Lanzko Insights
Practical notes on claims innovation and AI trends—built for claims leaders.
What makes AI usable in regulated operations is when it is placed inside a workflow with defined ownership, review, and escalation. Governance instills confidence and ensures accuracy.
Organizations adopt AI and automation, but accountability for decisions becomes less clear.
Outputs are delivered quickly and confidently. People begin to treat them as guidance. Over time, AI influences decisions without a defined decision owner, a review step, or an escalation path.
In regulated environments, this creates a quiet risk. The issue is not only correctness. It is whether the organization can explain how a decision was made and who was responsible for making it.
Why it persists
Governance is often treated as a document problem instead of an operating design problem.
Teams write policies about acceptable use, but they do not define:
where AI outputs appear in the workflow
who must review them
what decisions they can influence
what happens when the output conflicts with human judgment
Without these details, governance is theoretical. The real operating system becomes informal and inconsistent.
The enabling approach
Governance starts by defining the decision boundary.
For any AI-enabled workflow, you should be able to answer:
What is the decision being supported?
Who owns the decision?
What inputs are required before the decision?
Where does AI provide assistance, and where does it stop?
What triggers escalation?
What gets documented for auditability?
Then design a simple control model:
AI produces a draft or a structured input
a human reviews and confirms
exceptions route to escalation
key actions are logged
This keeps the workflow fast while preserving accountability.
Practical example
Consider AI summarization for a claim file, legal matter, or audit record.
A safe design looks like this:
AI creates a structured summary in a standard format
the user confirms, edits, or rejects the summary
the system logs user edits and the final version
if the AI flags a high severity indicator, the workflow routes to a defined escalation queue
settlement, authority, or exception decisions remain explicitly human
The value is not only the summary. It is the consistent decision process around it.
Governance and risk note
Governance fails when AI outputs are treated as system truth.
Controls that matter in practice:
label AI outputs as draft unless confirmed
require human approval for decisions and external communications
maintain a clear record of what was reviewed and changed
define escalation rules for conflicts and high risk flags
ensure users can override AI without friction
These are workflow controls, not legal disclaimers.
The takeaway
The goal is not to prevent AI use. The goal is to prevent unclear decision making.
When AI is placed inside a workflow with defined ownership, review, and escalation, it reduces friction without reducing accountability.
That is what makes AI usable in regulated operations.
