Data used

Aggregated view of every field captured on a claim across systems and channels.

Signals (rules, scores, outliers) flagging suspicious or unusual claim patterns.

Authorized payout figure and the technical reserves held against the claim.

Negotiated panel of repairers, vendors and providers with contracted rates.

Reusable, compliance-vetted text blocks for letters, emails and disclosures.

Hard caps on what can be spent or paid given the policy and authority matrix.

Payment instructions and tax data needed to disburse funds to a payee.

Early signals suggesting a claim involves personal injury rather than property only.

Live availability of repair slots and expected delivery times for parts.

Prior claims for the policyholder, vehicle or risk used for context and fraud checks.

When and where the loss occurred — a core fact used by most downstream agents.

Lifecycle state of the claim and the timestamps of major workflow events.

All inbound and outbound messages exchanged with the claimant on the file.

Recorded customer complaints with category, severity and resolution outcome.

Quotes from external contractors for repair, restoration or remediation work.

Technical data model of the claims platform — tables, fields and relationships.

Per-peril sums insured, sub-limits and deductibles defined by the policy.

The decision on whether and to what extent the policy responds to the loss.

Phone, email and address details for the insured and any third parties involved.

NPS, CSAT and free-text feedback collected after key claim interactions.

Costed assessment of the damage — line items, totals and methodology.

Visual evidence of the damage submitted by the claimant or captured on site.

Excess amount the policyholder must bear before insurance pays out.

Where and when a service (repair, towing, replacement) needs to be delivered.

Bundle of evidence and quantum sent to a third party or their insurer to recover.

Clinical codes and severity flags summarizing the medical condition claimed.

Medical certificates attesting to incapacity, work stoppage or impairment.

Inception, renewal and cancellation dates that define when cover applied.

Full text content of emails exchanged on the claim, used for NLP and triage.

Records of deductible amounts already collected from the policyholder.

Policy clauses that explicitly remove cover for certain perils, items or behaviors.

Adjuster notes and structured outputs from earlier agents in the workflow.

Structured fields submitted in the First Notice of Loss intake form.

The full FNOL document combining structured data and narrative.

Concise summary of the FNOL highlighting facts material to next steps.

Geographic and time-window availability of providers, services or appointments.

Distributions of past claim costs by LOB, peril and segment for benchmarking.

Track record of which solutions or vendors produced the best outcomes and CSAT.

Verbatim transcript of the customer's first contact across voice, chat or web.

Graded assessment of how serious the bodily injury is, from minor to catastrophic.

Log of all touchpoints with the customer across channels and over time.

Identification and reachability data for every party named on the claim.

Reference list mapping incident locations to the competent police and authorities.

Letters and filings exchanged with lawyers, courts or opposing parties.

Generated or received postal letters attached to the claim file.

Documented conclusions on who is at fault and to what proportion.

Final liability decision used to drive recovery, settlement and reserves.

Indicators that a claim is likely to escalate to legal proceedings.

Per-line-of-business rules for setting and adjusting case reserves.

Jurisdiction-specific civil liability principles applied to the loss facts.

All documents evidencing the existence, cause and extent of the loss.

French nomenclatures (CCAM, NGAP) pricing medical and surgical procedures.

Clinical reports from treating physicians or appointed medical experts.

IoT, telematics or device telemetry corroborating the incident.

UK National Health Service records of treatment received by the claimant.

Tracker of documents and information still pending from the claimant or third parties.

Reference catalogs of part prices and standard labor times for repairs.

Recent claim activity on the same policy — useful for fraud and frequency checks.

Comparable historical injury claims used to anchor quantum and duration.

Instructions describing how, to whom and when a payment should be issued.

Running ledger of every disbursement made on the claim to date.

All visual and document evidence uploaded by the claimant or third parties.

Photographic evidence attached to the claim — damage, scene or documents.

Official police report describing circumstances and parties of an accident.

Linked view of the policy contract and the policyholder's master record.

Wordings, schedules and endorsements that define the contractual cover.

Curated panel of in-network suppliers with negotiated quality and pricing.

Valuation of damaged or insured property used for indemnity calculations.

Directory of medical or repair providers with their network status.

Inventory of documents received against the per-LOB checklist.

Communication preferences (language, channel, accessibility) for each recipient.

Inbound payments received from third parties or their insurers.

Internal reference codes for cause, peril, coverage and other taxonomies.

Statutory and contractual deadlines that govern claim handling timelines.

Signed releases and discharges closing the claim against further demands.

Itemized repair quotes provided by body shops or workshops.

Standard letters and consent forms used to request reports from third parties.

Identification of the person reporting the loss, who may differ from the insured.

Per-line-of-business list of mandatory documents needed to progress the claim.

Current case reserve held against the ultimate cost of the claim.

Structured plans helping injured claimants resume activity and work.

Estimated resale value of damaged assets recovered after total loss.

Sanctions, PEP and AML watchlists screened against involved parties.

Photographs of the loss scene capturing context, position and conditions.

Formal monetary offer extended to the claimant to close the claim.

Early scoring of how large or complex a claim is likely to become.

Performance metrics tracking handling times against SLA targets.

Written or recorded statements from insured, claimant and witnesses.

Per-jurisdiction time bars within which a claim or recovery must be pursued.

Auxiliary documents (PDFs, emails) substantiating elements of the claim.

In-vehicle and sensor data captured around the time of loss.

Identifiers and credentials of third parties involved in the loss.

Replies from opposing insurers on liability, quantum and recovery.

Highway code and traffic regulations used to assess fault in road incidents.

Invoices from medical providers for treatment delivered to the claimant.

Prescribed care pathways outlining expected treatment and duration.

US fee schedules (Medicare, workers' comp, state) bounding medical bill review.

Catalogue of OEM and aftermarket parts with prices and compatibility.

Vehicle registration and driver licence data used to validate parties and cover.

Market value of the insured vehicle used to settle total-loss claims.

Reports from external recovery vendors on subrogation progress and outcomes.

Indicators identifying customers needing additional care or accommodations.

Sanctions and watchlists screened before payment or settlement.

External weather and catastrophe event feeds used to corroborate loss causes.

Statements from independent witnesses describing what they observed.

Any written supporting document submitted on the claim file.