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Claims

Claim Report Agent

Turns raw adjuster notes into a bundled packet of claim status reports, one page per claimant.

Adjuster notesReservesReturn to workLitigation
claim report agentexample activity
  1. CLAIM REPORT Weekly adjuster notes loaded. 10 open claims. Reading.
  2. CLAIM REPORT 3 new claims found with no claim summary on file. Marked new.
  3. CLAIM REPORT Reserve check: 1 claim paid at 80%+ of incurred. Flagged.
  4. CLAIM REPORT Packet built: cover index and 10 claimant reports. Ready.

How it works

What the agent does

The agent handles each step and hands over finished work.

  1. Read the notes

    Reads the weekly adjuster notes and claim summaries for every open claim.

  2. Fill each report

    Builds the claimant, injury, work status, medical, legal and reserve sections.

  3. Flag what matters

    Marks attorney involvement, approved surgery, impairment ratings and critically low reserves.

  4. Bundle the packet

    Adds a cover index with total incurred and what changed since the last report.

Inputs and outputs

What goes in, what comes out

What the agent needs to start, and what it hands back.

Goes in

Inputs

  • Weekly adjuster notes
  • Claim summary files
  • Reserve figures

Comes out

Outputs

  • A cover index of every open claim
  • One status report per claimant
  • Flags for attorney, surgery, impairment and low reserves
  • A forward-looking medical, legal and reserve review

Example output

What the work looks like

Names and figures below are examples.

L. Moreau · Claim WC-26-0291 (example)WC · Left knee
Work statusModified duty
Surgery approvedYes
Total incurred$52,000
Paid / incurred22%

What happened

Stepping down from a scaffold platform, the employee's left knee twisted. MRI confirmed a medial meniscus tear.

Action plan

Confirm the 10/20 surgery date holds. Plan modified duty for the return.

Outlook

Expect an increase of $6,000 to $10,000 if time off after surgery runs past four weeks.