Coley, Inc.

Covered.

Every denial. Every determination. Every claim. Covered.

The Identity platform for insurance.

Denial letters pressure-tested before they mail. Adverse determinations reviewed for bad faith exposure. Claim files designed to survive regulatory examination and litigation discovery. This is what the platform looks like in insurance.

Industries We Cover · Insurance Confidential · April 2026
Coley, Inc. · We read the room.
The Problem

Every denial is a potential lawsuit. Every file is discovery.

An insurance carrier processes thousands of claims a year. Each denial letter, each adverse determination, each claim file is a document that will be read by bad faith attorneys, state regulators, policyholder advocates, and class action counsel. The denial letter that goes out today becomes Exhibit A tomorrow.

Bad Faith
Denial Letter Exposure
Every denial letter is a potential bad faith exhibit. The language, the reasoning, the timing, the investigation documented in the file — bad faith attorneys read these documents looking for unreasonable interpretation of policy language, inadequate investigation, and delayed processing.
Regulatory
Market Conduct Examination
State DOI market conduct exams review claim handling practices at scale. They look for patterns: denial rates, processing timelines, investigation adequacy, and language consistency. One carrier's internal template that uses "not covered" when the policy says "excluded" becomes a compliance finding across thousands of files.
Where each product is designed to help
Enterprise (Carrier Operations)
Edge
Staff systems —
designed to protect
claimant PII in
files, emails, portals
Route
AI conversations —
claimant intake,
complaint triage,
DOI escalation
Comply
Back office —
claims documentation,
regulatory reporting,
exam-ready files
Audit
Legal —
denial letters,
adverse determinations,
adversarial review
A Day at the Carrier

A Friday at Pacific Mutual.

Mid-market P&C carrier. Personal lines and commercial. 180,000 policies in force across California. Every claim decision and every policyholder communication runs through regulatory frameworks that bad faith attorneys know by heart.

8:00 AM
Identity Audit™
The Homeowner's Claim Denial
A homeowner filed a water damage claim. The adjuster is denying based on the "gradual seepage" exclusion. The denial letter is ready to mail. Audit runs it from the perspective of a bad faith plaintiff's attorney, a CDI examiner, and a policyholder advocate. Identified: the letter cites the exclusion but doesn't address the "resulting loss" exception that California courts have interpreted broadly. A bad faith attorney would argue the carrier failed to consider coverage under the exception before denying. The letter is revised to address both the exclusion and the exception analysis.
9:30 AM
Identity Edge™
The Adjuster's File Share
A claims adjuster is emailing medical records from a bodily injury claim to an outside defense counsel. The email includes the claimant's SSN, medical diagnoses, and treatment history. Edge is designed to identify the PII at the keyboard — before it transmits through the carrier's email system. The records are uploaded to the secure claims portal. The email contains a link, not the data.
11:00 AM
Identity Route™
The Policyholder Complaint
A policyholder calls about a denied auto claim. The conversation starts routine — status inquiry, payment timeline. Then: "I'm going to file a complaint with the Department of Insurance. Your company is acting in bad faith." Route reads the input: potential CDI complaint, bad faith allegation, regulatory reporting trigger. Route escalates to the claims manager and flags for compliance. The AI doesn't respond to bad faith allegations. A human does.
1:30 PM
Identity Comply™
The Market Conduct Prep
CDI has announced a market conduct examination focused on homeowner claims handling. The carrier needs to produce 200 randomly selected claim files. Comply is designed to cross-reference each file against California's Fair Claims Settlement Practices Regulations, identifying gaps in documentation: missed acknowledgment timelines, incomplete investigation notes, denial letters that don't cite specific policy language. Files are remediated before the examiner arrives.
3:00 PM
Identity Audit™
The Policy Form Update
The carrier is updating its homeowner's policy form for the next filing cycle. Audit runs the draft from the perspective of a CDI form reviewer, a coverage litigation attorney, and a consumer advocacy organization. Identified: an anti-concurrent causation clause that California courts have narrowed significantly since Vandenberg. The clause as written may not survive a coverage dispute under current California precedent. Revised before filing.
4:30 PM
Identity Comply™
The Claims Diary Review
End of week. 47 open claims need diary updates. California requires acknowledgment within 15 days, acceptance or denial within 40 days. Comply is designed to track every statutory deadline across every open claim, flagging files approaching compliance windows. Three claims are within 5 days of the 40-day determination deadline. None of them will miss it.
The Numbers

One carrier. Four products. Potential impact.

~2,000
Denial letters reviewed per year for a mid-market carrier.
100%
Adverse determinations designed to be reviewed before delivery.
40 days
California determination deadline. Every claim file matters.
$0
Outside counsel needed for routine denial letter review.
The math on bad faith exposure.
A single bad faith verdict in California averages $3M–$15M. Punitive damages in bad faith cases can be multiples of compensatory damages. A CDI market conduct fine can run $10K per violation, per file. The cost of Audit is less than one hour of the coverage counsel you're currently paying.
Why Insurance

Why insurance is a natural fit.

Every denial letter is a potential exhibit
Bad faith litigation starts with the denial letter. The language, the reasoning, the investigation documented in the file — these are the first documents a plaintiff's attorney reads. Getting them right isn't optional.
Bad faith is the existential risk
California's bad faith framework is among the most plaintiff-friendly in the country. Unreasonable denial, inadequate investigation, delayed processing — each creates independent grounds for extracontractual damages.
Market conduct exams review at scale
CDI doesn't review one file — they review hundreds. A pattern of deficient denial letters or missed statutory deadlines across a book of business creates systemic compliance exposure.
California sets the standard
Fair Claims Settlement Practices Regulations, Prop 103 rate requirements, SB 1060 wildfire disclosure obligations — California carriers face the most prescriptive claims handling framework in the country.
"The cost of Audit is less than one hour of the coverage counsel you're currently paying."
Pilot Terms

Try it. For free. On your documents.

The 30-Day Pilot
Give us 5 denial letters and 3 claim files. We run them through Audit for free over 30 days.
If the findings identify bad faith exposure your current review process missed, we talk pricing.
Audit
5 denial letters reviewed for bad faith, regulatory, and coverage exposure
Audit
3 claim files pressure-tested for documentation adequacy and compliance
Start a Pilot
No integration. No contract. No risk.
Just your documents, and our findings.
Platform Context

This is one industry. The platform extends.

Insurance is one deployment. The same architecture is designed to serve banking, healthcare, government — any domain where compliance pressure meets operational complexity.

Edge
Active
Route
Active
Comply
Active
Audit
Active
Locker
Industries We Cover
Banking Healthcare Government Education Insurance Pharmaceuticals General Legal
Covered.
A Coley, Inc. industry deployment
"We read the room. And protect everyone in it."
Patent pending · getcoley.ai · Confidential
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