AI Prompts for Insurance Adjusters

Summarize the following insurance claim file into a concise, structured summary I can drop into my claim notes.

Claim type: [property / auto / general liability / bodily injury]
Claim number: [number]
Date of loss: [date]
Insured / claimant: [name]
Cause of loss: [e.g. water damage from burst pipe, rear-end collision]
Raw file notes / statements / documents:
[paste adjuster notes, recorded statement summary, estimates, emails, etc.]

Produce:
1. One-paragraph overview (what happened, who is involved, current status)
2. Key facts and timeline (bulleted, chronological, with dates)
3. Coverage issues or questions flagged so far
4. Outstanding items and next actions with the responsible party
5. Reserve or exposure notes if mentioned in the file

Requirements:
- Neutral, factual tone. Do not draw conclusions I haven't stated in the notes.
- Do not invent dates, amounts, names, or policy provisions. If something isn't in the file, write "not stated in file."
- Keep it under 300 words.
- End with a "Gaps to verify" section flagging anything inconsistent or missing.

Write a status update email to a policyholder on an open claim.

Policyholder name: [name]
Claim number: [number]
Date of loss: [date]
Current status: [e.g. inspection completed, waiting on contractor estimate, in review]
What's been done: [2-3 items]
What's next: [next step and rough timeline]
What I need from them: [documents, access, signed form, or "nothing at this time"]
My name / title: [name, title]

Requirements:
- Warm, clear, and professional. Plain English, no insurance jargon or undefined acronyms.
- Reassure without promising a coverage outcome or a dollar amount.
- Use short paragraphs and, where helpful, a short bulleted list of next steps.
- End with how to reach me and my typical response time.
- Under 180 words.
- Do not state or imply a coverage decision unless I have written one in the status above.

Turn my field inspection notes into a clean, professional inspection report narrative.

Claim number: [number]
Property / vehicle: [address, or vehicle year/make/model/VIN]
Date of inspection: [date]
Type of loss: [wind / hail / water / fire / collision / etc.]
My raw observations:
[paste notes on what you observed, area by area or panel by panel: damages, measurements, materials, pre-existing conditions, photo references]

Produce a narrative with these sections:
1. Scope of inspection (what was inspected, conditions, who was present)
2. Observed damage (organized by area/component, describing type and extent)
3. Cause and origin observations (only what I noted; do not speculate beyond it)
4. Pre-existing or unrelated damage noted
5. Recommended follow-up (engineer, contractor bid, additional photos)

Requirements:
- Objective, third-person, past tense.
- Use only facts from my notes. Do not infer causation, coverage, or dollar values I didn't provide. Mark anything uncertain as "to be confirmed."
- Reference photo numbers where I included them.
- Keep language specific: materials, dimensions, and locations.

Draft a coverage approval / claim confirmation letter to a policyholder.

Policyholder name & address: [name, address]
Claim number: [number]
Policy number: [number]
Date of loss: [date]
Covered cause of loss: [as determined]
What's being covered: [scope, e.g. dwelling repairs, ALE, vehicle repair]
Payment details: [amount, less deductible of $X, payee, ACV/RCV holdback if any]
Any conditions: [e.g. recoverable depreciation released on completion, proof of repairs required]
My name / title / contact: [details]

Requirements:
- Professional, clear, and reassuring.
- State exactly what is approved, the amount, how the deductible was applied, and any depreciation or holdback and how to recover it.
- Reference the applicable policy coverage by name (I will confirm exact section numbers).
- Include next steps and required documentation.
- Stay neutral on anything not yet decided; do not over-promise on items still under review.
- End with contact info.

Note: This is a draft. I will verify all figures, policy provisions, and payee details against the actual policy and file before sending. Leave any figure I haven't provided as a [bracketed placeholder] rather than guessing.

Draft a claim denial letter to a policyholder based on the coverage analysis I provide.

