Quick answer: Zian AI is our pick: it answers claims calls 24/7, books inspections, follows up by SMS, WhatsApp and email, and transfers to adjusters; LeadsNow.ai runs it for you. For Guidewire connectors, see Liberate, Strada, Hi Marley and Talkdesk. The AI takes facts in and reads facts out; coverage, liability and settlement go to a person. The NAIC model allows 15 days to acknowledge a US claim.
General information as at 18 October 2026, not legal advice. Rules differ by state and country; confirm your design with counsel.
A claims line is not a sales line. Callers already hold the policy; they are reporting a crash or a storm-damaged roof, then ringing back to ask where the claim is up to. The choice turns on which calls the agent can finish alone, which clock each call starts, which claims system it writes to, and whether it survives a catastrophe surge. For the sales side (quotes, renewals, telemarketing consent), see our comparison of AI voice agents for insurance agencies.
Where Zian fits on a claims line
Zian AI is our first pick for the claims calls an AI can finish alone: it answers inbound calls 24/7 as an AI receptionist (qualifying, booking, transferring and taking messages) and follows up by voice, SMS, email, WhatsApp, Instagram DMs and Facebook Messenger in 30+ languages. For agents run for you, LeadsNow.ai is the done-for-you option.
On a claims line, Zian can answer the 2am FNOL call, capture the caller’s facts, book the inspection slot and follow up by SMS or WhatsApp with what the adjuster still needs, then hand anything needing judgment to an adjuster. Zian’s features page lists human-in-the-loop approvals and call summaries and dispositions, and its knowledge-base scope, tool access and rules are configurable, so the agent can be fenced to facts on the claim record. It connects to HubSpot, Salesforce, HighLevel and Zapier, offers an API, and can run on private models on your own infrastructure. SmartReach AI™ paces follow-up across channels; PrecisionPitch AI™ split-tests scripts against real outcomes. Behind it: outbound acquisition since 2017 and 50,769+ qualified sales appointments set.
The one line against us: Zian is in a partnership-application beta with no public price for its agent plans (zian.ai lists an Intel + Widgets plan as Free Forever), and it publishes no insurance-specific agent and no claims-system integration, so a carrier that needs straight-through FNOL into Guidewire ClaimCenter on day one will find named connectors in the insurance-native products below.
LeadsNow.ai is a pay-per-result managed AI appointment-setting and lead-generation service that runs on Zian; it answers leads in under 60 seconds, 24/7, and has set 50,769+ appointments.
What an AI voice agent may do alone on a claims call
Apply the Facts In, Facts Out rule to any product on this page: an AI claims agent may take facts in (who, what, when, where, what is damaged, a photo, a document) and read facts out (the claim number, its status, the adjuster’s name, the next appointment, what the policy record says). The first opinion on coverage, liability or value belongs to a person.
The law points the same way without naming AI. Texas defines an adjuster as a person who “investigates or adjusts losses on behalf of an insurer”, or who “supervises the handling of claims” (Texas Insurance Code section 4101.001, plus a workers’ compensation limb). One of the eleven exemptions in section 4101.002(a) is “a person who performs clerical duties and does not negotiate with parties to disputed or contested claims”, a fair description of intake. Two others are narrower than they look: data entry into an “automated claims adjudication system” is exempt only for portable consumer electronics claims, under a licensed independent adjuster or its affiliate, with no more than 25 people per licensed supervisor; and an insurer’s employee may adjust a first-party property and casualty loss of up to $500 (or authorise payment where the coverage limit is $500 or less) unlicensed. So the line falls at negotiation and judgment, not at every claims conversation. The statute is written about people, not software; whoever takes over should be a claims professional, licensed where your state requires it.
The insurer stays responsible. The NAIC Model Bulletin on the Use of Artificial Intelligence Systems by Insurers (adopted 4 December 2023) says decisions or actions impacting consumers that are “made or supported” by AI systems must comply with all applicable insurance laws, including unfair claims settlement practices law, and asks insurers to vet third-party AI systems and, where available, contract for audit rights and the vendor’s cooperation with regulatory inquiries.
One vendor draws the line differently. Retell’s insurance page says its agent “answers routine coverage and eligibility questions directly” with “No transfer needed”, yet its FAQ hands off “for anything involving coverage interpretation or settlement”. Reading back the policy record is a fact; saying whether this loss is covered is an opinion.
