How to run an AI agent incident drill for the claims team

Choose a scenario where money and customers meet: the claims agent has been drafting settlement offers with the wrong excess after a policy wording change. Over about 90 minutes, claims handlers practise pausing the agent to draft-only, escalating to the claims manager, recording every decision, and reporting to customers, leadership and, where required, the regulator.

What is a claims drill, and who runs it?

Claims teams rely on agents for acknowledgement letters, document requests, fact gathering and settlement proposals. A claims agent might request documents at depth 3 within bounds and draft settlement offers at depth 2 for a handler to approve. Payment of the settlement sits at depth 4 at most, and most insurers keep it with a person.

A drill is a rehearsal of the people's response, not a test of the agent. The claims manager owns it; a team leader or quality lead facilitates. Handlers, a complaints handler and someone from the product team take part. The background is in what an incident drill is.

The scenario

A home insurance product's standard excess rose six weeks ago for new and renewed policies. The policy schedules were updated, but the claims agent's source for excess amounts still holds the old figure for some policies. The agent has drafted 400 settlement offers since then; handlers approved most; about 80 underpaid customers by the difference, and 15 overpaid. A customer complains that their neighbour, with the same insurer, received more.

The drill, step by step

1. Person (facilitator): reads the scenario and starts the clock.
2. Person (complaints handler): spots the pattern and escalates to the claims team leader. The test: do they see a complaint as a possible systemic issue?
3. Person (claims team leader): pauses the agent to draft-only. Document requests that ran at depth 3 are now held as well. The verdicts show the insurer's own limits as the deciding bound.
4. Person (team leader): escalates to the claims manager and product team. Product confirms which policies changed and when.
5. Agent, depth 1: lists from the record every settlement drafted using the old excess source. Handlers check a sample against policy schedules.
6. Person (claims manager): decides on remedy. Top up the underpaid customers with an apology; decide the approach for overpayments, which many insurers choose not to reclaim.
7. Person (team leader): records each decision with owner and time.
8. Person (claims manager and compliance): decide on reporting to leadership and, if rules require, the regulator. Customer treatment rules may require prompt, fair remedy.
9. Person (facilitator): runs the debrief.

What does this drill reveal that others do not?

Two things specific to claims. First, the excess source and the policy schedule disagreed, and both looked authoritative. Handlers need to know which one wins. In this case the schedule the customer holds is the contract, and the agent's source should have been drawn from it.

Second, complaints are an early warning system. The pattern was visible in the complaints queue days before anyone looked at the agent. Training complaints handlers to recognise systemic issues is part of incident readiness.

The drill also tests whether handlers can explain a top-up to a customer without confusing them. A short script, written in the drill and approved by the claims manager, helps: what went wrong, what the customer will receive, and that nothing else about their claim changes.

Which controls are tested, and what evidence do they leave?

The pause. Evidence: the limit change in the record, name and time.

Scope from the record. Every verdict and every handler approval is filed append-only, so the 400 offers can be listed exactly.

Remedy. Evidence: the written remedy decision and each top-up payment, released by a named person.

Source change control. Evidence: a named owner for keeping the agent's excess source aligned with product changes.

What should the claims manager measure?

• Time from complaint to pause.
• Completeness of the affected list against a manual sample.
• Time to remedy every underpaid customer.
• Whether handlers can say which source wins when two disagree.

Where does a claims drill go wrong?

Paying first, recording later. In the rush to put customers right, payments go out without a recorded decision. Record the decision, then pay.

Not involving product. The fault began with a product change. Without product in the room, the source fix is guesswork.

Handlers blamed. They approved offers that looked right. The lesson is about checking sources against the schedule, not about individual fault.

Claims teams can compare drills in neighbouring teams: the IT team drill tests the technical side of a source failure, and the operations team drill covers capacity when an agent loses depth. To build the drill itself, use the AI agent incident drill script template, and for the wider training question see how to train a team to handle an AI agent incident and training teams for AI agents.

Where the Academy fits

Pryme Intelligence Academy's Operator track covers how a governed agent decides, human review and when something goes wrong. Its practicum, two weeks of real review decisions signed off by a Pryme assessor with no missed red line, is where a claims handler shows they check sources rather than approve plausible offers.