What is an adjuster copilot?
Software that supports a claims adjuster through the life of a claim. It reads the file as it develops, including notes, documents, correspondence, and payments, and brings the adjuster specific recommendations: an investigation gap to close, a deadline coming up, a reserve that no longer reflects exposure, or a recovery to pursue. The adjuster decides whether to act.
The name comes from aviation, where the copilot assists and the captain has command. Claims needs that split because adjusting decisions carry legal weight: many states license adjusters, and regulators expect a person to make and document adverse claim decisions. The Field Guide covers how P&C rules and adjuster licensing apply to AI.
How is a copilot different from a chatbot?
A chatbot waits for a question. A claims copilot monitors open files and brings the next step to the adjuster unprompted. It works inside the claim system adjusters already use, so there's no new screen to check or system to learn.
What does it do across a claim?
- At intake, it confirms coverage basics, spots early red flags, and rates severity and complexity.
- On coverage and liability, it applies the policy language and weighs liability across parties.
- During investigation, it tracks statutory deadlines and points out gaps in the file.
- At resolution, it checks reserve adequacy and supports settlement strategy.
Why do complex claims need one?
Complex claims generate long files, and under a heavy caseload a deadline, a document, or a third-party liability angle can slip past. A copilot that reviews every open file catches those items while they can still change the outcome. Supervisors get one consistent view of risk across the open book.
What should you look for in an adjuster copilot?
- Recommendations that explain their reasoning and cite the claim file
- Human control, with no autonomous actions on claims
- An optional supervisor review layer
- Integration with your existing claim system
- Proven performance on your most complex lines, such as litigated liability or construction defect
Who uses an adjuster copilot?
In-house claims teams at carriers and MGAs, TPAs that want AI support behind every adjuster, and self-insured organizations with their own claim handlers. It complements an AI claims audit, which assesses handling quality at a point in time.
Ely Adjust is Elysian's adjuster copilot, purpose-built for complex claims. It runs alongside the claim system your adjusters already use.