Policyholder name & address: [name, address]
Claim number: [number]
Policy number: [number]
Date of loss: [date]
Claimed loss: [what they claimed]
Reason for denial: [factual/coverage basis, e.g. cause of loss is excluded, loss outside policy period, condition not met]
Relevant policy language: [paste the exclusion/condition wording I'm relying on]
Jurisdiction: [state]

Requirements:
- Respectful, plain-language, and non-adversarial in tone.
- Clearly state the decision, the specific factual reason, and quote the exact policy provision(s) relied on.
- Explain the policyholder's options: how to submit additional information and how to appeal or file a complaint with the state Department of Insurance.
- Do not disparage the policyholder or make legal conclusions beyond the coverage basis I provided.
- Include a statement that the insurer reserves all other policy terms and defenses and waives none.

Important: This draft is not legal advice. I will verify the quoted policy language, confirm it applies to these facts, check state-specific claim-handling and notice requirements, and have it reviewed by my supervisor or counsel before sending. Do not invent policy provisions, statutes, or deadlines; if you are unsure, insert [placeholder: verify] instead.

Draft a reservation of rights (ROR) letter for a claim still under investigation.

Insured name & address: [name, address]
Claim number: [number]
Policy number: [number]
Date of loss / occurrence: [date]
Nature of claim: [describe]
Coverage issues under investigation: [list the specific questions, e.g. whether an exclusion applies, late notice, business-use question]
Potentially applicable policy provisions: [paste the provisions/exclusions I'm citing]
Jurisdiction: [state]

Requirements:
- Professional and non-committal on the ultimate coverage outcome.
- State that the insurer is investigating and continuing to handle the claim under a full reservation of rights.
- Identify each coverage issue and the specific policy language it relates to.
- Make clear that no coverage position is final, no rights are waived, and the insured may retain their own counsel where appropriate.
- Invite the insured to submit information relevant to the issues raised.

Important: Not legal advice. ROR content and timing are governed by state law. I will confirm the policy language, the applicable statutes and case law, and required timing, and route this through my supervisor or counsel before sending. Never fabricate provisions or legal standards; use [placeholder: verify] where unsure.

Write a plain-English narrative to accompany a repair/damage estimate.

Claim number: [number]
Property / vehicle: [address or vehicle details]
Type of loss: [describe]
Line-item estimate summary:
[paste key line items with quantities and amounts, or a summary of the estimate]
Total estimate: $[amount]
ACV / RCV basis: [which one, and depreciation applied if any]
Deductible: $[amount]

Produce:
1. Summary of the damages the estimate addresses
2. Explanation of major line items in everyday language (what and why)
3. How the total was calculated (RCV, depreciation, deductible, net payable)
4. Any items excluded from this estimate and why
5. Notes on supplements (how to request one if hidden damage is found)

Requirements:
- Clear enough for a homeowner or claimant to follow; define any trade terms.
- Use only the figures I provided. Do not recalculate or invent totals; instead, flag any math I should double-check.
- Neutral tone. This explains the estimate; it does not argue coverage.
- Under 350 words.

Draft an internal subrogation referral memo.

Claim number: [number]
Our insured: [name]
Date of loss: [date]
Loss description: [what happened]
Potentially responsible party: [name/role, e.g. other driver, manufacturer, contractor]
Basis for subrogation: [negligence / product defect / contract, plus the key facts supporting it]
Payments made to date: $[amount] (breakdown: [detail])
Deductible owed back to insured: $[amount]
Evidence available: [police report, photos, expert report, statements]
Applicable considerations: [statute-of-limitations concerns, comparative fault, other insurance]

Produce:
1. Summary of the loss and our payments
2. Liability analysis (facts supporting the responsible party's fault)
3. Recovery target and estimated exposure
4. Evidence inventory and any gaps
5. Recommended next steps (preservation letter, demand, expert, referral to counsel)
6. Time-sensitivity flags (limitations period, spoliation risk)

Requirements:
- Internal, analytical tone.
- Base the liability analysis only on the facts I provided; label assumptions clearly.
- Do not assert legal conclusions about limitations periods or fault percentages as fact; flag them as items to verify with counsel.
- Under 400 words.