The claims call routing table
Each row gives a call type, what the agent may finish alone, what makes it hand over, and the clock the call starts or feeds. US clocks come from the NAIC Unfair Property/Casualty Claims Settlement Practices Model Regulation (its “days” are calendar days) and California’s 10 CCR 2695.5 and 2695.7; Australian clocks from the General Insurance Code of Practice 2020, in Business Days (Monday to Friday, excluding public holidays).
| Call type | The AI may do alone | Hand-off trigger | Clock it starts or feeds |
|---|---|---|---|
| First notice of loss (new claim) | Verify the caller to your standard; take the facts of the loss; give the claim number; explain the claims process, the excess on the policy record and how to make contact; send an upload link | Anyone hurt or unsafe (emergency services first); “am I covered?”; signs of vulnerability; a lawyer or representative on the line | US model: acknowledge within 15 days unless payment is made in that time, and note and date a non-written acknowledgement in the claim file (s6A); promptly provide necessary claim forms, instructions and reasonable assistance so first-party claimants can comply with the policy conditions and the insurer’s reasonable requirements, which, done within 15 days of notification, counts as compliance with s6A (s6D). California: 15 calendar days to acknowledge, provide forms and begin investigating. Australia: within 10 Business Days, say what information is needed and estimate the timeframe (para 68) |
| Claim-status enquiry | Read the status, the last update, the adjuster’s name and the next step from the claim file | The caller disputes a decision or amount, or expresses dissatisfaction (a complaint) | US model: reply within 15 days to communications that reasonably suggest a response is expected (s6C). California: 15 calendar days. Australia: routine enquiries answered within 10 Business Days; progress updates at least every 20 Business Days (paras 70–71) |
| Adjuster or inspection appointment | Offer slots, book, confirm, reschedule and remind; tell the claimant who has been appointed and their role | Access or safety problems at the site; the claimant objects to the assessor | Australia: tell the claimant within 5 Business Days that a loss assessor or loss adjuster has been appointed and what their role is (para 72). US model: no separate day count; it sits inside the investigation clocks below |
| Document and photo chasing (outbound) | Request the specific items the adjuster listed, say why each is needed, send the link, confirm receipt, remind | The claimant cannot provide a document, or asks to argue what is relevant | US model: if more time is needed, notice within 21 days of proofs of loss, then a letter 45 days from the initial notification and every 45 days after (s7B). California: written notice, then every 30 calendar days. Australia: ask for everything in one request where possible (para 68a) |
| Catastrophe surge (inbound overflow and outbound check-ins) | Take FNOL at volume; flag urgent cases (uninhabitable home, urgent financial need) to the front of the queue; outbound check-ins and document requests | Urgent financial need (a person decides any advance); vulnerability; anything in the rows below | Every clock above keeps running. Australia: where the event causes urgent financial need, the insurer fast-tracks the claim, pays an advance within 5 Business Days once the need is shown, or both (para 64); the 4-month decision limit stretches to 12 months only for an Extraordinary Catastrophe and four other listed cases (paras 77–78) |
| Coverage, liability or settlement question | Read back the policy wording on the record; log the question for the adjuster | Always | US model: tell a first-party claimant of acceptance or denial within 21 days of proofs of loss (s7A), and pay within 30 days once liability is affirmed, if the amount is determined and not in dispute (s7F). California: 40 calendar days to accept or deny, with exceptions. Australia: decision within 10 Business Days of having all information, and within 4 months of the claim (paras 76–77) |
| Complaint or dispute | Recognise it, acknowledge it, record it, explain the complaints process | Always: route to the complaints team | Australia: handled by a person with appropriate authority, knowledge or experience who is not the person complained about; updates at least every 10 Business Days; decision within 30 Calendar Days (paras 144–147) |
A caution about the US column: the NAIC regulation is a 1990 model (amended 1991), not law, and binds only where a state adopts it, often with different numbers. California gives 40 calendar days to accept or deny, not 21, and repeats the more-time notice every 30 calendar days instead of 45. The model relaxes some timeframes where fraud is reasonably suspected, and California’s duties stop or change once notice of legal action is served. Check your state’s rule before you hard-code a clock.
