Agentic TeamInsuranceintermediate

Claims Intake and Triage Desk Template

Team of 4 specialists · hierarchical

A coordinated first-response team that takes a new loss from FNOL to a ready-for-adjuster package: clean intake, severity triage, a coverage-verification worksheet, and a fraud red-flag screen: all as recommendations for a licensed adjuster to decide.

A roster of specialist sub-agents behind one chat. Each message is routed by intent to the sub-agent that owns it.

Officialby Turtle Techsai

What's inside

Everything this template installs, by name.

Specialist agents4
Coverage AnalystIntake SpecialistIntegrity ScreenerTriage Analyst
Tables2
ClaimsPolicies
How this team works

Coordinates specialists into one result.

A coordinated first-response team that takes a new loss from FNOL to a ready-for-adjuster package: clean intake, severity triage, a coverage-verification worksheet, and a fraud red-flag screen: all as recommendations for a licensed adjuster to decide.

Routing rules
  1. Take a new loss from FNOL to a ready-for-adjuster package.
  2. Sequence: (1) capture clean FNOL intake and missing-info list, (2) score severity and recommend routing/reserve range, (3) produce a coverage-verification worksheet with cited clauses, (4) screen for fraud red flags and give an SIU refer/do-not-refer recommendation.
  3. Everything is a recommendation or draft for a licensed adjuster; never approve/deny coverage, set a binding reserve, authorize payment, accuse anyone of fraud, or give legal advice.
  4. Follow fair-claims-practices: prompt, honest, equal treatment; no misrepresentation of policy terms.
  5. Use only the facts provided; cite the policy section for any coverage observation and mark missing info to request.
The roster

4 specialists, one team.

Coverage Analyst
Produces a coverage-verification worksheet

Verify potential coverage against the policy with cited clauses, never a final determination.

Policies · ReadKnowledge
Intake Specialist
Captures clean FNOL intake

Produce a complete FNOL summary and a precise missing-info list, with no coverage promises.

Claims · Read · Create · UpdateKnowledge
Integrity Screener
Screens for fraud red flags

Produce a neutral SIU refer/do-not-refer recommendation with cited red flags.

Knowledge
Triage Analyst
Scores severity and recommends routing

Assign severity and recommend routing plus an initial reserve range as estimates.

Knowledge

Shared tables

Claims

Claims from FNOL to settlement: claim number, policy, claimant, loss type, loss date, description, severity, reserve, status, adjuster, and fraud/subrogation flags.

Claim Number textPolicy Number textClaimant textLoss Type selectLoss Date dateDescription textSeverity selectReserve Amount numberStatus selectAdjuster textFraud Flag booleanSubrogation Potential boolean
Policies

Insurance policies: policy number, insured, line of business, coverage limits, deductible, effective/expiry dates, premium, and status. Reference table for claims, coverage checks, and renewals.

Policy Number textInsured Name textLine of Business selectCoverage Limit numberDeductible numberPremium numberEffective Date dateExpiry Date dateStatus select

What you can do with it

Streamlined Claims Processing
Efficiently manage new loss submissions with ease
Fraud Detection
Identify potential fraud early in the process
Severity Assessment
Quickly triage claim severity for prioritization
Coverage Verification
Ensure accurate coverage details for adjusters