Claims Status Update Agent AI Agent
Automate claim status updates and document reminders across WhatsApp, SMS, Web chat while improving claim transparency and reducing inbound calls.
Example: Claims Status Agent that sends live updates, reminders, and survey scheduling notifications.
Claims Ops, Policy Servicing, Renewals Ops, CX
Website widget · Inbound number · WhatsApp deep link · Email · Agent/broker portal
Secure actions, supervised handoff, and full audit trails.
Built for teams that need speed and control
Outcomes-first jobs your buyers care about
Share claim status
How: Reads claim system and provides next steps.
Outcome: Lower inbound queries
Chase missing documents
How: Automated reminders for pending docs.
Outcome: Faster claim cycles
Update survey schedule
How: Notifies customers of surveyor appointment.
Outcome: Better coordination
Escalate delays
How: Flags overdue claims to ops.
Outcome: Reduced escalations
Step-by-step flow buyers expect to see
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1
Trigger: status check
Customer asks for update.
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2
Lookup
Claim stage and pending tasks.
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3
Notify
Share status and SLA.
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4
Action
Send doc reminders or schedule survey.
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5
Exceptions
Overdue escalations.
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6
Wrap-up
Notes logged.
Real scenarios with clear resolution paths
Agent: Your claim is approved. Settlement in 2 business days.
Customer: Thanks.
Agent: We still need the repair invoice. Upload here.
Agent: Survey is delayed. I am escalating to the survey team.
Systems connected with secure actions
Systems of record
Policy admin, Claims system, CRM, TPA
Service stack
Zendesk, Freshdesk, Knowledge base
Comms
Dialer/telephony, WhatsApp provider, SMS, Email
Action tools
Document collection, eSign, Payment links, Survey tools, Claims system, Doc upload, Survey scheduling
Enterprise readiness built in
What you will improve
FNOL completeness
Claims initiated with full documentation.
Claim cycle time
Time from FNOL to settlement.
Renewal rate
Policies renewed before lapse.
Lapse rate
Policies not renewed within grace.
AHT
Average handling time per interaction.
CSAT
Customer satisfaction post-servicing.
Complaint rate
Escalations per 1,000 policies.
Agent productivity
Cases handled per FTE.
Flexible to your policies, tone, and tools
A phased rollout with clear deliverables
Discovery + call listening
- Workflow map and intent list
- SOP alignment and compliance notes
- Success metrics and QA plan
Pilot on 1 channel + 1 workflow
- Agent prompts and guardrails
- Test cases and failover scripts
- Live dashboard with baseline KPIs
Expand intents + integrate systems
- System actions and data sync
- Multi-channel coverage
- Supervisor playbooks
Optimize + scale
- Continuous QA coaching
- A/B tested prompts and flows
- Governance and reporting
Buyer objections, answered
How do you handle exceptions?
The agent routes exceptions to a human with full context, suggested next steps, and a clear disposition.
What happens when the agent is unsure?
It asks clarifying questions, consults the approved knowledge base, or escalates based on confidence thresholds.
Can we restrict what it can say or do?
Yes. Guardrails lock sensitive responses and require approvals for authenticated actions.
How are transcripts stored?
Transcripts and action logs are stored with retention controls and audit access.
How does handoff work with our CRM or ticketing?
The agent writes structured notes, tags, and next steps directly into your system of record.
What languages and accents are supported for voice?
Major Indian and global languages with configurable voice and accent options.
See this agent live on your workflow
See the agent live with your data, policies, and channels.
Deploy an AI-supervised agent for your highest-volume workflow.
We consult, design, build, and manage the agent end-to-end.