state DOI protocol, with span and citation already attached to each finding.

How QA actually scales, cohort n=2.4M filesIndustry baseline
Files closed
100% files closed
Baseline
Sampled by QA
3% sampled today
Industry avg
Findings raised
18% of sampled
Industry avg
Re-work cycle
11% re-worked
Industry avg
Owl-reviewed
100% reviewed, every file
cohort study

100%

Files reviewed

38×

Rule-checks per file

$0

Findings to a state DOI uncited

03Examples by line of business

Pick a line. See the findings Owl raises: at close, before they become a market-conduct exam.

Each line has its own QA framework: timing, communication, reserve discipline, decision-rationale. Owl indexes them all.

OwlVision
What it read
Closed claim file
184 pp
Read, Indexed
Adjuster diary log
22 pp
Read, Timing-validated
Reserve history
4 pp
Read, Movement-mapped
Correspondence + letters
38 pp
Read, NAIC-checked
Structured extraction
Claim AB-2025-44218, closed 2025-09-22, settled $48K, cycle time 162 days, 4 reserve changes, 2 letter delays, no coverage letter on file, state NY (NAIC framework + 11 NYCRR 216)
OwlSignal
What it cross-referenced
high
Coverage acknowledgement, NY 216.6

NY 11 NYCRR 216.6 requires coverage acknowledgement within 15 business days of FNOL. File shows no acknowledgement letter; reg violation. Pattern in 7 of 84 files audited this quarter for this examiner.

mid
Reserve discipline, 4 changes

Reserve moved 4× post-30-day mark. Each change supported in file notes; pattern is acceptable but at the edge of the carrier QA scorecard threshold of 3.

OwlAssist
What it answered
Examiner asked
What are the findings, and what’s the corrective action?
Owl answered in 0.5s

Two findings: (1) NY 216.6 coverage-acknowledgement letter missing: reg violation, examiner coaching required, pattern across 7/84 files. (2) Reserve discipline at scorecard edge but not a finding. Corrective action: examiner refresh on NY 216.6 timing requirements, add coverage-acknowledgement letter to FNOL automation. Cohort outcome at next state DOI exam: 0 findings post-correction. Finding memo, examiner coaching memo and CAP attached.

NY 11 NYCRR 216.6NAIC Model #672File diary 2025-04-12Examiner pattern 7/84

How Owl plugs into the QA workflow. Continuous, not periodic.

01OWL

File closes

Owl reads every closed file end-to-end against the carrier QA scorecard and the state DOI framework.

02OWL

Findings raised, cited

Each finding cites the file span, the rule, and the cohort-pattern it fits. No uncited findings.

03OWL

Examiner coaching

Pattern findings group by examiner with coaching memos. Owl drafts the framework.

04QA REVIEWER

QA reviewer signs

Loads findings, drafts CAP, drafts coaching note. Validates and edits.

05QA REVIEWER

Market-conduct ready

On exam, Owl produces the universe pull, the tracer file, the case-sample response and the citation packet.

05What changes

Numbers from carriers running Owl in QA & audit.

MetricWithout OwlWith Owl
Files reviewed3%100%
Findings cited to span38%100%
Cycle time, QA review per file94 min4 min
Market-conduct exam findings14 / exam2 / exam
Examiner coaching cyclequarterlyreal-time
Reserve-leakage detection±21%±4%
Source: rolling 12-month average across 4 carriers running Owl in QA, n = 1.4M closed files reviewed.

Built for the regulatory shape of state DOI market-conduct exams.

NAIC Model #672Unfair Claims Settlement Practices: per-state element framework.
State DOI examsUniverse pulls, tracer files, case sampling, finding-response packets.
ERISA, §503Administrative-record discipline, reasoned-decision validation.
HIPAA, HITECHPHI segmented per tenant, access log per record.
Reg AI / NYDFSBias testing on findings-models, explainability per finding.
SOX 404Internal-control documentation for reserve and payment systems.
SOC 2 Type IIAnnual audit, continuous control monitoring.
Records retentionPer state, per carrier, per LOB.
07Integrations

Lives where your Quality & Audit team lives.

Claims platforms

Guidewire ClaimCenter, Duck Creek, FINEOS, Origami, Majesco

QA platforms

WorkView, Athenium, MajorAccounts QA, in-house

Compliance platforms

Archer, LogicGate, MetricStream, ServiceNow GRC

Reporting + BI

Snowflake, Databricks, Tableau, PowerBI, Looker

DOI portals

NAIC SERFF, state market-conduct portals

Identity & SSO

Okta, Azure AD, PingFederate, SAML, SCIM

08Get started

Bring us a quarter of closed files. We’ll review every one and surface what your sample missed.

Two-week pilot. Your last 100K closed files, your QA scorecard, your state DOI framework. We measure findings-rate, cite-quality, examiner-pattern detection and market-conduct-readiness against your audit team’s ground truth.