Preparing insurance claim documents for human review

1. Create a document register before a summary

Agree which document types belong in the selected workflow. Build a register that points to the approved source location rather than creating uncontrolled copies. Record the case reference, file type, received time, supplied version, and review status. Where the relationship to a case is uncertain, ask staff to resolve it before including the file in a packet.

• Source location and document identifier
• Received time and sender or source channel
• Version, readability, and outstanding questions
• Reviewer and permitted audience

2. Separate reported facts, extracted text, and interpretation

A description supplied by a claimant, text extracted from an attachment, and a reviewer's assessment serve different purposes. Label them so a polished summary does not hide that distinction. If AI proposes a sentence, let reviewers open the supporting file and locate the relevant passage. Leave illegible text or unsupported details unresolved instead of filling gaps with plausible wording.

• Use source references beside material statements.
• Mark draft summaries and unanswered questions clearly.

3. Make revised and conflicting documents visible

A revised estimate or corrected report may change the review packet. Preserve the relationship between versions and identify which document the reviewer used. A newer upload is not automatically the authoritative version. When two files disagree, record the conflicting fields and assign a clarification task; do not let a summary silently choose one account.

• Distinguish duplicates from revised documents.
• Record who confirmed the version to use and why.
• Identify whether changed information requires another review.

4. Use a compact review packet template

Keep the packet short enough to scan, with links for detail. Choose fields with the people who make the next decision. Apply the organization's access rules to both original files and generated summaries; creating a summary should not broaden who can see the underlying information. Confirm these access and source-link requirements during integration scoping.

• Purpose: the specific review requested
• Available evidence: document register and source-linked draft
• Open issues: missing, unreadable, or conflicting information
• Handoff: owner, next action, and packet version

5. Illustrative example: two repair estimates

A fictional case receives an estimate followed by a revised estimate. The packet shows both versions and highlights a changed line item for review. A staff member checks the originals and records a question for the appropriate contact. The draft comparison does not approve the repair, assess liability, or authorize payment; those decisions remain with the designated people.

6. Evaluate traceability before expanding the pilot

Use synthetic files with duplicates, a corrected version, and unreadable text. Ask reviewers to find the source of each material statement and identify unresolved issues. Record unsupported statements, correction effort, and missing source links. A potential BlissOS pilot can then focus on the preparation tasks and document connections confirmed during scoping.