Which clocks a US claims call starts
The first clock matters most. Section 6A of the model regulation says every insurer, on notification of a claim, shall within 15 days acknowledge receipt “unless payment is made within that period of time”, and that “notification given to an agent of an insurer shall be notification to the insurer.” If the acknowledgement is not in writing, “an appropriate notation of the acknowledgement shall be made in the claim file of the insurer and dated.” So the FNOL call can do the acknowledging, provided it is logged in the claim file with its date. An agent that leaves the report in a separate call log has acknowledged nothing an examiner can see.
Section 6D adds a second duty and a second route to meeting the first. Every insurer, on notification of a claim, “shall promptly provide necessary claim forms, instructions and reasonable assistance so that first party claimants can comply with the policy conditions and the insurer’s reasonable requirements”, and “Compliance with this paragraph within fifteen (15) days of notification of a claim shall constitute compliance with Subsection A of this section.” Section 6D’s own deadline is “promptly”, not 15 days; the 15 days decides whether it also satisfies the acknowledgement duty in 6A. So an FNOL call, or the message sent straight after it, that provides the necessary forms, instructions and assistance within 15 days does both jobs; log it in the claim file either way, because section 4B requires files that permit reconstruction of the insurer’s activities.
Updated 20 October 2026: we added section 6D’s final sentence, which this page previously left out, after re-reading the NAIC model regulation (July 1997 printing; the archived copy linked above is the same file).
California’s section 2695.5(e) is stricter: within 15 calendar days the insurer must acknowledge, provide forms, instructions and reasonable assistance, and “begin any necessary investigation”. A claims agent’s failure to transmit notice promptly “shall be imputed to the insurer” (assigned-risk auto policies excepted). A voice agent is the newest place for a notice of claim to sit unread.
The model Act sets the enforcement bar. Under section 3 of the NAIC Unfair Claims Settlement Practices Act, a listed act is an unfair claims practice only if committed “flagrantly and in conscious disregard” of the Act, or “with such frequency to indicate a general business practice”. One missed acknowledgement is not a violation on that test. A misconfigured AI agent repeats its mistake on every call, and frequency is what the second limb measures.
Australia: what the General Insurance Code of Practice requires on claims calls
The General Insurance Code of Practice 2020 took effect on 5 October 2021 and was last updated in October 2023. It binds the insurers that have adopted it, and its claims part covers retail insurance products only. When a claim needs more information or assessment, within 10 Business Days the insurer says what it needs (using “best endeavours” to ask in one request), appoints a loss assessor or adjuster if necessary, and estimates the timeframe (para 68). It updates the claimant at least every 20 Business Days and answers routine progress enquiries within 10 (paras 70–71).
Three clauses bear on what an AI agent says. A customer may ask whether a loss is covered before claiming; the insurer “will not discourage you from making a claim” and will say the loss will be fully assessed (para 58), so a scripted “that probably isn’t covered” is a breach waiting to happen. Insurers take “reasonable measures” to help people meet identification requirements, with a “flexible” approach (para 100). And where practicable they provide an interpreter if asked or needed, and record whether one was used (para 101).
The timeframes are not absolute: an insurer may agree an alternative timetable, and a miss is excused where its conduct and the actual timeframe were reasonable or an expert’s report was delayed (paras 83–84). The Code is also being rewritten; the Insurance Council of Australia’s Code of Practice site says submissions on a redrafted Code closed on 21 July 2026, so check the version in force before you build these numbers into an agent.
Want claims calls answered at 2am, inspections booked and follow-ups sent by SMS, WhatsApp and email, with a transfer when a call needs a person? Zian is in a partnership-application beta.
Best AI voice agents for insurance claims calls, compared
How we picked, and what we are. zian.ai publishes this page, and it is a list Zian appears in, at the top: Zian AI first as our platform pick, LeadsNow.ai second as the done-for-you pick (it runs on Zian). No vendor paid to be included or excluded.
Inclusion rule for the other five, applied identically: (i) the vendor’s own site describes an AI agent that holds live phone conversations; (ii) a page on that site markets it for insurance claims by name; (iii) we read its product, integration and pricing pages and walked its sitemap on 18 October 2026. These are the five we compared, not a category sweep. Others qualify: Five9’s banking and insurance page says “An AI agent can gather first-notice details through voice or digital channels” and promises “Catastrophe volume absorbed without a queue”; we did not score it on this page (as at 18 October 2026).
