3 AI prompts for Canadian insurance professionals

Canadian insurance professionals need AI prompts that understand our regulatory landscape. These three templates address claims analysis, OSFI compliance documentation, and bilingual policy drafting while maintaining PIPEDA compliance. Each prompt incorporates specific Canadian legal frameworks and provincial variations that generic AI tools miss.

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Prompt 1: Complex claims analysis with regulatory compliance

Insurance claims in Canada require analysis across multiple regulatory frameworks. This prompt helps you evaluate complex claims while ensuring compliance with provincial insurance acts and federal privacy requirements under PIPEDA Principles 4.1 through 4.9.

The prompt:

Act as a Canadian insurance claims analyst. Analyze this claim for [PROVINCE] jurisdiction:

[PASTE CLAIM DETAILS]

Provide analysis covering:
1. Coverage determination under [POLICY TYPE] standards
2. Provincial regulatory compliance ([specify: Ontario Insurance Act, Quebec Civil Code, etc.])
3. Documentation requirements per provincial regulations
4. Fraud indicators based on Canadian insurance fraud patterns
5. Settlement recommendations within regulatory guidelines

Flag any cross-border elements requiring PIPEDA consideration. Reference specific regulation sections where applicable.

This prompt structure ensures your analysis considers Canada's decentralized insurance regulation model. Each province maintains distinct requirements under their respective Insurance Acts, with penalties for non-compliance ranging from C$5,000 to C$100,000 under provincial legislation.

Canadian insurers processing claims across provincial boundaries must navigate 13 different regulatory frameworks while maintaining PIPEDA Principle 4.1 accountability, where organizations remain responsible for personal information under their control regardless of processing location.

For British Columbia claims, reference the Insurance Act RSBC 1996 Chapter 226 sections 75-82 for claims handling requirements. Ontario claims fall under Ontario Insurance Act RSO 1990 Chapter I.8 sections 419-441. The regulatory differences matter significantly for coverage determinations and claims handling timelines mandated by provincial regulations.

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Prompt 2: OSFI regulatory documentation and risk assessment

The Office of the Superintendent of Financial Institutions (OSFI) requires specific documentation for AI implementations in federally regulated insurers under Guideline E-23 sections 42-48. This prompt generates compliant risk assessment documentation.

The prompt:

Act as an OSFI compliance specialist. Generate risk assessment documentation for AI implementation in our federally regulated insurance company.

Context: [DESCRIBE AI USE CASE]

Create documentation addressing:
1. OSFI Guideline E-23 Technology Risk Management requirements
2. Operational risk assessment per OSFI's Corporate Risk Management guidelines
3. Third-party risk evaluation (if applicable)
4. Board reporting summary for Technology and Cyber Risk Committee
5. Implementation timeline with OSFI notification requirements

Include specific OSFI guideline references and align with our ORSA (Own Risk and Solvency Assessment) framework.

OSFI's E-23 guideline section 44 requires board oversight of technology implementations that could materially impact operations. AI systems processing claims, underwriting, or customer data typically meet this threshold under the "material change" definition in section 45.

The documentation must address OSFI's expectation for "proportionate and risk-based" technology governance under section 43. For AI implementations, this means demonstrating model validation, data governance, and operational resilience planning with penalties under Insurance Companies Act section 645 for non-compliance.

OSFI expects federally regulated insurers to maintain "effective challenge" processes for AI decision-making under E-23 section 47, particularly in underwriting and claims where consumer outcomes are directly affected, with supervisory intervention possible under section 645(1) of the Insurance Companies Act.

Remember that OSFI distinguishes between AI tools for operational efficiency versus those affecting consumer-facing decisions under section 46 of E-23. The latter requires more robust governance documentation and ongoing monitoring frameworks with quarterly reporting to the Technology and Cyber Risk Committee.

