AI for property and casualty claims
Read the policy for coverage, compare estimates line by line, evaluate injury claims and write the file note, from the documents already in each claim file.
Open-claims-review.xlsxExampleClaims review, week of Nov 10
- PR-24-1187Kitchen fire$48,200Flagged
Contents estimate is 22% over the pricing guide, so ask the contractor for line detail.
- AU-24-0932Rear-end, injury$31,500Ready
Medical specials reviewed and the evaluation drafted for the supervisor.
- PR-24-1201Hail, roof$19,750Ready
Coverage confirmed, because the roof-age exclusion does not apply.
- GL-24-0415Slip and fall$65,000Waiting
Request the incident report and video before the reservation of rights.
How it works
- 1
Open the claim file
The policy, the loss notice, photos, estimates, medical records and correspondence, exported from your claims system or saved as they arrive.
- 2
Ask for the next piece of work
A coverage position with the policy language quoted, an estimate comparison, an injury evaluation or the file note.
- 3
Decide and document
Each finding cites the page it came from, so the adjuster makes the call and the file shows why.
Inside the P&C Claims mode
Claim file handling
Insurance claim files from first notice through coverage verification, investigation and liability or compensability, case reserves, subrogation and salvage, within unfair-claims-practices deadlines.
Insurance coverage analysis
Coverage analyses for an insurer, policyholder or claimant mapping a claim to policy grants, exclusions, conditions and limits, with tenders and position letters, and gap reviews of an existing program.
Property damage estimate review
Property and auto damage estimate reviews in Xactimate or CCC for scope, line items, RC versus ACV depreciation and supplements.
Bodily injury evaluation
Bodily injury evaluations: medical specials and causation, liens including Medicare secondary payer, comparative fault, and settlement ranges within limits and time-limited demand deadlines.
Business interruption claim
Business interruption and extra expense loss quantification from financial records.
Investigation plan and findings report
Investigation plans, evidence logs, interview outlines and memoranda with Upjohn or Garrity advisements, and findings on each allegation.
- Office skills
- Excel, Word, PowerPoint, PDF
- Tools
- Read, edit and write files, Search files, Run code, Search and read the web, View images
- Connectors
- SharePoint, Google Drive, Gmail, and additional custom connectors
- House style
- Your fonts, layouts and rules, on every file
Ask it for
“Read the policy and the loss notice and tell me whether the water damage is covered, quoting the policy language.”
Coverage-analysis.docx“Compare the contractor’s estimate to the desk adjuster’s and list every line that differs by more than 10%.”
Estimate-comparison.xlsx“Summarize the medical records and specials for the bodily injury evaluation.”
BI-evaluation.docx“Work out the business interruption loss from the insured’s monthly P&Ls and payroll.”
Business-interruption.xlsx“Write today’s file note from the call notes and the documents received this week.”
File-note-PR-24-1187.docx
Who it’s for
Property, auto and liability claims staff at carriers, TPAs and independent adjusting firms, from desk adjusters and appraisers to claims managers.
Questions
Does it decide coverage or set reserves?
No, it reads the policy and the facts, quotes the language that applies and lays out the position, and the adjuster decides. Reserve recommendations come with their support for you to accept or change.
Which lines of business does it handle?
Personal and commercial property, auto and general liability, including property damage estimates, bodily injury evaluation, business interruption and investigations.
Where does claimant data go?
Ultramarine Work changes files only in the project’s folder. When a request needs it, it can read files elsewhere on your computer, never passwords, keys or app data, and you can turn that off in settings. The model runs on Paper Instruments’ servers, so the content it works on is sent there to be processed. Paper Instruments is SOC 2 Type II, and our security and compliance details are on our compliance page.