AI claims follow-up agent for insurance agencies
The Covera Agents claims agent turns a claim notice into a sourced file, with the documents to gather and a drafted request to the client. It then tracks the documents until the account manager closes the file.
Covera Agents builds AI agents for insurance brokers. The claims agent supports the account manager from the client's first notice to a complete file. It reads the notice, extracts the facts with the proof of each one, sets the list of documents to gather, and drafts the request to the client.
Where claims files lose time
A claim notice arrives by email, often with a few photos and little context. The account manager has to find the policy, work out which documents this type of loss requires, ask the client for them, then follow up until everything is in. Meanwhile other files wait at the same step: a missing document nobody has chased.
What the claims agent does
- Once the agent is set up, it watches a mailbox chosen by the agency and opens a file for each identified claim notice. Sorting follows fixed rules, not an AI model.
- It extracts the client, the policy, the date and the type of loss, each with the exact excerpt and page it came from.
- It links the file to a policy of the agency's book only on an exact match of carrier and policy number; otherwise the file is flagged for review.
- It builds a document checklist for the type of loss, such as photos, a repair estimate or a police report for a theft.
- It drafts the request to the client and proposes a status, which the account manager accepts or not.
What stays with the account manager
The claims agent does not send emails and does not file the claim with the carrier. Each request is a draft in the agency mailbox. The account manager validates or rejects each document, accepts the proposed status or not, and closes the file with a reason. Nothing is created in the agency management system.
Supported claims and limits
The agent covers the notice, the extraction, the checklist and the document follow-up. It does not track the carrier's side of the claim, such as adjustment or settlement. Its default document lists were calibrated only on French building and condominium claims, and are not validated for auto, health or professional liability. For a US agency, availability and document requirements are confirmed with Covera before activation, and the agency can replace the list of any type of loss with its own. The agent never requests medical documents, but it does not detect them either: a medical attachment in a sorted email is read like any other document.
Linked agents
The document tracking works like the document collection agent: one checklist per file, kept current as replies arrive. The same mailbox sorting sends identified unpaid premium notices to the past-due collections agent. A claim reported inside an existing document collection thread stays with collection, and the account manager opens the claim by hand.
Data
Every fact in a claims file links back to its source. Covera does not train any AI model on agency data.
Frequently asked questions
What does the Covera Agents claims agent do?
The Covera Agents claims agent reads a claim notice, extracts the facts with their proof, sets the document checklist for the type of loss, drafts the request to the client, and tracks the documents until the account manager closes the file.
Does the Covera Agents claims agent file the claim with the carrier?
No. Covera Agents prepares the file and the client request as a draft. The account manager sends the request and handles the carrier.
Which claims are the Covera Agents default checklists built for?
The Covera Agents default claims checklists were calibrated only on French building and condominium claims. For other lines and for US agencies, the lists are confirmed with Covera and can be replaced by the agency's own.
What happens if the policy cannot be matched?
The Covera Agents claims file opens flagged for review. The account manager sets the policy and product, and the checklist is rebuilt without losing the documents already received.