Policy answers grounded in your handbook. Claims status from your system. The hard calls handed off.
PrimeAssist answers from the policy text you have approved, looks up claim status through your existing APIs, and escalates anything touching denial reasons, fraud signals, or vulnerable customers to a licensed agent — with full context.
// what is hard about insurance support
Policy language is dense, state-specific, and product-specific. Hallucinated coverage costs the carrier on the back end. Off-script answers fail compliance audits. The agent must stay strictly within the handbook and the system of record.
// sample use cases
What an actual day of insurance support looks like.
-
question
“What does my policy cover for X?”
how it is handled
Cites the exact section of your policy handbook. Surfaces the relevant endorsement.
Grounded
-
question
“What's the status of claim 12345?”
how it is handled
Read-only lookup through your claims API. Returns status, next step, and the adjuster's name.
Actionable
-
question
“How do I update my beneficiary?”
how it is handled
Walks the procedure cited from your forms repository. Offers to start the form via API.
Controlled
-
question
“Why was my claim denied?”
how it is handled
Hands off to a licensed adjuster with the conversation, the policy section, and the denial reason.
Escalatable
// integration shapes
The systems PrimeAssist talks to in insurance deployments.
Illustrative — every deployment connects to your own stack, on your own infrastructure, scoped by your own tool-level governance.
Policy management
- Guidewire PolicyCenter
- Duck Creek Policy
- Sapiens
- in-house systems
Claims platforms
- Guidewire ClaimCenter
- Snapsheet
- Origami Risk
Agent CRM
- Salesforce Financial Services Cloud
- MS Dynamics 365
Document repositories
- policy handbooks
- endorsements
- declarations pages
- state filings
// escalation defaults
What we treat as a human handoff by default in insurance.
These are the defaults the agent ships with. Every tenant can tune them, but the bias is conservative — when in doubt, the human gets the conversation, the policy, and the candidate answer.
- 01
Claim denial or appeal language
Denials carry regulatory exposure. Always to a licensed adjuster.
- 02
First Notice of Loss
Captured by the agent, always routed to a licensed adjuster for adjudication.
- 03
Hardship or vulnerable-customer signals
Financial distress, recent loss, accessibility needs — human handling by default.
- 04
Fraud indicators
Anti-fraud policy triggers route to SIU with the full conversation.
// see it answer
Two snippets before you open the chat.
Lead-authored synthetic examples — not real customer transcripts. The live demo below runs the same template against the same sample documents.
Does my homeowners policy cover water damage from a burst pipe in the basement?
Burst-pipe water damage is generally covered under the dwelling and personal-property sections of a standard HO-3 form, subject to the named perils, your deductible, and any sub-limit on basement losses. Coverage for the burst pipe itself (the failed component) is usually excluded; the resulting water damage is what the policy responds to.
cites Covered Perils — Section I, page 14
Can I get my claim approved over chat? I really need this fast.
I can walk you through how to start the claim and what to gather, but coverage decisions are made by a licensed adjuster reviewing your file — not in chat. I will hand you off to one now with everything we have discussed so far.
// try the live demo
Open the chat in the corner and ask it anything about insurance.
- Limited to 5 messages per hour per visitor. No real customer data is exchanged.
- Handoff and privileged tool calls are disabled in the demo. Sign up to wire your own.
// case studies
How insurance teams use PrimeAssist.
coming soon
How a named insurance customer uses this template — problem, approach, outcome. The detailed write-up lands as customer sign-offs complete.
- Problem The before-PrimeAssist support workflow and the costs it imposed.
- Approach Which template, which integrations, which policies — wired in.
- Outcome Measured against time-to-first-response, repeat-question rate, and human-handoff disposition.
// compliance posture
The regulatory ground PrimeAssist plants on for insurance.
- State DOI requirements (per-state policy and disclosure rules)
- Agent licensing constraints (state-specific producer authority)
- NAIC model laws and Fair Claims Settlement Practices
- Audit log retention aligned with state record-keeping rules
// build it your way
Your knowledge, your APIs, your policies — wired in by hand.
We onboard insurance customers personally so the policies, tool-level governance, and escalation rules are right on day one.