Terms used in the cells. A claims job is one of five: FNOL intake, claim-status enquiry, adjuster or inspection scheduling, document and photo chasing, and catastrophe-surge overflow. Named means the vendor’s own page names that job for its AI product. Generic means the vendor publishes the underlying capability (answering calls, booking, sending messages) without marketing it for claims. Not found means we could not find it on the pages listed in the source table, as at 18 October 2026; it is not a claim the product cannot do it. A claims system is a claims-administration or carrier policy-administration platform such as Guidewire or Duck Creek; agency management systems, CRMs and contact-centre platforms are not counted.
| Option | Built for (own framing) | FNOL | Claim status | Inspection scheduling | Document chasing | Surge | Claims systems named | Hand-off it documents | Price model (18 Oct 2026) |
|---|---|---|---|---|---|---|---|---|---|
| 1. Zian AI (platform pick) | AI sales and reception agents, inbound and outbound; not insurance-specific | Generic: answers inbound calls 24/7, qualifies, takes messages | Generic: knowledge-base and third-party lookups | Generic: appointment booking | Generic: SMS, WhatsApp, email follow-up | Generic: “scales on demand” | None named; HubSpot, Salesforce, HighLevel, Zapier, API | Transfers and takes messages; human-in-the-loop approvals; call summaries and dispositions | No public price for agent plans (partnership-application beta); Intel + Widgets listed as Free Forever |
| 2. LeadsNow.ai (done-for-you pick) | Managed, pay-per-result AI appointment setting and lead generation that runs on Zian; leads answered in under 60 seconds, 24/7; 50,769+ appointments set. Ask it the routing-table questions as you would any vendor. | ||||||||
| Liberate | “insurance-native AI agents across sales, service, and claims” | Named, voice; a Voice FNOL Accelerator for Guidewire ClaimCenter (July 2026) | Named: status “read back, straight from the file” | Named: inspection times across voice, SMS, email and digital | Named: secure links for photos and documents; requests what is missing | Named: “Overflow & surge coverage”; outbound calls during catastrophe surges | 7 of 23 listed integrations: Guidewire, Duck Creek, Five Sigma, Snapsheet, CCC, Insuresoft, Socotra | Hands off “with context” when human judgment is needed; warm transfer with full call context | No pricing page (/pricing returns 404); demo-led |
| Strada | “AI that runs insurance operations” for carriers, TPAs and MGAs | Named: phone, chat or email, around the clock | Named: “Claimant status calls” | Named: “IMEs, inspections and follow-ups booked into the calendar” | Named: documents collected and attached; photos by email linked to the claim | Named: “Scale on Demand”, “Thousands at once, with no queue” | Guidewire, Duck Creek; “200+ systems connected, by API or browser agent” | Handover with the whole transcript; escalation thresholds your team defines | Its /pricing page is a book-a-demo form |
| Hi Marley | “the trusted communication fabric for P&C insurance”; its FAQ says “powered by SMS” | Named: Conversational FNOL™ “across voice and messaging” | Named: Claims Inquiry Assist™ across calls and texts | Named: “Schedule adjuster inspection” shown as an AI next-best action for the adjuster (channel not stated) | Named: photos and documents by text | Named: a “Scalable CAT Communication” webinar page | Guidewire ClaimCenter and InsuranceNow, Duck Creek, Sapiens, InsureSoft Diamond | Hand-offs “preserve context” as the conversation moves to an adjuster | No pricing page in its 490-URL sitemap; demo-led |
| Talkdesk | Contact-centre platform; “Talkdesk AI Agents for Insurance” on its CXA platform | Named: “AI automates first notice of loss (FNOL)” | Named: “Claims status updates” (datasheet) | Named: booking “across voice and digital channels for claims” | Generic: “proactively engaging them via voice, SMS, and digital channels” (insurance page) | Named: its Insurance Smart Service release (October 2021) cites “natural disasters” and a platform that lets insurers “rapidly adjust to fluctuations in call volume”; its insurance AI ebook page promises to “Scale operations efficiently even during disruption or high demand” | Guidewire, Duck Creek Technologies | Autopilot for Insurance escalates “to an agent only when necessary”; human-in-the-loop | Industry Experience Clouds (insurance among them) US$225 per user a month; AI-agent (CXA) pricing through sales |
| Retell AI | General voice-agent platform with insurance pages | Named: takes the loss report and assigns it “to an adjuster queue” | Named: “claim status checks” | Named: Cal.com scheduling “for adjuster visits” (a 2025 resource page) | Generic: SMS follow-ups and texted payment links; its insurance industry page handles enquiries about “required documents” | Named: storm FNOL; 20 concurrent calls included, US$8 per extra line a month | None among its 61 integration pages; says it “works with your existing AMS” | Warm transfer with transcript; coverage interpretation or settlement goes to a licensed adjuster or producer | US$0.07–$0.31 a minute headline; its own estimate US$0.11 plus US$0.015 US telephony |
Read across the rows: all five third-party vendors name FNOL, claim status and inspection or adjuster scheduling. Three name document chasing (Liberate, Strada, Hi Marley), and Retell and Talkdesk describe it generically; all five name surge handling. Four name a claims system (all but Retell). Only Retell publishes per-minute and per-line AI prices. Zian is Generic on every claims job and names no claims system, because it is a general platform.
