AI agent for insurance risk analysts
Subrogation Opportunity Finder Agent
Find recoverable claims early, with evidence, before the time limit passes.
What it does
When someone else caused a loss, the insurer can try to recover what it paid, but many cases are never noticed or are noticed after the time limit. This agent scans paid claims for signs of third-party fault, such as a rear-end collision, a defective product, a contractor error or a police report naming another party. For each candidate it checks the time limit for that state, the evidence on file and an estimate of the recoverable amount. It drops cases with weak evidence or low value and drafts a referral list ranked by expected recovery. If a case lacks evidence but has high value, it requests the missing items first. The claims manager approves referrals.
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.
Read the steps as a list
- Weekly scan of paid claims
- Read paid claims and adjuster notes
- Flag signs of third-party fault
- Look up the time limit for the state and claim type
- Check evidence on file such as reports and photos
- Is there enough evidence to support a recovery?If not: request the missing evidence if the value is high, or drop the case. Back to step 4.
- Estimate the recoverable amount and cost to pursue
- Rank cases and draft the referral list with deadlines
- Claims manager approves referralsThe agent waits here for your OK.
- Subrogation referral list
How it decides
It ranks cases by expected recovery, from the amount paid, the strength of the evidence and the days left on the time limit.
- Drop cases with expected recovery below $1,500
- Prioritize cases with less than 90 days left on the limit
- Require a report naming the other party or product
- Request evidence first for cases above $25,000
Make it yours
Every agent is a starting point. You choose these settings for your own situation.
- Minimum recovery value (default $1,500)
- State time limits
- Warning window (default 90 days)
- Fault signals to scan for
What keeps you in control
It always asks you first
- Claims manager approves each referral
- Claims manager approves any demand letter
Hard limits
- Never contacts the other party
- Never files a recovery action
It stops when
- Done: referral list approved
- Stop: claim data lacks adjuster notes for most claims
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.
- 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
