Claim follow-up on WhatsApp: keeping the client informed at every stage

A claim is the moment a client finds out what their broker is actually for. It is also the moment when the brokerage has the least control: the file sits with the insurer, the assessor works to their own diary, and every silent day turns into an inbound call, usually a tense one, that pulls a consultant away to say "nothing yet".

WhatsApp changes this for two reasons. The client is already there: that is where they sent the photos of the hail-damaged bonnet or the burst geyser, from the scene. And a short, time-stamped message filed in the same thread as the notification costs less than a call and leaves a record you can retrieve months later if the settlement is disputed or a complaint reaches the ombud.

This guide covers the full journey, from acknowledgement to closure, for a brokerage of 3 to 50 people, whether its insurers pay by EFT in Johannesburg, by bank transfer in Manchester or by M-Pesa in Nairobi. At each step it sets out what falls inside WhatsApp's 24-hour customer service window, what needs a Meta-approved template, and what fair-treatment and record-keeping duties require of the brokerage.

The journey, step by step

1. Acknowledge within the hour and frame the notification. The client messages first, so the 24-hour window is open and the consultant can reply in free text. Confirm the date, place and circumstances, ask for missing photos and remind the client of the notification period in the policy wording (short-term policies commonly require notice within a set number of days; the schedule is the authority, not memory). From this first message, name the person handling the file ("{conseiller} is your contact") so the client does not end up messaging three people at the brokerage.
2. List the documents and appoint a single owner. In the same thread, send the list of supporting documents: police case number or accident report, repair quotes or invoices, proof of ownership, banking details or the mobile-money number for settlement. A firm rule on sensitive data: for an injury, disability or medical claim, never request medical reports over WhatsApp; point the client to the insurer's secure channel or the brokerage's email. Record the owner on the client file and keep the conversation in the shared inbox, not on a consultant's personal handset.
3. Submit to the insurer and commit to a date for the next update. The file goes to the insurer through its broker portal or by email; the brokerage records the insurer's claim reference on the client file and shares it with the client. The decisive habit: before leaving the conversation, the consultant commits to a date for the next update ("I will come back to you by {date}, even if the assessor has not reported"). Kept consistently, that promise removes most inbound calls. It must be realistic: promise a contact date, never a settlement date that only the insurer controls.
4. Send progress updates outside the window with a utility template. Once 24 hours have passed without a client message, free text is no longer allowed: the brokerage sends a Meta-approved utility template such as the claim progress update, with the claim reference and the current stage. An update with no news is still an update: "the assessor has not yet filed the report, I am chasing today" beats silence. As soon as the client replies, the window reopens and the consultant can continue in free text.
5. Announce the assessment and explain the excess and the offer. When the insurer confirms the assessor's visit or makes a settlement offer, relay it immediately and explain it: policy excess, depreciation or betterment, sum insured limits, what the client will still pay. This is where advice continues after the sale: if the client disputes the figure, explain the route (insurer's internal complaints process, then the ombud for short-term or long-term insurance in South Africa, the Financial Ombudsman Service in the UK, the regulator's complaints desk in Kenya or Nigeria). Write amounts with the currency and refer to the insurer's formal letter, which is the only binding document.
6. Confirm payment, close the file and measure satisfaction. Once the EFT or mobile-money transfer has been released, ask the client to confirm receipt, then send a closing message summarising the claim (date, amount, reference). Two to five days later, a short satisfaction question (the post-claim satisfaction template, with quick-reply buttons) catches a disappointed client before they lapse at renewal. Claims also expose cover gaps (no replacement-value cover, sums insured too low): that is the cue for a cover review, sent separately from the closing message and only to clients who have not opted out.

Sample messages

Acknowledgement, inside the 24-hour window

Progress update at day 8, utility template

Settlement offer received

Pitfalls to avoid

• Promising a settlement date: the brokerage controls only its own turnaround; commit to a contact date, never to the insurer's decision.
• Letting more than a week pass without a message: silence, not slow progress, is what generates calls and complaints.
• Requesting medical reports or hospital records on WhatsApp: special personal information under POPIA and UK GDPR, to be routed through the insurer's secure channel.
• Running the claim from a consultant's personal phone: when they are on leave or resign, the brokerage loses the history and the evidence.
• Failing to record the insurer's claim reference on the client file: every update then means logging into the insurer portal to find it.
• Slipping a sales pitch into the closing message: a client who has just suffered a loss reads it as opportunism; the cover review is a separate conversation.

How ORIS organises this use case

In ORIS the notification lands in the shared inbox and stays attached to the client record in Customers & Segments, with the claim reference kept as a note. The Window Open / Window Closed indicator tells the consultant whether they can reply in free text or must use a Meta-approved template from the claims category.

For long-running claims, a campaign with the "Claims follow-up" goal sends progress updates to a list of claimants, and response classification surfaces negative replies: a client who writes "this is unacceptable" triggers an "AI Flagged for Review" notification and a draft reply for a human to approve, never an automatic answer. When the conversation reveals a gap in cover, the consultant raises a coverage_gap flag, which becomes a coverage_review opportunity in Opportunities & Risks. The CSV export lets the brokerage attach the message history to the insurer's file or to a complaints record.

Frequently asked questions

Can I send a progress update if the client has not messaged for several days?

Yes, provided you use a Meta-approved template in the utility category. Free-text messages are only allowed within 24 hours of the client's last message; as soon as they reply to the template, the window reopens.

Do claim updates need a separate marketing opt-in?

No. A claim update is a service message about an existing policy, not direct marketing under POPIA or PECR. The client must still have agreed to receive WhatsApp messages from the brokerage, and anyone who has asked for no messages at all should be contacted another way.

Does a WhatsApp thread count as a record for FAIS or Consumer Duty purposes?

It is a time-stamped record of what was said and when, far more robust when kept on a brokerage number and exported regularly. It does not replace the insurer's formal documents: claim registration, assessor's report, settlement letter.

What if the insurer goes quiet and the client is losing patience?

Tell the client the truth, give the date of your next chase with the insurer, and keep it. If delays become unreasonable, point the client to the insurer's complaints process and, depending on the country, to the relevant ombud or regulator.