Who each option is wrong for
Liberate is wrong for a team that wants to self-serve and see a price. It sells by demo, with no pricing page. Its July 2026 Guidewire accelerator validates the policy in PolicyCenter and submits the claim into ClaimCenter, which is the point if you run Guidewire and less so if you do not.
Strada is wrong for a small claims team without integration resources. Its model is forward-deployed engineers on a 4-week plan, with a book-a-demo pricing page. Its home-page demo is instructive: a rental-car coverage question gets “No confident answer” and is handed to a person, the behaviour the Facts In, Facts Out rule asks for.
Hi Marley is wrong for a carrier that wants a voice-only agent. Its heritage is texting (“powered by SMS”, says its FAQ), and its voice capability sits inside Conversational FNOL™ and Claims Inquiry Assist™, alongside messaging. A carrier whose claimants already text their adjusters is the natural fit.
Talkdesk is wrong for a buyer who only wants an AI agent. It is a full contact-centre platform priced per human seat, with its industry Experience Clouds, insurance among them, at US$225 per user a month and AI-agent pricing through sales.
Retell is wrong for a carrier that needs a named claims-system connector. None of its 61 integration pages is a claims-administration platform, so FNOL into ClaimCenter or Duck Creek is a build through its API or your middleware. It is the easiest to price, which is why the surge calculation uses it.
Catastrophe surge: a worked capacity calculation from ex-Tropical Cyclone Alfred
Size surge from a real event. The Insurance Council of Australia (ICA) declared an insurance catastrophe for ex-Tropical Cyclone Alfred on 9 March 2025, covering claims since 28 February. Its counts: almost 3,000 claims on 9 March, more than 9,000 by midday on 10 March, more than 22,000 on 11 March, more than 44,000 on 13 March and 63,600 on 17 March. By August 2026: 131 thousand claims, 95.8% closed.
| Step | Input (source) | Arithmetic | Result |
|---|---|---|---|
| 1. Industry claims a day, 11 to 13 March | More than 22,000 (11 Mar) to more than 44,000 (13 Mar), ICA | (44,000 − 22,000) ÷ 2 | About 11,000 a day |
| 2. Your share | Assumption: 20% market share in the area (substitute yours) | 11,000 × 0.20 | 2,200 claims a day |
| 3. Reported by phone | Assumption: 60% by phone (substitute yours) | 2,200 × 0.60 | 1,320 FNOL calls a day |
| 4. Busiest hour | Assumption: 15% of the day’s calls in the busiest hour | 1,320 × 0.15 | 198 calls |
| 5. Lines in use at once | 15-minute calls (Liberate says insurance calls “run fifteen, twenty minutes”) | 198 × 15 ÷ 60 | 49.5 calls at once on average |
| 6. Human-only equivalent | Assumption: 85% occupancy target | 49.5 ÷ 0.85 | About 59 people on the phones, before breaks |
| 7. AI lines to provision | About 20% headroom over step 5; Retell includes 20 lines, US$8 per extra line a month | (60 − 20) × US$8 | US$320 a month for 60 lines |
| 8. AI minutes a day | Retell’s estimate US$0.11 a minute plus US$0.015 US telephony | 1,320 × 15 × US$0.125 | US$2,475 a day |
| 9. People still needed | Assumption: 20% of FNOL calls hit a hand-off trigger | 1,320 × 0.20 × 0.15 × 15 ÷ 60 ÷ 0.85 | About 12 people in the busiest hour |
Three things the arithmetic shows. The peak is short: from 13 to 17 March the count grew by about 19,600, roughly 4,900 a day, less than half the earlier rate, which is the case for elastic AI lines over hiring. The AI does not remove the human queue; it shrinks it to the hand-off rate, so you staff for the 12, not the 59. And the ICA counts are claims lodged with all insurers through every channel, not calls to one carrier, with status calls on top, so treat the result as a first-week floor, not a forecast. Step 6 is a simple occupancy estimate, not an Erlang C model; step 7 uses Retell because it is the only one of the five that publishes a per-line price.
