Insurance claims

Works like Guidewire ClaimCenter, Duck Creek or Majesco. Work a made-up carrier's claims desk: verify coverage on three new losses and catch the one a day past cancellation, set exposures and reserves, pay a homeowners claim with depreciation and the ALE limit, refer the one theft with real fraud indicators to SIU, then send the denial and diary the open claims.

Claims

Brightwater Mutual · May 13, 20270 of 5 done right

QuickCruit Claims

New losses

Reported overnight. Verify coverage before anything else happens on the file.

Details

Claim: 27-036876
Caller: Imani Castillo
Reported: May 12, 2027
Driver, as named: Imani Castillo
Other driver: Rosa Rasmussen
Other vehicle: 2022 minivan

Call notes, overnight line

Imani here. I rear-ended a 2022 minivan at a red light on Sparrow Lane on Wednesday, May 12, around 2 PM. Nobody was hurt. The other driver is Rosa Rasmussen, and we traded information.

Triage

QuickCruit AssistantAI

CoverageCovered
The driver is listed on the declarations, and the loss falls inside the policy term.
Basis: listed driver
Suggested reserve$8,337.46
- Collision, first party$6,051.96
- Liability property damage, third party$2,285.50
The insured's car net of the collision deductible, the other car at its estimate.
Fraud score17 of 100Low
No indicators from the manual's checklist seen.
Also noted: Reported the day of the loss.

AI responses can be inaccurate.

Coverage verification

Declarations are in Policy lookup

Loss reported, done
Policy found, to do
Loss date set, to do
Coverage decided, to do

Every caller, policy and car here is made up for practice.

Brightwater Mutual

May 13

Your morning on the claims deskBianca Oyelaran, claims supervisor

Three auto FNOLs hit the queue overnight. Coverage on all three before anything else, and open exposures and set reserves on the two-car loss. Andre's homeowners file is ready to pay. Two thefts are flagged for the fraud checklist. Denial letter goes out today, and nothing open leaves your desk without a diary date.

Pull the dec page in Policy lookup before any coverage call. Reserves, the depreciation table and the fraud indicators are all in the claims manual.

Brightwater Mutual is a made-up carrier. Its policyholders, policies and numbers are made up too, and nothing here is insurance advice.