Lemonade, Root, Hippo - modern insurtech companies use algorithms for underwriting and claims. Generic terms don't address AI-driven denial triggers, behavioral data collection, or instant claims processing limitations.
These clauses separate adequate terms from bulletproof ones
What data points can trigger automatic claim denials? AI underwriting creates hidden denial conditions that traditional policies don't have. Your terms must disclose algorithmic factors.
Telematics, app usage, social media - insurtech companies collect data that affects premiums and claims. Terms should explicitly list data sources and how they impact coverage.
"3-minute claims" have fine print. What claims qualify for instant processing? What triggers human review? Your terms need clear escalation criteria.
Dynamic pricing means your premium can change. What behaviors trigger increases? How much notice is required? Are there caps on mid-term adjustments?
Can the insurer change coverage terms mid-policy? Many insurtech platforms reserve broad modification rights that traditional insurers don't claim.
When an algorithm denies your claim, what's the appeals process? Human review requirements, timeframes, and escalation paths must be clearly defined.
Beyond insurtech-specific provisions, I confirm these insurance essentials are properly addressed
What's explicitly not covered
Per-incident vs annual caps
Notice periods and refund terms
Time limits for reporting
Insurer recovery claims
Policyholder obligations
Arbitration vs litigation
Jurisdiction-specific rules
Paste your Terms of Service below. I'll check insurtech provisions first, then insurance essentials.
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