---
name: al-191-pull-the-facts-out-of-a-dense-insurance-claim-file-for-th
description: "Have an agent read a messy claim file, surface the facts that matter, and suggest next steps so adjusters spend time deciding instead of hunting through PDFs. Five Sigma's Clive, built on Google's Gemini Enterprise Agent Platform, helps claims teams work up to 60% faster this way. Use when the user wants help with insurance claims review (operations) for a small business."
---

# Pull the facts out of a dense insurance claim file for the adjuster

Have an agent read a messy claim file, surface the facts that matter, and suggest next steps so adjusters spend time deciding instead of hunting through PDFs. Five Sigma's Clive, built on Google's Gemini Enterprise Agent Platform, helps claims teams work up to 60% faster this way.

## Inputs to collect first
Ask the user for anything below that they haven't already given you. Don't guess missing facts.

- Auto / home / commercial / other
- Coverages, limits, deductibles, key exclusions
- Notes, FNOL, repair estimates, photos descriptions, police/medical…

## Instructions

Do the task below with the user's inputs in place of each [bracket].

You are assisting a claims adjuster. Claim type: [auto / home / commercial / other]. Policy summary: [coverages, limits, deductibles, key exclusions]. Claim file materials: [paste notes, FNOL, repair estimates, photos descriptions, police/medical summaries]. Step 1: list the hard facts with a source line for each (date of loss, parties, damages claimed, prior claims mentioned). Step 2: flag coverage questions and missing documents. Step 3: suggest next steps for the adjuster (request docs, inspect, reserve change, deny/partial pay) with a one-line reason each. Step 4: draft a short adjuster note they can paste into the claim system. Use only the file I gave you, mark gaps as 'needs info', and do not approve or deny the claim yourself.

## Safety checks (share these with the user)

- Check names, dates, numbers and any claim against your own source material before you use the answer. AI can misread or invent details.
- Say clearly which parts need a person to review or approve before anything is sent, paid, posted or filed.

## About this skill

- Works with: Five Sigma Clive, Gemini, ChatGPT, Claude
- Based on this real-world example: https://cloud.google.com/transform/10-companies-making-ai-work-across-industries
- Free prompt from AgentPlaybook Real Estate: https://agentic-library.netlify.app/prompt/al-191-pull-the-facts-out-of-a-dense-insurance-claim-file-for-the-a/
- To install in an agent that supports Agent Skills, save this file as SKILL.md in a folder with the same name as `name` above (for example in your skills directory). Install steps for Claude.ai, Claude Code, Cursor and Codex: https://agentic-library.netlify.app/skills/