AI agent for claims adjusters
Subrogation Opportunity Agent
Recoverable claims identified early, evidence preserved and demands ready before the deadline
What it does
Recovery rights are missed when nobody looks for third-party fault until the file is closed. This agent reads new and open claim files for signs that someone else may be responsible, such as another driver's citation, a defective product or a contractor's work. It lists the evidence to preserve and checks the statute of limitations for the loss. When new evidence arrives, it rechecks the file. If a recovery looks worthwhile, it drafts a demand package with the facts, damages and supporting documents. The adjuster and recovery team approve every demand. Edge case: the file's statute deadline is 60 days away, so the agent moves it to the top of the list.
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
- New or updated claim file
- Read the file for signs of third-party fault
- List the evidence to preserve and who holds it
- Check the statute of limitations for the loss type and place
- Is there enough evidence to support a recovery claim?If not: list the missing evidence and request it, then reread the file. Back to step 2.
- Estimate recoverable amount and cost to pursue
- Draft the demand package
- Adjuster and recovery team approve the demandThe agent waits here for your OK.
- Demand sent by the team and the deadline tracked
How it decides
A file is a recovery candidate when evidence shows third-party fault and the expected recovery is above the cost. Files near the deadline rank first.
- Flag a file when evidence names a third party at fault
- Rank by days left before the statute deadline
- Skip when expected recovery is below the cost threshold
- Add paid amount and deductible to the demand
Make it yours
Every agent is a starting point. You choose these settings for your own situation.
- Recovery cost threshold (default: $1,500)
- Statute of limitations table
- Review schedule
- Evidence checklist by claim type
What keeps you in control
It always asks you first
- Adjuster and recovery team approve every demand
Hard limits
- Never sends a demand
- Never closes a file as not recoverable without the adjuster
It stops when
- Done: the demand is approved or the file is marked not recoverable
- Stop: the file lacks any fault evidence after a request
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