Write an internal settlement rationale / evaluation memo to support my reserve and negotiation position.

Claim number: [number]
Claim type: [bodily injury / property / liability]
Date of loss: [date]
Summary of facts: [brief]
Damages claimed: [medical specials, wage loss, property damage, general damages, with amounts]
Liability assessment: [clear or disputed, comparative fault %, supporting facts]
Coverage / policy limits: [limits, applicable coverages]
Prior offers/demands: [demand $X, our last offer $Y]
Comparable factors: [venue tendencies, similar claim outcomes I'm aware of]

Produce:
1. Case summary and liability posture
2. Damages evaluation (which are supported, which are questionable, and why)
3. Settlement range with low / target / high and the reasoning for each
4. Key risks (litigation exposure, sympathetic claimant, evidence gaps)
5. Recommended authority and negotiation strategy (opening number, key concessions)

Requirements:
- Objective and defensible; this may be reviewed by a supervisor or file auditor.
- Use only my inputs. Do not invent verdict data, statutes, or medical facts; mark estimates as estimates.
- Keep amounts as ranges tied to the stated facts, not guesses.
- Under 400 words.

Generate a question list for a recorded statement.

Statement from: [insured / claimant / witness]
Claim type: [auto / property / liability / injury]
Date of loss: [date]
What I already know: [brief facts]
Key issues to clarify: [e.g. sequence of the accident, prior damage, who was driving, extent of injuries, business vs personal use]

Produce an organized question list with these sections:
1. Preliminary (confirm identity, date, and that the statement is recorded with consent)
2. Background (relationship to the loss, relevant history)
3. The loss itself (open-ended and chronological: let them narrate, then follow up)
4. Damages / injuries (nature, extent, treatment, prior conditions)
5. Coverage-relevant facts (usage, occupancy, other insurance, prior claims)
6. Wrap-up (anything to add, corrections, confirm accuracy)

Requirements:
- Mostly open-ended, non-leading questions; note where I should probe for detail.
- Neutral and professional; nothing accusatory or coercive.
- Include reminders for me (in brackets) on what to listen for.
- Do not assume facts not in evidence; frame everything as questions, not accusations.

Note: I will confirm recording-consent and statement rules for [state] before proceeding and adapt to the interviewee's role.

Draft a first-contact / acknowledgment letter to a policyholder who just reported a claim.

Policyholder name: [name]
Claim number: [number]
Date reported: [date]
Date of loss: [date]
Type of loss: [describe]
Assigned adjuster: [my name, title, phone, email]
Immediate next step: [e.g. inspection to be scheduled, documents needed]
What they should do now: [mitigate damage, keep receipts, take photos]

Requirements:
- Warm, prompt, and reassuring; set expectations for the process.
- Confirm we received the claim and provide the claim number and my direct contact.
- List what happens next and what I need from them as a short bulleted list.
- Include practical loss-mitigation guidance appropriate to the loss type.
- Stay neutral on coverage; make clear the claim is being reviewed, without promising an outcome.
- Under 200 words.

Draft a letter explaining an auto total-loss valuation to an insured.

Insured name: [name]
Claim number: [number]
Vehicle: [year, make, model, trim, mileage]
Date of loss: [date]
Actual cash value (ACV): $[amount]
Valuation method/source: [e.g. market valuation report with comparable vehicles]
Deductible: $[amount]
Applicable taxes/fees: [if included]
Net settlement: $[amount]
Payoff / lienholder: [if applicable]
Options offered: [accept settlement / retain salvage for $X / dispute with additional comps]

Requirements:
- Clear, empathetic, plain English; totaling a vehicle is stressful.
- Explain what "total loss" and "actual cash value" mean and how the value was determined (comparable vehicles, condition, mileage, local market).
- Show the math: ACV, deductible, taxes/fees, and net to the insured or lienholder.
- Explain how to dispute the valuation and what evidence helps (recent maintenance, comparable listings).
- Do not invent comparable vehicles, figures, or state-specific total-loss thresholds; use my numbers and mark anything missing as [placeholder].
- Under 250 words.