Claims lifecycle · Stage 06 of 08 · Settlement
AI demand package review for bodily injury claims
The demand digested, the specials checked against the records, and a drafted response before the clock runs out.
In short
Hesper AI is an AI claims resolution platform for P&C carriers, TPAs, and MGAs. When a bodily injury demand arrives, its agents read the package against the claim file, check the claimed specials against the underlying records, flag what the demand omits, benchmark the valuation, and draft a response for the adjuster. Settlement authority and the negotiation stay with your team.
Why are demand packages a deadline problem?
A demand arrives as a few hundred pages with a response window attached, and often a statutory one. Someone has to read the records, check that the billed specials are actually in them, work out what the package leaves out, value the claim, and get a response out before the date. Miss it, and the exposure is no longer the claim: it is the bad-faith argument that follows.
The work is mechanical, and that is the problem. It is also the reason it gets started late.
What does the demand-review agent do?
- Reads the demand and extracts what is actually being claimed: liability theory, injuries, treatment, specials, lost wages, and the deadline.
- Checks the claimed specials against the underlying records: billed against treated, duplicated dates, unrelated conditions, and pre-existing findings.
- Flags what the package omits, such as gaps in treatment or records referenced but not attached.
- Benchmarks the valuation against the file's own evidence and comparable claim characteristics.
- Flags litigation risk early: representation, venue, prior demands, and language suggesting a time-limited demand.
- Drafts the response, with each figure tied to the record that supports it.
Why does a cited response matter?
Because the response is evidence too. A drafted response that shows which records support each adjustment is harder to characterise as arbitrary later, and it gives the adjuster something to negotiate from rather than a number.
The file behind it is the same one built at claim file review and used for coverage, so the response does not depend on someone re-reading the records under time pressure.
Who decides the number?
Your adjuster, within your authority limits. Hesper does the reading, the checking and the drafting, and shows its work. It does not settle claims, send responses, or make authority decisions.
For the attorney's side of the same trend, see our post on AI demand packages and the social inflation gap.
What does Hesper do, and what does your team decide?
| Hesper's agents | Your team |
|---|---|
| Reads the demand and extracts what is claimed | Confirms the deadline and the file is complete |
| Checks specials against the records and flags omissions | Weighs which adjustments to make |
| Benchmarks valuation and drafts the response | Sets the number and the authority |
| Flags litigation risk early | Decides on counsel and negotiation strategy |
What does the output look like?
- Demand
- Policy-limits demand with a response deadline stated in the letter
- Claimed specials
- Medical bills, lost wages and future care, totalling more than the file supports
- Records check
- Part of the billed therapy post-dates the last documented visit
- Omissions
- Prior treatment for the same body part referenced in the records but not in the demand
- Risk
- Represented claimant, venue with elevated verdict history noted for the adjuster
Evidence cited
- Billed therapy dates listed against the treatment notes that cover them
- Prior-treatment reference quoted from the records with its page
- Wage claim compared against the employer's wage statement
Recommended next action: Adjuster reviews the drafted response, sets authority, and answers before the deadline.
Frequently asked questions
What is AI demand package review?
Software that reads a bodily injury demand against the claim file: what is claimed, whether the records support the specials, what the package leaves out, and what the claim is worth on the evidence. It produces a drafted response for the adjuster to decide on.
Does it respond to demands on its own?
No. It drafts. Your adjuster sets the number, the authority and the strategy, and sends the response. Nothing goes out of the system without a person deciding.
How does it handle time-limited demands?
It extracts the stated deadline and any statutory framing from the letter itself and surfaces it at the top of the review, so a short-fuse demand is visible on day one rather than discovered late. Your team confirms the applicable requirements for the state.
What about demand packages assembled with AI?
They are getting longer and arriving faster, which is exactly why the checking has to be mechanical. The same document forensics that runs on any claim file runs here, so altered or synthetic records are flagged.
Which lines does this cover?
Auto and general liability bodily injury, and casualty claims in commercial lines. The valuation inputs differ by line and venue, and the review adapts to the file.
Other stages of the claim
Book a demo of Hesper's settlement agents
Bring a live demand package. We will show the checks, the omissions and the drafted response.
Book a demo