Insurance chatbots: automating claim and policy enquiries

Map the existing process

Document entry channels, where policies are stored and the stages a claim passes through. Identify owners for fields such as case references, missing documents and renewal dates. Cover only a few frequent enquiries in the first release.

Connect policy and claim sources

Review access options in the insurer’s existing software. If no ready-made connection exists, define the custom integration scope. Separate read and record-creation permissions in the system connection. Knowing a policy number alone should not be treated as sufficient identity verification.

Turn information into a clear next step

Explain the current claim stage in plain language. For missing documents, show what is required and the organisation’s approved upload channel. Share a reference when a new request is created. Do not confuse “request received” with “claim approved,” or invent a payment date absent from the source.

Escalate disputes and exceptions

Define handoff rules for coverage disputes, suspected fraud, conflicting records and requests for a specialist. Give the agent a summary and relevant records within their permissions. Avoid repeatedly requesting documents, without exposing confidential information to unnecessary recipients.

Validate before going live

Test wrong customers, multiple policies, outdated statuses, missing documents, connection errors and repeated submissions. Track answer accuracy and correct routing. When policy terms or case stages change, update both the knowledge base and status mappings.

Evaluate your own workflow

Explore Palmate customer support. Request a demo to review the flow with your own systems and customer requests.