Investigate claims
How investigate claims are reshaped as AGI capability advances.
The bottom line
About 60% of the work in Investigate 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: With no child occupations seeded, the digital scalar is derived from the process name 'Investigate claims' and its industry anchor 'Direct Property and Casualty Insurance Carriers'. Claims investigation in P&C insurance is a classic hybrid workflow, blending physical field inspections of damaged property or vehicles with heavy desk-based information processing, such as reviewing policies, reports, and digital evidence.
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 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 claims inherits.
Where Investigate claims sits
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How the work flows
Trigger: A property or casualty claim is formally filed and assigned to an adjuster for review.
- Review the initial loss report and verify active policy coverage
- Contact the insured party and relevant third parties for statements
- Gather supporting evidence including police reports and medical records
- Inspect physical property damage or coordinate with field appraisers
- Determine liability and calculate the total estimated loss
- Document the findings to recommend claim settlement or denial
Outcome: The claim is fully evaluated with liability determined, damages quantified, and a coverage decision documented.