For Alfred, ICA reported that insurers “added hundreds of additional claims consultants” and pre-emptively contacted “more than a quarter of a million customers”. An AI agent can do both jobs, inbound overflow and outbound check-ins, if the hand-off queue behind it is staffed.
Identity, recording and the claim file
Three controls sit around every row of the routing table. Verify the caller before reading anything from a claim file; our caller verification ladder for AI phone agents sets out which check suits which disclosure. Give the right recording notice; our page on two-party consent states for AI call recording covers the US map. And when the agent transfers, pass the transcript and captured facts so the adjuster does not start again; see AI-to-human handoff with context transfer.
The claim file ties these together. The NAIC model requires claim files detailed enough “to permit reconstruction of the insurer’s activities relative to each claim” (section 4B), with each relevant document dated as received, processed or mailed. An agent that writes its notes, dates and documents into the claims system meets that by design; one that leaves them in a vendor dashboard does not. That is the strongest argument for the claims-system column above.
Sizing an AI claims line against your own surge numbers? Zian’s AI receptionist answers calls 24/7 in 30+ languages, books appointments and transfers, with call summaries and human-in-the-loop approvals. It is in a partnership-application beta.
Frequently asked questions
What is the best AI voice agent for insurance adjuster calls?
Zian AI is our pick: it answers claims calls 24/7, books inspections, follows up by SMS, WhatsApp and email, and transfers to your team, though it names no claims-system integration; LeadsNow.ai is the done-for-you option. Of the five claims-marketed vendors we compared on 18 October 2026, Liberate, Strada, Hi Marley and Talkdesk name Guidewire connectors, and Retell publishes per-minute and per-line prices.
Can an AI agent take a first notice of loss on its own?
Yes, for the facts. Taking the report, giving a claim number and explaining next steps is intake, not adjusting. Hand over when someone is hurt or unsafe, when the caller asks whether the loss is covered, or when the caller sounds vulnerable.
Does an AI phone call count as acknowledging the claim?
It can. Section 6A of the NAIC’s model regulation requires acknowledgement within 15 days unless payment is made in that time, and an acknowledgement not in writing must be noted in the claim file and dated. Under section 6D, promptly providing the necessary claim forms, instructions and reasonable assistance within 15 days of notification also counts as compliance with 6A. Log the call there, with its date, and check your state’s version of the rule.
Can an AI voice agent tell a policyholder whether they are covered?
Not as an opinion. It can read back what the policy record says, such as the excess or whether the policy is in force; whether this loss is covered is for a claims professional. Australia’s Code adds that an insurer answering a coverage question before a claim will not discourage the claim.
How fast must an insurer respond to a claim status call?
In Australia, insurers that have adopted the General Insurance Code of Practice respond to routine enquiries about a claim’s progress within 10 Business Days and update the claimant at least every 20 Business Days. In the US, the NAIC model expects a reply within 15 days to a communication that reasonably suggests a response is expected, and California’s section 2695.5(b) sets 15 calendar days.
Who must handle a claims complaint?
A person. Under Australia’s Code, a complaint is handled by someone with appropriate authority, knowledge or experience who is not the person complained about, and decided within 30 Calendar Days or the delay explained in writing. An AI agent can recognise, record and route a complaint, not resolve it.
How many lines does an AI agent need for a catastrophe surge?
Work it out from your share of the event. On the Insurance Council of Australia’s ex-Tropical Cyclone Alfred counts, a carrier with a fifth of about 11,000 claims a day, 60% by phone, 15-minute calls and 15% of calls in the busiest hour needs about 50 lines at once. Provision about 60, and staff people for the hand-offs.
