Overview
Claims Copilot is an AI-assisted experience built into BriteCore's claims workflow. It appears directly on the claim details page and uses claim data already in BriteCore — notes, documents, tasks, and other claim context — to help adjusters to understand and act on a claim more efficiently.
Claims Copilot can:
- Generate a concise summary of the claim based on available data.
- Surface flags known as Insights relevant to the claim.
- Answer follow-up questions about the claim in a conversational chat interface.
- Suggest recommended next steps based on the claim context
Note: Claims Copilot is read-only. It surfaces insights from claim data but does not modify the claim record or take any action without your explicit confirmation.
Who Uses Claims Copilot
Claims Copilot is designed for two primary user groups. What each user sees depends on their role and your organization's permission configuration.
| User | What they see |
| Adjusters | Claim summaries, operational flags, recommended next steps, and Q&A related to claim handling. |
| Special Investigation Unit (SIU) | Investigative signals and SIU-specific insights, in addition to the standard claim context. |
The terminology, insight types, and available prompts may differ between adjusters and SIU team. This is by design and controlled by your organization's permission and persona configuration.
Where to Find Claims Copilot
Claims Copilot appears on the claim Information page inside BriteCore. Look for the AI Copilot entry point on the right side of the page. If you do not see it, your administrator may need to verify your permissions or confirm that the feature is enabled for your organization.
Using Claims Copilot
Basic workflow
- Open the claim Information page for the claim you are working on.
- Select the AI Copilot entry point on the page.
- Review the claim summary, insights, or recommended next steps.
- Ask follow-up questions in the chat interface if you need more details.
- Review any suggested action carefully before taking it in BriteCore.
Claim summary
When you open Claims Copilot, it generates a summary of the claim using data available in BriteCore. The summary gives you a quick overview without requiring you to read every note or document individually.
The claim summary draws from:
- Claim details and loss information.
- Notes and tasks associated with the claim.
- Documents attached to the claim.
- Exposure, coverage, and accounting context.
Note: The claim summary is AI-generated and should be treated as a starting point, not a final record. Always verify key details against the underlying claim data in BriteCore.
Adjuster briefing
When you open a claim, Claims Copilot reads the claim's peril, date of loss, and location to produce a claim-aware briefing: which coverages apply, the limits and deductibles in play, and any completed sections. The full coverage detail is available behind an expand toggle.
Carrier-custom checks
Your organization may have configured additional claim checks tailored to your workflows. These appear alongside standard insights and follow the same read-only rules. Contact your administrator for details on which custom checks are enabled for your organization.
Claim Insights
Claim insights are AI-evaluated flags surfaced on the claim. They help adjusters and SIU team members identify items that may need attention, further review, or escalation.
How insights work
Insights are generated by evaluating claim data against configured insight types, considering the full claim context: data, documents, notes, tasks, and other available information. Each insight includes a brief explanation of why it was surfaced.
| Method | How it works |
| Automatic | Insights are reconciled in the background when a claim changes. BriteCore compares current data against existing insights and keeps, updates, removes, or creates items as needed. |
| On-demand (if enabled) | If your role has on-demand evaluation enabled, you can manually trigger a re-evaluation from the claim details page. |
Generating or refreshing insights
- Open the claim details page.
- Review the current flags or signals displayed.
- If on-demand evaluation is enabled for your role, select the option to re-evaluate insights.
- Wait for the background process to complete.
- Review new, updated, removed, or unchanged insights.
Insight visibility
Not all users see the same insights. Visibility is controlled by your role and permissions, the insight types enabled for your persona, and your organization's configuration.
Adjusters typically see operational flags related to claim handling. SIU users typically see investigative signals. If you expect to see certain insights but do not see them, contact your administrator to verify your insight-type permissions.
Chat and Q&A
Claims Copilot includes a conversational chat interface where you can ask questions about the claim in plain language. The copilot uses the claim's data as context to answer your questions.
Examples of questions you can ask:
- "What is the current status of this claim?"
- "Are there any open tasks on this claim?"
- "Summarize the most recent notes."
- "What documentation is attached?"
- "What are the recommended next steps?"
Note: Keep questions focused on the claim you have open. Claims Copilot only uses data from the specific claim you are currently viewing and does not have access to other claims or external systems.
When Claims Copilot suggests a next step or action, it will not take that action automatically. Any action that affects the claim requires you to confirm it through the appropriate workflow in BriteCore.
Data and Privacy
Claims Copilot uses BriteCore's standard access controls. It only accesses claim data that your role is already permitted to see — the copilot does not expand your data access.
- Do not enter unnecessary sensitive information into the chat interface.
- Your session is scoped to your user account.
- Claims Copilot reads claim context to generate responses. It does not modify the claim record without your confirmation.
Troubleshooting
| Issue | What to check |
| I don't see the Claims Copilot panel. | Confirm the feature is enabled for your organization and that you have the required permission (britecore/ai/claims:rw). Make sure you are on the claim details page. |
| Claims Copilot is available to some users but not others. | Compare role permissions, claim insight-type permissions, and persona configurations across the affected users. |
| The copilot doesn't appear to have full context on the claim. | Make sure you are on the correct claim details page and that the claim is fully loaded. Try refreshing the page. |
| I don't see expected insights. | Contact your administrator to verify that the correct insight types are assigned to your role and that claim insights are enabled for your organization. |
| Background insight evaluation isn't running. | Contact your administrator to verify the claim insights feature flag and workflow configuration, and that your role has the required evaluation permissions. |
| A suggested next step looks incorrect. | Treat all AI-generated suggestions as starting points. Do not act on a suggestion without verifying it against the claim record. You can ask clarifying questions in the chat. |
Frequently Asked Questions
Does Claims Copilot automatically update the claim?
No. Claims Copilot is read-only. It can suggest next steps or actions, but it does not write to or update the claim record without your explicit confirmation.
Why do I see different information than a colleague?
Insight types and terminology are tailored to your persona and permissions. Adjusters and SIU users are configured to see different types of flags and signals. Your administrator controls which insight types are visible to each role.
Can I ask Claims Copilot about other claims?
No. Claims Copilot is context-aware and only uses data from the claim you currently have open. To work on a different claim, navigate to that claim's details page.
How current is the claim summary?
The summary reflects the claim data available at the time it was generated. If significant changes have been made to the claim since you opened the copilot, refresh the page and re-open Claims Copilot to get an updated view.
What should I do if a summary or insight looks wrong?
Treat the output as a starting point. Review the underlying claim data in BriteCore to verify accuracy before making decisions. If something consistently appears incorrect, report it to your administrator so they can review the configuration.