Claims iQ
Terms and Conditions
Last Updated: 01/01/2026
These Terms and Conditions (“Terms”) govern access to and use of the ClaimsIQ website, platform, and related services (collectively, the “Services”) provided by ClaimsIQ (“ClaimsIQ,” “we,” “our,” or “us”).
By accessing or using the Services, you agree to be bound by these Terms. If you do not agree, do not use the Services.
1. Eligibility and Authorized Use
The ClaimsIQ Services are intended solely for:
Business and enterprise users
Authorized representatives of insurance carriers, administrators, and partners
Individuals acting on behalf of an organization with a valid agreement with ClaimsIQ
You represent that you have authority to bind your organization to these Terms.
2. Relationship to Customer Agreements
Use of the ClaimsIQ platform is governed primarily by a separate written agreement (such as a Master Services Agreement, Subscription Agreement, or Statement of Work) between ClaimsIQ and the customer organization.
In the event of a conflict between these Terms and a signed customer agreement, the customer agreement controls.
3. Use of the Services
You agree to use the Services only:
For lawful business purposes
In accordance with applicable laws and regulations
In accordance with your organization’s agreement with ClaimsIQ
You may not:
Attempt to gain unauthorized access to systems or data
Interfere with platform security, availability, or performance
Reverse engineer, copy, or misuse the platform
Upload malicious code or exploit vulnerabilities
Use the Services for unlawful, deceptive, or fraudulent purposes
4. User Accounts and Access
Access to the ClaimsIQ platform is restricted to authorized users.
Users are responsible for safeguarding login credentials
Access rights are role-based and limited to assigned permissions
ClaimsIQ may suspend or revoke access if misuse or security risk is detected
Customers are responsible for managing user access within their organization.
5. Data and Content
a. Customer Data
“Customer Data” means data, information, and content submitted to the Services by or on behalf of a customer in connection with the processing and management of insurance claims, which may include personal information and other sensitive or confidential data.
As between ClaimsIQ and the customer, Customer Data remains the data of the customer. ClaimsIQ does not acquire ownership rights in Customer Data.
ClaimsIQ processes Customer Data solely to provide the Services, in accordance with applicable customer agreements, the Privacy Policy, and documented customer instructions.
b. Use of De-Identified and Aggregated Data
Subject to applicable law and only where expressly permitted under a written agreement with the customer, ClaimsIQ may use Customer Data that has been aggregated, anonymized, or de-identified such that it cannot reasonably be used to identify an individual or a specific claim for purposes such as:
Improving and operating the Services
Developing analytical insights and trends
Enhancing security, reliability, and performance
Supporting responsible development and improvement of AI-assisted functionality
ClaimsIQ will not use identifiable Customer Data for these purposes without the customer’s explicit contractual authorization.
c. Platform Content
All software, models, interfaces, documentation, and platform content provided by ClaimsIQ, including any enhancements or modifications thereto, are and remain the intellectual property of ClaimsIQ or its licensors.
No rights are granted except as expressly stated in these Terms or applicable customer agreements.
6. AI-Enabled Functionality
a. AI Implementation
ClaimsIQ may use artificial intelligence (“AI”) and machine learning technologies to support certain features of the Services, including the analysis, classification, and interpretation of insurance claim information submitted by customers.
AI-enabled functionality may be used to assist with the processing of sensitive or confidential claim-related data. Such use is intended to enhance efficiency, consistency, and analytical support, and does not replace human review or decision-making.
AI-generated outputs are informational and assistive in nature only and are provided to support customer workflows. Final claim determinations, coverage decisions, and actions remain solely the responsibility of the customer.
ClaimsIQ does not make fully automated decisions that produce legal or similarly significant effects on individuals without customer oversight, and does not guarantee the accuracy, completeness, or outcomes of AI-assisted insights.
AI functionality is governed by internal AI governance, risk management, and monitoring controls designed to promote transparency, reliability, and accountability, consistent with recognized industry frameworks.
