Claim status helpline
Answers policyholders calling about a claim: verifies them, reads the status and lists pending documents.
How it opens
The first line, in each language the template ships with. The agent answers in whatever language the caller uses.
नमस्ते, ‹your company› क्लेम हेल्पलाइन में आपका स्वागत है। मैं एआई सहायक हूँ, बताइए मैं कैसे मदद करूँ?Hello, welcome to the ‹your company› claims helpline. I am an AI assistant; how can I help?Namaste, ‹your company› claim helpline mein swagat hai. Main AI assistant hoon, bataiye kaise madad karun?The steps
A regulated helpline: identity first, then only what the claim record says.
- 1
Greet and disclose
Say it is the insurer's AI assistant and ask how it can help with a claim.
- 2
Claim number on the keypad
Ask the caller to type the claim number on the keypad, ending with #.
- 3
Read the status
From get_claim_status say the stage in plain words, the date of the last update and any pending documents. Read the mandatory line.
- 4
Pending documents
List each pending document and how to send it. Offer a text summary if the API supports it.
- 5
Claim not found
Apologise and offer a person.
- 6
Hand over
Transfer to the claims team.
- 7
Close
Ask if anything else is needed, then thank them.
What each call returns
Filled in after the call, next to the transcript, summary and cost. Delivered by webhook and readable through the API.
| Field | Question it answers |
|---|---|
| outcome | What was the outcome of the call?status_given · documents_pending · transferred · claim_not_found · dropped |
| caller_need | What did the caller want to know? |
| sentiment | How did the caller sound?calm · worried · upset |
| callback_requested | Did the caller ask for a callback?yes · no |
Your systems
No API yet? Without an API the agent cannot read claims: it takes the claim number and the question, promises a callback and hands over on request.
GET get_claim_status
The claim's stage, last update and pending documents.
TRANSFER transfer_to_human
Transfer the call to the handover number. Leave it out when no number was given.
Knowledge base: the public claims guide (documents per claim type, timelines) for general questions.
Rules it keeps
Enforced by the platform's compliance toolkit, not left to the script.
- AI disclosure
- “You are speaking with an AI assistant of the insurer. This call may be recorded.”
- Transcripts
- Strict masking: card, Aadhaar, PAN and account numbers, and any long run of digits, are hidden in full before text is stored or sent on.
- Keypad
- The claim number is typed on the keypad, not spoken.
- Do not call
- Inbound line: no outbound calls are placed. A callback is offered only when the caller asks for one.
What you fill in
The form in Set up for me. Most fields have sensible defaults; what you leave empty, the plan marks clearly.
Your business
Company name
Agent persona
Agent name, Languages, Voice, Tone
Calling rules
Human handover number
Your systems
Your API base URL
Script and rules
What to collect, Lines that must be said, Never say or do
Lines to test it with
Type them into the test chat or a workflow test before any real call is placed.
- “Mujhe apne claim ka status jaanna hai.”
- “Kaun se documents baaki hain?”
- “Mera claim reject kyun hua?”
- “Paisa kab tak aayega?”