Where every figure on this page comes from
| Figure | Who published it | Link | Date read |
|---|---|---|---|
| 15 days to acknowledge unless paid; dated notation for non-written acknowledgement; s6D forms, instructions and reasonable assistance “promptly”, and compliance within 15 days “shall constitute compliance with Subsection A” (s6 re-read 20 October 2026); 15-day reply; 21 days to accept or deny; 21-day and 45-day more-time notices; 30 days to pay; days are calendar days; file-reconstruction standard | NAIC, Unfair Property/Casualty Claims Settlement Practices Model Regulation (1990, amended 1991; July 1997 printing) | NAIC model regulation (archived PDF) | 18 October 2026 |
| Unfair practice only if flagrant and in conscious disregard, or frequent enough to indicate a general business practice | NAIC, Unfair Claims Settlement Practices Act, section 3 | NAIC model Act (archived PDF) | 18 October 2026 |
| AI Model Bulletin adopted 4 December 2023; third-party AI due diligence and audit terms | NAIC | NAIC AI Model Bulletin (archived PDF) | 18 October 2026 |
| 15 calendar days to acknowledge, provide forms and begin investigating; 15 calendar days to respond | California Code of Regulations, title 10, section 2695.5 (via Cornell LII) | 10 CCR 2695.5 | 18 October 2026 |
| 40 calendar days to accept or deny; notices every 30 calendar days; 30 calendar days to pay | California Code of Regulations, title 10, section 2695.7 (via Cornell LII) | 10 CCR 2695.7 | 18 October 2026 |
| Adjuster definition; eleven general exemptions; 25-person supervision cap; $500 loss exemption | Texas Insurance Code sections 4101.001 and 4101.002 (Public.Law reproduction of the official text) | s4101.001; s4101.002 | 18 October 2026 |
| 5, 10 and 20 Business Day timeframes; 4-month and 12-month decision limits; complaint updates every 10 Business Days and decision in 30 Calendar Days; effective 5 October 2021, updated October 2023 | Insurance Council of Australia, General Insurance Code of Practice 2020 | Code PDF | 18 October 2026 |
| Redrafted Code submissions 24 June to 21 July 2026 | Insurance Council of Australia | codeofpractice.com.au | 18 October 2026 |
| Alfred declared 9 March 2025; almost 3,000 claims (9 Mar); more than 9,000 (10 Mar) | Insurance Council of Australia | 9 March release; 10 March release | 18 October 2026 |
| More than 22,000 claims (11 Mar); more than 44,000 (13 Mar); 63,600 (17 Mar); hundreds of additional claims consultants; more than a quarter of a million customers contacted | Insurance Council of Australia | 11 March; 13 March; 17 March | 18 October 2026 |
| 131 thousand claims; 95.8% closed rate (as at August 2026) | Insurance Council of Australia | Catastrophe 252 page | 18 October 2026 |
| Liberate: 23 integrations; Guidewire accelerator (14 July 2026 release); calls “run fifteen, twenty minutes”; surge and outbound catastrophe calls; /pricing 404 | Liberate | integrations; Guidewire release; voice; claim status; scheduling | 18 October 2026 |
| Strada: 200+ systems; scale on demand; 4-week plan; pricing page is a demo form | Strada | home; platform; multi-channel FNOL; pricing | 18 October 2026 |
| Hi Marley: voice and messaging FNOL; calls and texts inquiries; named connectors; 490-URL sitemap with no pricing page | Hi Marley | claims automation; AI and automation; FAQ; CAT webinar | 18 October 2026 |
| Talkdesk: FNOL, claims status and scheduling; SMS outreach; call-volume scaling; Guidewire and Duck Creek; Industry Experience Clouds US$225 per user a month | Talkdesk | insurance page; AI for Insurance datasheet; scheduler datasheet; pricing; Insurance Smart Service release; insurance AI ebook page | 18 October 2026 |
| Five9: AI agent gathers first-notice details by voice or digital channels; catastrophe volume absorbed without a queue (not scored) | Five9 | banking and insurance page | 18 October 2026 |
| Retell: US$0.07–$0.31 a minute headline; US$0.11 estimate; US$0.015 US telephony; 20 lines included, US$8 per extra line; 61 integration pages | Retell AI | pricing; insurance page; claims intake resource | 18 October 2026 |
| Assumptions in the surge calculation (20% share, 60% phone, 15% busiest hour, 85% occupancy, 20% line headroom, 20% hand-off rate) | zian.ai (illustrative inputs, not measurements) | This page | 18 October 2026 |