Essential private and public services and benefits
Annex III point 5 - Point 5(c)
Life and health insurance risk assessment/pricing
AI for risk assessment and pricing in life and health insurance for natural persons.
Examples to assess
Premium pricing, underwriting recommendations or risk selection.
Health data or behavioural signals in insurance models.
Classification path
First confirm whether the system is an AI system under Article 3(1).
Determine whether the intended purpose falls within Point 5(c).
Assess whether the Article 6(3) filter may apply and whether profiling blocks it.
Document provider/deployer roles, human oversight, data governance and evidence.
What to assess
Which decision, assessment or access point the system supports.
Which data, scores or recommendations determine the output.
Who provides human oversight and which explanations are available.
Next step for this use case
Use the classifier for an initial route check or discuss the use case when the AI output may affect access, assessment, priority or rights.