AI Claims Assistant — Claims analyst
Analyzes a claim, resolves statutes and deadlines, calculates recovery, and drafts a settlement-grade report a licensed professional reviews and owns.
What it does
Responsibilities
- Extracts the coverage structure and classifies the peril from policy and loss documents.
- Resolves the governing statute and calculates a defensible recovery figure.
- Drafts a written, source-cited report — gated behind a review step before it reaches a customer.
- Audits an estimate against the photographic record and flags missed or underpriced scope.
How it works
A day in the life
- 01
A policy and loss file come in.
Settlement IQ extracts the coverage terms and classifies the peril.
- 02
The assistant drafts a recovery position.
A source-cited report is produced; AI Estimating separately checks the estimate against project photos.
- 03
A licensed professional reviews the draft.
The report is gated behind a verdict step — an unreviewed analysis cannot reach a customer.
- 04
The reviewed report goes out under the professional's name.
The assistant drafts; the human owns the conclusion.
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Where this role is headed
No platform engine powers this role yet — it isn’t wrapped around an existing product, so there’s nothing to demo or license today.
Employed Under Governance
Permissioned
Every action runs under scoped capabilities, never ambient access.
Audited
Every action writes an immutable audit event.
Capped
Usage and spend enforce hard limits, checked at approval time.
Stoppable
Any role can be paused or revoked instantly, no cascading cleanup.
AI Workforce roles are software — permissioned, audited, and stoppable systems, not employees, contractors, or legal persons.
Availability & licensing
Not yet available. Being built or specified — not licensable yet.
Licensed per organization — talk to us.
Per-seat licensing, metered services, and white-label terms are all quoted directly; nothing here is self-serve checkout.
How pricing works →Hire AI Claims Assistant.
Analyzes a claim, resolves statutes and deadlines, calculates recovery, and drafts a settlement-grade report a licensed professional reviews and owns.