Insurance
Financial crime, conduct and controls across the insurance value chain
Insurers, reinsurers, MGAs and brokers carry financial-crime, sanctions, conduct and data-protection obligations across a distributed value chain of intermediaries, policyholders and claimants. OnyxOne gives underwriting, claims and compliance teams one operating system to screen parties, assess risk, monitor relationships, investigate suspicious claims and evidence governance — with every decision captured in a single audit trail.
How OnyxOne fits your operation
Your compliance, risk, audit and legal teams work in OnyxOne, which centralises risk, controls, policy, obligations, cases and evidence, and connects to the systems, screening and data providers your deployment requires.
The pressures this sector carries
The compliance and regulatory realities that shape how firms in this sector operate. Described generically — your obligations depend on your jurisdiction, licence and activities.
How accountability is structured in a regulated financial institution — the model the platform is built to support.
Financial-crime obligations apply across the chain
Depending on the lines written and jurisdiction, insurers face AML/CFT and sanctions expectations covering policyholders, beneficiaries, claimants and intermediaries. Life and investment-linked products in particular attract diligence duties. The platform supports this programme shape; your obligations depend on your licence and products.
Sanctions exposure runs to every party
Insurers must screen not just policyholders but beneficiaries, claimants and counterparties, and keep that screening current. Defensible match handling and a record of every decision are what supervisors look for.
Conduct and fair-value expectations are rising
Product governance, fair value and fair treatment of customers increasingly require documented policies, controls and evidence across the product lifecycle and distribution chain.
Claims fraud sits alongside compliance
Financial-crime risk in insurance includes fraudulent and manipulated claims. A structured investigation capability that captures evidence and decisions supports both anti-fraud and AML objectives.
What makes this hard today
The operational realities compliance and risk teams in this sector wrestle with.
Risk spread across a distribution chain
Policies are sold through brokers, MGAs and aggregators, so the insurer is often distant from the end customer, making diligence and oversight of intermediaries hard.
Screening many party types
Policyholders, beneficiaries, claimants and counterparties all need screening, but legacy policy and claims systems rarely make that straightforward or continuous.
Claims investigations run on email
Suspicious or high-value claims are investigated in ad-hoc threads and documents, with evidence and decisions scattered and hard to defend.
Intermediary oversight is patchy
Assessing and monitoring the brokers and MGAs that distribute products is inconsistent, yet the conduct and financial-crime risk they carry flows back to the insurer.
Product-governance evidence is manual
Demonstrating fair-value and product-governance decisions across the lifecycle relies on documents assembled by hand.
How OnyxOne serves the sector
Screen every party, continuously
Policyholders, beneficiaries, claimants and counterparties are screened at inception and on an ongoing basis, with every match captured against the relevant record.
Structured claims investigations
Suspicious or high-value claims route into a defined investigation workflow with evidence, entity links, ownership and review — supporting both anti-fraud and AML outcomes.
Intermediary due diligence and monitoring
Brokers, MGAs and distributors are onboarded, risk-assessed and monitored as third parties, so the risk they introduce is understood and tracked.
Governance and controls across the lifecycle
Product-governance, conduct and fair-value decisions are supported by a controls-and-evidence backbone, so the story is captured as work happens.
One audit trail for the value chain
Screening, claims investigations, intermediary reviews and governance decisions all write to an immutable trail, defensible to supervisors and internal audit.
The end-to-end workflow
A defined, sector-specific process with clear ownership at every stage.
Every result, decision and override is captured against the record it belongs to.
Onboard & screen parties
Policyholders, beneficiaries and intermediaries are captured and screened against sanctions, PEP and adverse-media sources at inception.
Assess risk
Parties and products are risk-assessed against your methodology, with higher-risk life and investment-linked business attracting enhanced diligence.
Monitor relationships & intermediaries
Ongoing screening and third-party monitoring surface changes across policyholders, claimants and distribution partners.
Investigate claims & alerts
Suspicious claims and screening alerts route into structured investigations with evidence and review captured.
Govern products & conduct
Product-governance and fair-value decisions are recorded against controls, with oversight and sign-off captured.
Report & preserve
Suspicious-activity content and management information are assembled and preserved in an immutable audit trail.
How teams in this sector use OnyxOne
Screening beneficiaries and claimants
Extend screening beyond the policyholder to every party in the chain, continuously, with decisions recorded.
Investigating suspicious claims
Move claims investigations off email into a structured workflow with evidence, entity links and defensible decisions.
Overseeing brokers and MGAs
Onboard and monitor distribution partners as third parties so the financial-crime and conduct risk they carry is tracked.
Evidencing product governance
Capture fair-value and product-governance decisions against controls so the evidence exists when asked for.
Modules that matter most here
The parts of the OnyxOne platform this sector leans on most. Turn on what you need and add more as your programme scales.
Works with your existing systems
Described as capabilities — OnyxOne connects to the systems your deployment requires, configured per implementation.
- Ingests policyholder, beneficiary and claims data from your existing policy and claims platforms
- Connects to the sanctions, PEP and adverse-media providers contracted for your deployment
- Integrates with your existing broker, MGA and counterparty records for third-party assessment
- Exports suspicious-activity and return content in the formats your submission channels require
- Routes alerts, investigations and approvals through your existing email and messaging tools
Security & reporting
Security & data handling
- Policyholder, claimant and case data are encrypted in transit and at rest.
- Role-based access separates underwriting, claims and compliance functions appropriately.
- Every screening result, claim investigation and governance decision is written to an append-only audit trail.
- Sensitive claims and suspicion-related data are restricted to authorised roles under need-to-know.
- Data residency and retention are configurable to your jurisdiction and record-keeping obligations.
Reports & returns
- Suspicious-activity / suspicious-transaction report content (SAR/STR)
- Party screening-coverage and disposition reports
- Claims-investigation outcome and evidence reports
- Intermediary and third-party risk reports
- Product-governance and conduct evidence reports
- Executive and board management information
What your team gains
Screening across the whole chain
Every party — not just the policyholder — is screened and monitored, closing a common gap.
Defensible claims investigations
Structured workflows and captured evidence make anti-fraud and AML decisions defensible.
Intermediary risk in view
Distribution partners are assessed and monitored so the risk they introduce is understood.
Governance evidence on hand
Product-governance and conduct decisions are recorded as work happens, ready for review.
Questions, answered
Is OnyxOne a regulated insurer or intermediary?
No. OnyxOne is a technology vendor providing compliance and risk software. It is not an insurer, broker or regulated firm, and is not an obliged entity. Your firm remains responsible for its obligations.
Can it screen beneficiaries and claimants, not just policyholders?
Yes. The screening workflow can cover policyholders, beneficiaries, claimants, intermediaries and counterparties, at inception and on an ongoing basis, with every decision recorded.
Does it help with suspicious-claims investigations?
Suspicious or high-value claims can route into a structured investigation workflow with evidence, entity links, ownership and review, supporting both anti-fraud and AML objectives.
How does it handle broker and MGA oversight?
Distribution partners can be onboarded, risk-assessed and monitored as third parties, so the conduct and financial-crime risk they introduce is tracked and evidenced.
Do you provide the sanctions data?
Screening and data providers are contracted and configured per deployment rather than fixed to a single named partner; OnyxOne applies your chosen sources through configurable match logic.
See OnyxOne for Insurance
Book a walkthrough and we'll show how the platform fits your sector's obligations, workflows and systems — then scope an implementation.