Integrations
Insurance
How the agent reads policies and claims, takes first notice of loss and collects documents in your core insurance systems, while every claims decision stays with your team.
On this page
In insurance, the answer a customer hears has to match the policy they hold and the claim as it stands. Connecting the agent to your policy administration and claims systems lets it take a first notice of loss (the first report of a claim) at any hour, in the structure your claims process needs, answer coverage questions from the policyholder's actual policy, and tell them where their claim has got to. The agent handles the conversation and the process around a claim. It never assesses liability, sets a settlement amount, or approves or declines a claim.
What connecting your insurance systems lets the agent do
| Ability | What it means for you | Example |
|---|---|---|
| Take first notice of loss | The right questions for the claim type, in the right order, written as a structured record into your claims system. Configured during implementation | A motor claim logged at 11pm with every detail the handler needs |
| Answer claim status | The agent reads the claim's status and can update the policyholder as it moves. Configured during implementation | "Your claim is with the assessor, who will visit on Thursday" |
| Answer policy and coverage questions | From the policyholder's actual policy and approved wording; the agent cannot describe cover the policy does not include. Configured during implementation | What the excess is, and whether windscreen damage is covered |
| Collect claim documents | Photos, reports and invoices received on WhatsApp, email or web and attached to the claim. Configured during implementation | A police report photographed and attached to the claim |
| Handle renewals | Reminders, questions about price changes, and the renewal conversation. Configured during implementation | A renewal reminder, followed by questions about the new premium |
| Support brokers | Policy checks, document requests and status queries from brokers. Configured during implementation | A broker checks the status of a client's claim |
Integrations in this category
| Integration | Type | What the connection covers |
|---|---|---|
| Guidewire | Core insurance platform | Policies, claims, documents and notes |
| Duck Creek | Core insurance platform | Policies, claims, documents and notes |
Regional and in-house policy and claims systems connect the same way, as custom actions. See Custom actions.
How the connection works
The agent reads the policyholder's policy, cover, excess and approved wording, and the status of any open claim. It writes only what your claims team has agreed: a new claim from a first notice of loss, documents attached to a claim, and notes. The functions that assess liability, set a settlement amount or reserve (the amount set aside to pay a claim), or approve or decline a claim are not exposed to the agent at all. There is nothing for it to call.
Medical judgements, anything that looks like fraud, claims involving serious injury or bereavement, and complaints already with the regulator also stay with your team. Where a policyholder shows signs of being vulnerable or distressed, the agent routes them to a person with the full conversation. See Decision boundaries.
The technical detail
Each platform connects through its standard API (application programming interface: the documented way other software exchanges data with it), using a dedicated integration account your administrators control and permissions granted action by action. Credentials are stored encrypted with AES-256 in your deployment, calls travel over TLS (Transport Layer Security), version 1.2 or higher, and the connection runs from your deployment in your chosen region. Policy figures such as the excess are inserted directly from the system record. Every read and write is logged, so your compliance team can show exactly what a policyholder was told and where it came from.
Permissions typical for this category
| Permission | Needed for | Default |
|---|---|---|
| Read policy, cover, excess and approved wording | Coverage questions | Granted, after identity checks |
| Read claim status and outstanding documents | Status questions and document chasing | Granted |
| Create a claim | First notice of loss | Granted where in scope |
| Attach documents and add notes | Document collection | Granted where in scope |
| Assess liability, set settlement amounts or reserves, approve or decline claims | Not needed | Not connected in any deployment |
The agent can only take actions your team has granted. Anything not granted cannot be invoked. See Permissions.
In practice
Wadi Assurance, a motor insurer, connects its core insurance platform.
- At 10:40pm, Ibrahim calls to report that his parked car was hit. The agent confirms he is safe, verifies his identity and finds his policy.
- It asks the insurer's motor claim questions in order and creates the claim in the claims system, then sends him a WhatsApp message listing the documents to send.
- He sends a photograph of the police report. The agent attaches it to his claim.
- He asks whether he will have to pay the excess. The agent explains what his policy says about the excess, and that whether it applies depends on the claims team's decision on the claim.
- The next morning, the handler opens a complete claim, with the documents attached and the full conversation.
What your team controls
- What the agent reads and writes in your policy and claims systems.
- The question flow for each claim type.
- The approved wording the agent answers from.
- Which situations go straight to a person.
Related
- InsuranceIndustry guides
- Decision boundariesGovernance and control
- PermissionsIntegrations
- How integrations workIntegrations
- Compliance flaggingQuality and analytics
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