Industry Vocabulary Reference

Insurance: P&C, Life & Annuity

Insurance fields describe policy administration, underwriting, pricing, claims, fraud review, and reinsurance. They provide a shared vocabulary for recorded decisions and mapped policy inputs.

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This page shows selected examples and categories. Download the JSON for the complete vocabulary, including every field, permitted value, and policy pattern in this catalog.

How to use this reference

1. Start with the core file if you need the cross-industry governance baseline.
2. Choose an industry file for its workflow fields and permitted values.
3. Match the OTel attributes to the policy paths your rules use, then verify the recorded fields in a test session.

Catalog context

For a claims workflow, capture the claim stage and the reason for routing it to a reviewer. Keep the review outcome separate from the action the application later takes.

Risk note: Determine applicable requirements by jurisdiction, insurance line, and intended use. A recorded review or bias-test result does not establish that the process meets those requirements.

Vocabulary file

• Download filename: 03_vertical_insurance_pc_life_annuity.json
• Kind: vertical

OTel namespaces

Referenced standards

These references explain the catalog's context. A listed standard does not establish that a configured application meets its requirements.

• ACORD 2.0, P&C XML and AL3 Standards
• ACORD Life & Annuity XML (OLI/TXLife)
• ACORD GRLC Generation 2.0, Global Reinsurance & Large Commercial (April 2025)
• ACORD Next-Generation Digital Standards, JSON-based microservices API standard
• NAIC Model Bulletin: Use of Artificial Intelligence Systems by Insurers (December 2023; 24 states adopted as of March 2025)
• NAIC Model Act #880, Unfair Trade Practices Act
• NAIC Model Act #900, Unfair Claims Settlement Practices Act
• Colorado SB21-169 / Regulation 10-1-1, Governance and Risk Management for ECDIS use (effective Oct 15, 2025; expanded to auto and health)
• New York DFS Insurance Circular Letter No. 7 (July 2024), AI transparency expectations
• California Insurance Code §10123.135, Prohibition on solely automated health care decisions
• HL7 FHIR v6.0, ClaimResponse and ExplanationOfBenefit resources (health insurance claims)
• CMS Interoperability and Prior Authorization Final Rule (2024), 72-hour expedited / 7-day standard PA timelines
• NAIC Own Risk and Solvency Assessment (ORSA) Model Act #505
• Lloyd's Blueprint Two Core Data Record (CDR), built on ACORD standards
• EU Solvency II Directive, Pillar 2 model governance and internal model validation

Source references

• https://www.acord.org/standards-architecture/acord-data-standards 
• https://acord.org/ACORD-about/acord-news/2025/04/10/acord-launches-grlc-generation-2.0-data-standards 
• https://content.naic.org/sites/default/files/inline-files/2023-12-4%20Model%20Bulletin_Adopted_0.pdf 
• https://doi.colorado.gov/for-consumers/sb21-169-protecting-consumers-from-unfair-discrimination-in-insurance-practices 
• https://www.dfs.ny.gov/industry_guidance/circular_letters/cl2024_07 
• https://build.fhir.org/claimresponse.html 

Subdomains

Implementation examples

• Underwriting, Rating & Pricing: Rating Factor Category. OPA rule: deny any rating action where factor_category is prohibited_characteristic_proxy or social_media_derived until Colorado Reg 10-1-1 bias test has been completed and approved. (Colorado Sb21 169: ECDIS factors require bias testing for proxy discrimination)
• Underwriting, Rating & Pricing: ECDISBias Test Outcome. OPA rule: block production deployment of any underwriting model where ecdis_bias_test_outcome is testing_not_yet_performed, material_disparity_corrective_action_pending, or model_suspended_pending_remediation. (Colorado Reg 10 1 1: Annual compliance report due Dec 1 (life); July 1, 2026 (auto and health); bias test outcomes must be documented)
• Underwriting, Rating & Pricing: Insurance AIModel Inventory Status. OPA rule: deny any agentic underwriting or claims decision where the dependent model status is not_in_inventory_shadow_model or third_party_vendor_model_pending_assessment. (Naic Model Bulletin: AIS Program must maintain inventory of all AI systems used in regulated decisions)
• Claims Intake, Triage & FNOL: Claim Severity Tier. OPA rule: route all tier_7 and above claims to human adjuster, block STP. Require HITL with senior_adjuster role for tier_8 and above. Require claims_compliance_officer for tier_10.

Control ideas

These patterns describe possible controls, not active rules. Confirm applicability, implement the control, and test its effect on the application.

Enforce before the action

Pass the request and your business action to this function. The core SDK checks policy before the action runs and again before its result is released. A deny or review decision means the action never runs.

import { Veriproof } from '@veriproof/sdk-core';
import type { GovernedResult, IndustryFact, JsonValue } from '@veriproof/sdk-core';

const veriproof = Veriproof.fromEnv();

export async function runProtectedAction<TInput extends JsonValue, TValue>(
  request: TInput,
  action: (input: TInput, signal: AbortSignal) => Promise<TValue>,
): Promise<GovernedResult<TValue, TInput>> {
  // Catalog values for this vertical. Replace them with facts from the current workflow.
  const industry: IndustryFact[] = [
    { attribute: "insurance.policy.lifecycle_status", policyInput: "insurance_policy_lifecycle_status", value: "application_received" },
    { attribute: "insurance.policy.transaction_type", policyInput: "insurance_policy_transaction_type", value: "new_business" },
    { attribute: "insurance.policy.line_of_business", policyInput: "insurance_policy_line_of_business", value: "personal_auto" },
  ];

  // Policy runs before action() and again before the result is released.
  // A deny or review decision means action() never runs.
  return veriproof.govern(
    "insurance.pc.life.annuity.evaluate",
    request,
    ({ input, signal }) => action(input, signal),
    { industry },
  );
}

• Replace the sample values with facts from the current workflow. Rules read them under input.snapshot.industry.
• Test both permitted and blocked actions. Confirm that a blocked action never reaches your business function.
• Only completed, completed_with_warning, and transformed results carry a released value.

For review decisions, follow the Human Review guide to configure continuation. Observe remains available when you need to record activity without enforcing a decision.

Set up the Insurance: P&C, Life & Annuity example. See the API reference for TypeScript, Python, or .NET.

Selected vocabulary categories

This page uses the vocabulary JSON distributed with the documentation. Check its version when comparing it with an installed SDK.

Download the vocabulary JSON for offline review or automated comparisons.

Use the SDK reference for configuration and supported APIs. Keep vocabulary selection separate from the compliance team's assessment of applicable requirements.