Collect photos, receipts and reports from the client
Checklists and reminders for missing documents can run automatically.
AI for Claims Officers
Claims Officer
Processes insurance claims, reviews documents, contacts policyholders, assesses eligibility, coordinates with assessors, and updates records through resolution.
What should stay human.
Keep and amplify
Take the first call after a client's loss
Prepare and lodge the claim with the insurer
Send claim progress updates to clients
Automate
Collect photos, receipts and reports from the client
Keep the claims register up to date
Book assessor and repairer visits
Tasks, by type of work.
Each task has an experience tag (CX, SX or BX), a verdict, and example agents that often help with this kind of work. Agent suggestions come from our editorial scores, not vendor claims.
Inbox
Send claim progress updates to clients
An agent can draft updates from the insurer's latest response. The officer adds context when the news is bad.
Bookings & calendar
Book assessor and repairer visits
Matching times between client, assessor and repairer is a scheduling job.
Phone & voice
Take the first call after a client's loss
People are often distressed after a crash, burglary or flood. Empathy and clear guidance come first.
Chase insurers and assessors for decisions
An agent can track overdue items and draft follow-ups. Escalation calls need a person.
Spreadsheets & data
Keep the claims register up to date
Logging status changes from emails into the register is routine.
Documents
Prepare and lodge the claim with the insurer
An agent can prefill claim forms from the policy and the client's notes. The officer checks the facts before lodging.
Write a summary when a claim closes
An agent can draft the summary and lessons from the file. The officer confirms it.
Research
Check the policy wording for cover and exclusions
An agent can find the relevant clauses quickly. Interpreting them for the client's situation needs the officer.
Customer chat
Advocate for a client when a claim is disputed or declined
This needs judgement, persistence and a relationship with the insurer.
Time freed, and where it goes.
Work an agent can take on
What comes off the desk.
- Collect photos, receipts and reports from the client
- Keep the claims register up to date
- Book assessor and repairer visits
Where those hours should go
Back into people, and the business.
- CX — Take the first call after a client's loss
- CX — Prepare and lodge the claim with the insurer
- CX — Send claim progress updates to clients
- CX — Chase insurers and assessors for decisions
- CX — Advocate for a client when a claim is disputed or declined
- SX — Staff experience: more time for the work that needs a person
- BX — Check the policy wording for cover and exclusions
- BX — Write a summary when a claim closes
Seen at
Business types where this role often appears, with a note on how it shows up there.
Business type
AI agents for Loss Adjusters
Logs new matters, gathers documents, communicates with insurers and policyholders, and tracks claim progress and deadlines.
Business type
AI agents for Insurance Agencies
Guides clients through claims lodgement, gathers documents, liaises with insurers, and tracks claim progress and outcomes.
Want this set up for you?
If you would like someone to build these claims officer flows in your business, tell us a little and we can match you with an agency. We don’t list agencies on this site.