# Insurance claims AI control kit

Use this kit to operate AI-assisted insurance claims workflows without hiding adjuster judgment, coverage constraints, or customer communication risk. The kit connects claim intake, evidence preparation, coverage references, reviewer controls, leakage monitoring, and escalation.

## What it includes

- A claims intake taxonomy for loss type, policy class, evidence gaps, severity, coverage ambiguity, and review route.
- An evidence checklist for policy references, loss documents, customer history, fraud indicators, and adjuster notes.
- A control schema for AI recommendations, authority boundaries, reviewers, evidence sources, and communication state.
- An adjuster review brief for AI-prepared claim context.
- A leakage map for missed evidence, unsupported coverage language, inconsistent guidance, and escalation delay.

## How to use it

Apply the taxonomy at claim intake and refresh it when new evidence arrives. Keep coverage interpretation, settlement decisions, and customer-facing language inside reviewer-controlled workflows. Monitor leakage risk as an operating signal, not only a post-settlement audit.