How to run a two-week practicum for claims handlers

Run ten working days on the agent's real claims output: held settlements, drafted coverage letters, reserve suggestions and fraud flags. A senior handler with a current certificate decides each item independently and releases every payment. The handler passes with at least 95 decisions in every 100 right and no missed red line, such as paying a claim the policy does not cover.

What is the practicum, and who owns it?

Claims handlers who work with a governed agent spend their day on what the agent cannot settle alone: payments above the insurer's own limit, claims with external evidence, coverage questions and anything that looks wrong. The practicum tests that judgement on live claims before the handler approves on their own.

The claims team manager owns the practicum. A senior handler supervises. The claims technical lead sets the red lines. The counter-fraud team should be available for any case flagged during the fortnight. The handler owns their decision and a short reason for each.

How do you build the queue?

Claims vary in effort. Twelve to twenty decisions a day gives a fortnight of around 150 to 200. The queue should include:

• settlements held because they are above the insurer's limit;
• settlements held because the deciding evidence is external, such as a repairer's estimate sent by email;
• drafted coverage acceptance letters and requests for information;
• reserve suggestions drafted by the agent;
• claims escalated for fraud indicators;
• potential declines, where the agent has drafted an evidence summary but the decision is the handler's;
• claimants showing signs of vulnerability.

Seed anonymised past claims for any type that is thin, especially declines and fraud. A practicum without a decline teaches handlers that the agent always gets coverage right.

For example, one seeded claim might involve escape-of-water damage where the policy has an endorsement excluding gradual leaks. The agent's coverage draft accepts the claim, because the first notice of loss described a sudden burst. The surveyor's report, which is signed, describes long-term staining. The handler should catch the conflict and hold the payment.

The steps

1. Person (claims manager): brief the handler on the bar, red lines and log.
2. Agent, depth 1: route items to the practicum queue, tagged by type.
3. Agent, depth 2: present each claim with its draft, deciding bound and evidence, marked by provenance: the policy record is sealed, a surveyor's report is signed, the claimant's account is declared, an emailed estimate is external.
4. Person (handler): decide: pay, edit, refer, request information, propose decline or escalate, with a reason.
5. Person (senior handler): decide independently, then compare.
6. Person (senior handler): release payments and send letters only on their own authority during the practicum.
7. Agent, depth 1: log both decisions, the match and any red-line flag.
8. Person (senior handler, then assessor): review the log at the end.

How do you set and apply the bar?

A decision is correct if it matches the senior handler's, or the senior agrees it was sound on the evidence. A reserve within a sensible range counts as correct; a payment of the wrong amount does not.

The red lines: paying a claim the policy does not cover; paying against unverified external evidence or bank details; proposing a decline without a policy basis; missing a fraud indicator that should have been escalated; missing clear signs that a claimant is vulnerable. One miss fails the practicum.

Which controls matter, and what evidence do they leave?

• Senior release of every payment. Evidence: the senior's name on each settlement in the append-only record.
• Independent senior decision. Evidence: the decision timestamped before comparison.
• Counter-fraud consultation. Evidence: notes on any escalated claim.
• Daily debrief. Evidence: a line per mismatch.
• Full log. Evidence: the practicum log template for claims handlers.

What should you measure?

Correct decisions out of the total, split by claim type. Red-line misses (zero). Conflicts between evidence sources that the handler caught. And the time held settlements spend waiting, which shows whether the handler can keep pace without cutting corners.

Where does it usually go wrong?

The queue is all small, clean claims. The handler scores well and has never seen a disputed one. Seed hard cases.

A storm or flood surge hits mid-practicum, and the senior stops checking properly. Pause the practicum rather than lower the standard.

Handlers learn to agree with the agent. Track how often the handler changed the agent's draft and whether the change was right.

Approval rights are granted without the log. Whether handlers need a certificate to approve held settlements is the insurer's decision; see do claims handlers need a certificate to approve AI agent actions. On who answers for errors, see are claims handlers accountable for an AI agent's mistakes. Operations managers run a similar practicum; compare running a practicum for operations managers.

Where the Academy fits

Pryme Intelligence Academy's Certified Pryme Operator ends with a practicum on these terms: two weeks of real review decisions, at least 95 in every 100 correct, no missed red line, signed off by a Pryme assessor. The certificate is issued through VerifyDoc.ai and valid 12 months. More in the guide to AI literacy and certification for people who work with agents.