Claim Agent

Claim Agent brings MosaicAI into your claim workspace. Ask about the current claim to get a summary, review supporting documents, draft an update, or plan the work ahead.

Open Claim Agent

Open a claim from the Claims List.
Select the robot icon before the Overview tab.
In the MosaicAI welcome view, choose a starter or type a question in Ask about this claim….
Review the request, then send it using the arrow in the message box.

The starters help you begin:

Summarize claim: Review the claim’s current situation and key information.
Review coverage: Ask about policy information and the documents supporting coverage.
Draft update: Prepare a claim update to review before sharing.
Find next steps: Identify missing information and work to move the claim forward.

Ask About Claim Information

Be specific about what you want to know. For example, ask “Summarize the latest activity and outstanding tasks” or “Compare the estimate with the invoice and identify differences.”

The Agent can review information and documents connected to the current claim, including policies, estimates, invoices, and correspondence. It can also help you understand goals, task progress, and outstanding work. Information available in a response depends on your access to the claim and its records.

Check the supporting documents and claim details when reviewing an answer. If information is missing, add it through the usual claim workflow and ask a follow-up question.

Draft Documents and Updates

Ask the Agent to help prepare a document or draft a response using the claim’s information. For example, ask “Draft a policyholder update covering recent progress and next steps.”

Review names, dates, amounts, coverage details, and wording before using the draft. A draft is not automatically sent as an email or added to the claim’s activity. Use the usual document or Activity workflow to save or send the reviewed content.

Plan and Update Tasks

Ask for a checklist of recommended tasks or a review of existing goals and tasks. The Agent can help identify follow-ups and propose changes to task status or assignments.

Review each proposal before approving it. A recommended checklist does not create tasks by itself, and a proposed change is applied only after approval and permission checks. Use the Tasks tab to review the resulting work and track progress.

Use Recommendations

When recommendations are enabled, Claim Agent may suggest requests based on the claim’s current information. Select a suggestion to fill the message box with an editable request. Review or change the wording, then send it when ready.

Selecting a recommendation does not send the request or approve a change. You remain in control of the request and any proposed action.