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AI agent for insurance agents

Client Claim Status Follow-up Agent

Keep clients informed and claims moving without the client having to chase

CommunicationMonitoringSalesInsurance
See how it worksGet access
Client Claim Status Follow-up Agent: what goes in, what the agent does and what you get

What it does

When a client files a claim, they look to their agent for updates, and silence feels like being let down. This agent logs each claim, the adjuster and the next expected step. Every few days it checks the carrier portal and emails for updates and compares progress with the normal timeline for that claim type. A claim is stuck when the next step is late, for example no adjuster contact in 7 days. Then it drafts a note to the adjuster and a short client update. Clients get an update at least weekly. It reads replies, updates the claim log and checks the claim moved. If the carrier denies part of a claim, it drafts a plain-language summary for the agent to review and gives no legal advice. The agent approves every client and carrier message. Edge case: partial denials get a plain-language summary for review.

How it works

Follow the arrows from top to bottom. The orange dashed arrow is the loop: when a check fails, the agent goes back and tries again.

Start and resultWhat it doesA check on its own workWaits for your OKGoes back and retries
Yes, continueApprovedYes, continueNoNo 1 STARTS WHEN Client reports a claim 2 USES A TOOL Log claim, adjuster and next expected step 3 USES A TOOL Check carrier portal and emails for updates 4 CHECKS THE RESULT Is the claim on its normal timeline? If not: draft an adjuster follow-up and a client update.Back to step 3. 5 DOES Draft a plain-language summary of any partial denial 6 YOU APPROVE Agent approves messages 7 USES A TOOL Update the claim log and client file 8 CHECKS THE RESULT Has the claim moved to its next step afterfollow-up? If not: follow up again and raise it with the carrier'sclaim manager. Back to step 3. 9 RESULT Claim closed with outcome recorded
Read the steps as a list
  1. Client reports a claim
  2. Log claim, adjuster and next expected step
  3. Check carrier portal and emails for updates
  4. Is the claim on its normal timeline?If not: draft an adjuster follow-up and a client update. Back to step 3.
  5. Draft a plain-language summary of any partial denial
  6. Agent approves messagesThe agent waits here for your OK.
  7. Update the claim log and client file
  8. Has the claim moved to its next step after follow-up?If not: follow up again and raise it with the carrier's claim manager. Back to step 3.
  9. Claim closed with outcome recorded

How it decides

A claim is stuck when the next expected step is late by the set number of days.

  • No adjuster contact in 7 days triggers follow-up
  • Partial denials get a plain-language summary for review
  • Client updates at least weekly

Make it yours

Every agent is a starting point. You choose these settings for your own situation.

  • Check frequency
  • Stuck threshold per claim type
  • Client update cadence
  • Message tone

What keeps you in control

It always asks you first

  • Messages to clients
  • Messages to adjusters

Hard limits

  • Never gives legal advice
  • Never negotiates the claim amount

It stops when

  • Done: claim closed
  • Stop: client hires a public adjuster or attorney

Set it up

We guide you through the set-up, step by step

Members get the full set-up guide for this agent. No technical skills needed: you copy, paste and upload.

10 minto set it up in your AI
5 AIsChatGPT, Claude, Copilot, Gemini, Grok
  • One set of instructions to paste into your AI, with the clicks for ChatGPT, Claude, Microsoft 365 Copilot, Gemini and Grok
  • The agent then walks you through connecting your own data, one source at a time
  • A downloadable copy with the flow chart, the rules and the full guide
Get access to this agent

An example run

What happensA water damage claim filed on August 2 had no adjuster contact by August 11, so the timeline check failed. The agent drafted a follow-up to the adjuster and a short client update, both approved by the agent that morning. The adjuster replied with an August 14 inspection date. The agent logged it, sent the client the date after approval, and set the next check.

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