Artificial intelligence is taking on one of the most delicate and regulated jobs in the financial industry: assessing who is insurable and at what price. Sixfold, the New York insurtech specializing in underwriting with AI, launched its AI Underwriter for Life & Health, an agent that analyzes medical histories, prescriptions, lab results, driving records, financial data and the internal rules of each insurer to issue a risk recommendation with its reasoning included (Sixfold).

The tool works across several product lines: life, disability, long-term care, and critical illness insurance. Rather than simply summarizing the file, the agent weighs the risks of mortality and morbidity, and shows his work: he points out relevant findings, links them to the source documents, and references the company's underwriting manual at each point (FinTech Global).

The flow begins when a request arrives: the agent evaluates the documentation and applies the insurer's manual, classifying each case from standard to complex. It also generates Narrative, a single-sided page with the essentials of the case, which speeds up triage and reduces requests for additional information. After the analysis, it proposes the decision: accept with conditions, refer, reject or postpone (Sixfold L&H).

The medical specialist can examine the proposal, question it and make the final decision. The system allows the incorporation of each company's own manuals, including their levels of authority and risk criteria, and respects human supervision: the subscriber retains the last word (ITIJ).

The launch comes months after the debut of the AI Underwriter for property and casualty (P&C) insurance, launched in June (Sixfold). Since its founding in 2023, the company has processed more than 1.5 million applications across more than 50 lines of business in North America, Europe, Latin America and Australia, and serves insurers that collectively underwrite about $270 billion in gross premiums, including Guardian, New York Life, Zurich North America and Skyward Specialty (Sixfold About · Insurance News BD).

In January 2026, Sixfold closed a US$30 million Series B round led by Brewer Lane, with strategic investment from Guidewire and support from Bessemer Venture Partners and Salesforce Ventures, to accelerate its autonomous underwriting agents (Sixfold Series B · The Insurer).

According to Alex Schmelkin, founder and CEO of the company, "life and health insurance is not a problem to summarize: it is impediments, products, manuals, evidence, exceptions and judgment", and considers that the sector "had not had a real technological moment in a long time". In their survey of more than 250 life and health underwriting professionals, 86% said they were more excited about the future of the industry thanks to AI (Sixfold).

Sources: Sixfold (official announcement) · Sixfold L&H · FinTech Global · ITIJ · Insurance News BD · Sixfold · The Insurer · Generation IA (Telegram). Cover: Doctor using a stethoscope on a hard drive, by Shixart1985 on Wikimedia Commons (CC BY 2.0).