Investigate and evaluate claims
How investigate and evaluate claims are reshaped as AGI capability advances.
The bottom line
About 60% of the work in Investigate and evaluate claims is information-shaped and increasingly AI-deliverable, with the rest a hybrid of judgment and hands-on work. The automation frontier runs straight through the middle of this role.
Why: Because there are no child occupations seeded for this composite, the scalar relies entirely on the process name and industry lens. 'Investigate and evaluate claims' within Direct Property and Casualty Insurance Carriers indicates a blend of physical property inspections (assessing damage) and heavy desk-based data analysis and documentation. This aligns precisely with the hybrid-trending-digital prior (~0.6) for insurance claims work.
grounded in the economy graph · digital scalar 0.60 · hybrid
Business-as-Code
Read as an executable program — the work decomposed into Code, Generative, Agentic, and Human.
Investigate and evaluate claims sits inside a larger value-flow — 1 parent structure it composes into. The hierarchy is grounding, not the story: it tells you which aggregate exposure Investigate and evaluate claims inherits.
Where Investigate and evaluate claims sits
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Recent capability events
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How the work flows
Trigger: A claims adjuster receives a newly filed property or casualty claim assignment following the First Notice of Loss.
- Verify policy coverage and limits for the reported loss event
- Interview the policyholder, claimants, and witnesses to obtain statements
- Collect supporting documentation including police reports, medical records, and photographs
- Assess property damage or bodily injury through physical or virtual inspections
- Determine liability and apportion negligence among involved parties
- Calculate the financial valuation of the loss and set claim reserves
- Compile investigation findings into a final evaluation report
Outcome: The claim is fully investigated with liability determined, damages quantified, and a final evaluation submitted for settlement.