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Considerations for Claims Service Employee Assistance

Considerations for Claims Service Employee Assistance

Before you set up an agent with the Claims Service Employee Assistance template, review these considerations.

Required Editions

Available in: Lightning Experience
Available in: Enterprise, Performance, Unlimited, and Developer Editions with Agentforce Financial Services and Agentforce for Financial Services add-on, or included in Agentforce 1 Financial Services Edition.

Language and Locale Support

The Claims Service Employee Assistance template supports these languages and locales.

Language Locale Code
English English (United States) en_US
  English (United Kingdom) en_GB

Large Language Model Support

The Agentforce platform supports OpenAI GPT-4o for reasoning engine calls. Agent actions can make calls to other predefined LLMs. Bringing your own model isn't supported, but custom actions that execute prompt templates can use any Salesforce-managed model. See Large Language Model Support.

Model
OpenAI GPT-4o

Einstein Trust Layer Service Support

Claims Service Employee Assistance is an Agentforce Employee agent template and supports the Trust Layer services that the Agentforce Employee Agent type supports.

Usage Types Billed by Claims Service Employee Assistance

Claims Service Employee Assistance is an Agentforce Employee agent template. Agentforce Employee agents use generative AI and Data Cloud to ingest, store, and process data. Before deployment, work with your Salesforce account team to confirm license availability and plan credit usage.

For more information on how usage is billed, see Considerations for Agentforce Employee Agent.

Tip
Tip This feature has access to Digital Wallet, a free account management tool that offers near real-time consumption data for products across your active contracts. Access Digital Wallet and start tracking your org's usage. To learn more, see About Digital Wallet.

Other Considerations

  • Closing the Claims Service Employee Assistance agent, it ends a session and the agent doesn't retain the conversation history or other context.
  • You can file only one claim in a session with the agent. To file a second claim, start a new session.
  • You can add participants and items only to the claim that was created in the same session. You can't update claims that you created in a previous session.
  • The template includes first-notice-of-loss (FNOL) intake instructions and can assist you in filing a claim for these policy types: Auto, Cyber, Health, Life, Medical, Pet, and Transport. To support other policy types, add new picklist values for the Policy Type field on the Insurance Policy object. Then, customize the Get Insurance Business Line Instructions flow to add instructions for the new policy types.
  • The agent can't cancel a filed claim for you.
 
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