Insurance Defense Initial Case Evaluation Report
Within the first weeks after assignment, once you have the pleadings, claim file and an insured interview, to produce the initial evaluation report the carrier's guidelines require.
The initial case evaluation is defense counsel's first real impression with the carrier. Claims professionals want a concise, guideline-compliant report that tells them what happened, how liability is likely to be decided, what the damages look like, what the case will cost to defend and what counsel recommends. Assembling it from the pleadings, a thin claim file and interview notes takes time that is rarely billable in full.
This prompt keeps the pleadings, the claim file and your notes in separate tags and asks Claude for a draft in your carrier's format. Each fact carries a source tag, conflicting accounts are marked, legal standards are left as bracketed items to verify, and exposure appears as ranges you fill in, with the assumptions written out. The budget is broken down by litigation phase, and open investigation items get owners and dates. Coverage is deliberately excluded from the report and flagged to you separately.
Claude cannot assess witness credibility, local verdict trends or the judge, and it should not be the source of legal standards or exposure numbers. Counsel must verify every fact and legal reference, set the ranges and budget, keep coverage issues properly handled given the duties owed to the insured, and approve the report before it goes to the carrier.
The Prompt
I am defense counsel retained by [CARRIER] to defend [INSURED] in [CASE CAPTION], pending in [COURT / JURISDICTION]. I need a first-draft initial case evaluation report for the claims professional, due [DATE], following this format: [CARRIER GUIDELINE FORMAT, e.g., PASTE REQUIRED HEADINGS AND PAGE LIMITS]. <pleadings> [PASTE COMPLAINT, ANSWER IF FILED, AND ANY MOTIONS] </pleadings> <claim_file> [PASTE CLAIM FILE MATERIALS PROVIDED BY THE CARRIER: INCIDENT REPORT, RECORDED STATEMENT SUMMARIES, PHOTOS DESCRIPTIONS, MEDICAL SPECIALS SUMMARY] </claim_file> <my_notes> [PASTE NOTES FROM INSURED INTERVIEW, SITE VISIT, EARLY RESEARCH] </my_notes> Draft the report with these sections: 1. Summary and recommendation (one paragraph). 2. Facts, each tagged to its source (e.g., [COMPLAINT ¶12], [CLAIM FILE: INCIDENT REPORT]); mark conflicting accounts and quote the source language for any disputed fact. 3. Liability analysis: plaintiff's theories, defenses, comparative fault or apportionment issues, and evidence that helps or hurts. Legal standards as [JURISDICTION RULE: VERIFY]; no case citations. 4. Damages: specials as documented, claimed general damages, and gaps in the medical or wage proof. 5. Exposure: verdict range [RANGE] and settlement range [RANGE], each with the assumptions stated so I can fill in the numbers. 6. Recommended strategy: early motions, key discovery, experts, and whether early resolution should be explored. 7. Budget by phase (pleadings, written discovery, depositions, experts, dispositive motions, trial) as hours and fees [RATE], with assumptions. 8. Open investigation items, with owner and target date. Do not discuss insurance coverage, reservation of rights or policy issues. Flag any coverage-sensitive facts for me separately at the end, outside the report. Flag gaps in the materials. This is a draft for attorney review before it goes to the carrier.
Example Output
A guideline-formatted first report with sourced facts, liability and damages analysis, bracketed exposure ranges with assumptions, strategy, a phase budget and an investigation task list, plus a separate coverage-sensitivity note for counsel.
Illustrative example — names, figures, and facts are fictional.
INITIAL CASE EVALUATION (DRAFT FOR ATTORNEY REVIEW) Re: Delacroix v. Brennan Supply Co. | Insured: Brennan Supply Co. | Carrier format: [CARRIER GUIDELINE] 1. SUMMARY AND RECOMMENDATION Customer alleges a slip on a wet floor near the loading entrance. Liability is disputed; comparative fault is a strong issue. Recommend early written discovery and an IME before evaluating resolution. 2. FACTS Incident on Feb 11 at the store's rear entrance [COMPLAINT ¶8]. Store manager states a "wet floor" sign was posted [CLAIM FILE: INCIDENT REPORT]. Plaintiff's recorded statement says "there was no sign" [CLAIM FILE: STATEMENT SUMMARY]. CONFLICT. Plaintiff was carrying two cases of tile [MY NOTES: INSURED INTERVIEW]. 3. LIABILITY Theory: premises liability, failure to warn [COMPLAINT ¶14-19]. Defenses: notice and warning; comparative fault (load carried, footwear). Standard: [JURISDICTION RULE: VERIFY]. Evidence needed: surveillance video (retention unknown). 4. DAMAGES Documented specials: $18,400 (ER, orthopedic follow-up) [CLAIM FILE: SPECIALS]. Claimed: wrist fracture, lost wages "about 6 weeks" (no wage records). Gap: no records after April. 5. EXPOSURE Verdict range [RANGE]; settlement range [RANGE]. Assumptions: comparative fault apportionment [X]%; no surgery; specials as documented. 6. STRATEGY Preserve and obtain video; interrogatories and RFPs; plaintiff deposition; consider IME. 7. BUDGET Pleadings 6 hrs | Written discovery 14 hrs | Depositions 30 hrs | Experts 10 hrs | Dispositive motion 20 hrs | Trial [TBD] | Rate [RATE] 8. OPEN ITEMS Video retention (counsel, Oct 9); identify sign placement witness (insured, Oct 12). SEPARATE NOTE TO COUNSEL (NOT FOR REPORT) Coverage or risk-transfer sensitive: insured mentioned an outside cleaning vendor; possible contractual tender issue.
Tips
- •Paste the carrier's actual reporting guideline headings and page limits; claims professionals notice when the format is off.
- •Fill in the exposure ranges yourself. The prompt asks Claude for the assumptions behind them, which is the part reviewers scrutinize most.
- •Keep coverage out of the report. Defense counsel owes duties to the insured (and in some jurisdictions to the carrier as a co-client), and the separate flag list helps you handle coverage-sensitive facts appropriately under [JURISDICTION] ethics rules.
- •Build the budget from your own staffing assumptions and the carrier's billing guidelines, then run it through a pre-bill or guideline check.
- •Verify every legal standard you insert. The report is a draft for attorney review.
Frequently Asked Questions
Why does the prompt exclude coverage from the report?
Defense counsel retained by a carrier owes duties to the insured, and in some jurisdictions the carrier is also a client. Commenting on coverage in a report to the carrier can create conflicts. The prompt keeps coverage out of the report and gives you a separate list of coverage-sensitive facts so you can handle them under your jurisdiction's ethics rules and the retention terms.
Can Claude estimate the verdict and settlement value?
It should not be your source for numbers. Verdict values depend on venue, judge, jury pool, local trends and experience that a model cannot reliably assess. The prompt leaves the ranges as placeholders and asks Claude to write out the assumptions, which you then adjust and price using your own judgment and verdict research.
How do I fit this to each carrier's guidelines?
Paste the guideline's required headings, page limits and budget format into the first section of the prompt. If you defend for several carriers, save a version of the prompt for each in a Claude Project so the format is ready when a new assignment arrives.
Can I paste the carrier's claim file into Claude?
Claim files contain personal, medical and sometimes privileged information. Check the carrier's guidelines, which may address AI or outside tools, along with your confidentiality obligations, and use a plan with appropriate data protections. Remove identifiers that are not needed for the evaluation.
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