AI-enabled features may automatically populate claim intake fields, categorize submissions, or route information within customer workflows. Such automation is subject to customer configuration and is intended to support operational efficiency. Final review, validation, and decision-making authority remains with the customer.
b. Voice and Telecommunications Services
Certain Services include voice-enabled and telecommunications functionality, including AI-assisted claims intake and SMS communications.
Customers acknowledge and agree that:
Voice interactions may be recorded, transcribed, and processed using AI technologies
ClaimsIQ processes voice and message data solely to provide the Services
ClaimsIQ does not use voice recordings or message content to train public or third-party AI models
Customer Responsibilities:
Customers are solely responsible for:
Providing legally required disclosures to callers regarding call recording and AI processing
Obtaining all necessary consents under applicable federal and state laws (including two-party consent requirements)
Ensuring compliance with the Telephone Consumer Protection Act (TCPA), state telecommunications laws, and carrier requirements for SMS messaging
Implementing required opt-out mechanisms for text messaging
ClaimsIQ disclaims liability for claims, penalties, or damages arising from a customer’s failure to obtain proper consent or comply with telecommunications laws.
7. Availability and Modifications
ClaimsIQ strives to maintain platform availability but does not guarantee uninterrupted service.
We may:
Perform maintenance or updates
Modify or enhance features
Temporarily suspend access for security or operational reasons
Material changes will be communicated where appropriate.
8. Security and Monitoring
ClaimsIQ implements administrative, technical, and operational security controls aligned with recognized industry standards and frameworks, including the SOC2 Trust Services Criteria, NIST Cybersecurity Framework (NIST CSF), and ISO/IEC 27001 principles.
These controls include logging, monitoring, and audit mechanisms designed to protect the confidentiality, integrity, and availability of the platform and customer data.
By using the Services, you acknowledge that:
Platform activity may be logged for security, operational, and audit purposes
Monitoring is performed to detect threats, prevent misuse, and protect the platform and its users
9. Confidentiality
Information accessed through the Services may be confidential or sensitive.
Users agree to:
Protect confidential information
Use it only for authorized business purposes
Comply with confidentiality obligations under applicable agreements
10. Third-Party Services
The Services may integrate with, or rely upon, third-party services and providers, including cloud infrastructure, security, analytics, and communications providers (“Third-Party Services”).
ClaimsIQ selects and manages Third-Party Services through a vendor risk management process designed to assess security, availability, and confidentiality risks consistent with industry standards.
ClaimsIQ is not responsible for the independent operations of Third-Party Services that are outside of its reasonable control. However, where Third-Party Services are used to deliver the Services, ClaimsIQ remains responsible for managing such providers in accordance with applicable customer agreements and its internal security and compliance obligations.
11. Disclaimer of Warranties
The Services are provided on an “as is” and “as available” basis.
To the extent permitted by law, ClaimsIQ disclaims all warranties, express or implied, including warranties of merchantability, fitness for a particular purpose, and non-infringement.
12. Limitation of Liability
To the maximum extent permitted by law:
ClaimsIQ shall not be liable for indirect, incidental, consequential, or punitive damages
ClaimsIQ’s total liability arising from use of the Services is limited as set forth in applicable customer agreements
13. Indemnification
Users agree to indemnify and hold harmless ClaimsIQ from claims arising from:
Unauthorized or unlawful use of the Services
Violation of these Terms
Breach of applicable laws or agreements
14. Termination
ClaimsIQ may suspend or terminate access:
For violation of these Terms
To address security or legal risks
As provided in applicable customer agreements
Termination does not affect accrued rights or obligations.
15. Governing Law
These Terms are governed by the laws specified in the applicable customer agreement.
If no agreement exists, governing law shall be determined by ClaimsIQ’s principal place of business, without regard to conflict-of-law principles.
16. Changes to These Terms
ClaimsIQ may update these Terms from time to time.
Updates will be posted with a revised “Last Updated” date.
17. Contact Information
For questions regarding these Terms:
ClaimsIQ Legal & Compliance
Email: legal@claimsiq.insure-well.com
Website: https://claimsiq.insure-well.com