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Prompt 3: Bilingual policy drafting with Quebec Civil Code compliance

Insurance policies in Canada often require bilingual versions, with Quebec policies needing Civil Code compliance under Law 25 sections 22-24 for sensitive information processing. This prompt handles the complexity of Canadian bijuralism and official language requirements.

The prompt:

Act as a Canadian insurance policy drafter fluent in both common law and Quebec Civil Code frameworks.

Draft [POLICY TYPE] language for:
Jurisdiction: [PROVINCE/FEDERAL]
Language requirements: [ENGLISH/FRENCH/BILINGUAL]

Policy provision needed: [DESCRIBE COVERAGE]

Ensure compliance with:
- Provincial insurance legislation ([specify relevant act])
- Official Languages Act requirements (if federal)
- Quebec Consumer Protection Act (if applicable)
- PIPEDA privacy policy language
- Unfair or Deceptive Acts or Practices regulations

Provide both English and French versions with legal equivalency. Flag any Civil Code vs. common law differences that affect coverage interpretation.

Quebec's unique legal framework creates distinct requirements for insurance policy language under Civil Code Articles 2389-2504. The Civil Code of Quebec affects contract interpretation differently than common law provinces, with specific penalties under Law 25 section 161 for privacy violations reaching C$25M.

Article 2389 CCQ defines insurance contracts with specific formal requirements under sections 2390-2396. Quebec policies must use precise French terminology that aligns with Civil Code concepts rather than direct translations of common law terms, with Consumer Protection Act sections 228-253 governing unfair practices.

The Supreme Court's decision in Ledcor Construction confirmed that insurance policy interpretation in Quebec follows Civil Code Article 1426, emphasizing the shared intention of parties over literal common law interpretation, making bijural drafting essential for national insurers operating under federal Insurance Companies Act jurisdiction.

For federally regulated insurers, Official Languages Act sections 21-22 compliance requires equal quality in both official languages. This goes beyond translation—each version must be legally equivalent and culturally appropriate, with Treasury Board Policy on Official Languages section 4.2 mandating equal accessibility.

Provincial variations matter significantly. Ontario's Statutory Accident Benefits Schedule sections 32-55 uses different terminology than Quebec's public insurance regime under the Automobile Insurance Act RLRQ Chapter A-25 sections 83-92.

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Using these prompts with Canadian data residency

These prompts work most effectively when used with AI platforms maintaining Canadian data residency under PIPEDA Principle 4.7. Cross-border data transfers create compliance risks under PIPEDA sections 4.1.3 and 4.3, with Privacy Commissioner penalties reaching C$100,000 per violation under section 17.1.

Augure's Canadian-built models understand the regulatory context embedded in these prompts without exposing data to foreign jurisdiction access laws. The Ossington 3 model's 256k context window handles complex regulatory cross-references without losing jurisdictional nuance, maintaining compliance with Law 25 section 17 data localization requirements.

When processing sensitive insurance information, verify your AI platform provides:

• Canadian data residency for all processing and storage under PIPEDA Principle 4.7
• No exposure to foreign access laws like the US CLOUD Act under section 702
• Built-in understanding of Canadian legal frameworks including provincial insurance acts

Remember that PIPEDA Principle 4.1 requires "accountability"—you remain responsible for privacy protection regardless of your technology provider's location or corporate structure, with cumulative penalties possible under section 17.1 for multiple violations.

Canadian insurance professionals using AI tools must balance operational efficiency with PIPEDA's accountability principle under section 4.1, where organizations face administrative monetary penalties up to C$100,000 per violation, with the Privacy Commissioner authorized to impose multiple penalties for systematic non-compliance affecting numerous customer records.

Start implementing these prompts gradually. Test outputs against your current regulatory compliance processes before deploying in production workflows, ensuring alignment with provincial insurance act requirements and OSFI guidelines where applicable.

Ready to try these prompts with a Canadian-built AI platform? Visit augureai.ca to access models designed specifically for Canadian regulatory environments.