Watch out. Claims data is sensitive personal data, so it must stay inside approved systems with access controls. The pipeline flags; it never approves or rejects a claim, and an assessor signs off every action.
Pre-check claim documents before assessment
A pipeline that checks each new claim for missing or mismatched documents and flags it for a person.
Recommended: ArchitectAutomationCompliance
Best for
- Claims operations teams with a document backlog
- Health or motor claims with a fixed document list
- Teams that already have a claims system with an API
What you need
- Access to your claims system through an approved integration
- The document checklist per claim type
- A set of past claims with known outcomes for testing
- Sign-off from compliance and IT
Starter prompt
Copy it, fill in the parts in square brackets, and paste it into the AI assistant your organisation allows.
You are the document-check step for [claim type] claims at [insurer name]. You receive the claim form fields and the text extracted from each uploaded document. Check against this list: [document checklist]. For each item return Present, Missing or Mismatch, with a one-line reason (for example, name on hospital bill does not match claim form). Do not decide whether the claim is payable. Output a short summary for the assessor and a list of documents to request from the customer. Claim data: [fields] Documents: [extracted text]
How to use it
1.Define the checklist
2.Build the steps
3.Evaluate on past claims
4.Deploy with a person in charge
- 1
Define the checklist
Write the required documents and match rules for one claim type. Agree them with the claims head before building anything.
- 2
Build the steps
Connect extraction, the document check and a summary step through approved integrations. Personal data stays inside your approved systems.
- 3
Evaluate on past claims
Run it on past claims where you know which documents were missing. Measure misses and false flags, and fix before going further.
- 4
Deploy with a person in charge
Go live so it only flags and drafts requests. An assessor approves every customer message and every decision.
What you end up with
Every new claim arrives with a document check and a draft request list for the assessor.
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