Waypoint Claims | P&C Claims Automation

My Open Claims 📋

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open

Overdue Follow-Ups ⚠️

—

needs action

Due Today 📅

—

on track

My Closed Claims ✅

—

all time

Today's Diary

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My Claims

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Adjuster Performance

Claim View History

🗺 Resources

Texas DOI - TDI Florida OIR California CDI New York DFS NAIC Resources

Filters

Adjuster

Loss Type

State

✅ No claims in queue — all claims are assigned.

Pending Approval

Awaiting Manager

Approved — Ready

Total Pending ($)

No payment requests on file.

View As

State

Status

Show per page

Loading compliance deadlines…

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First Contact ≤ 24hrs

—

Reserve Set ≤ 3 Days

—

ACK Letter ≤ State Req.

—

Missed Deadlines

SLA Performance by Adjuster

⚠️ Bad Faith Risk Indicators

No bad faith risks detected.

Screen Individual or Entity

Full Name / Entity Name *

Date of Birth (optional)

Country (optional)

Claim / Reference Number

📋 Screening History

No screens run yet.

🔌

Carrier API Integration

This page fetches live declarations from your carrier system via API. Enter a policy number above to retrieve declarations. Configure your API endpoint in Settings.

No policy loaded

Coverage	Coverage Limit	Deductible	Premium	Status
Loading coverage data…

📄

No Policy Loaded

Enter a policy number above and click Fetch Declarations to retrieve policyholder information from your carrier API.

Request ISO Report

Claim Number or Policy Number *

📋 Request History

No ISO requests yet.

Filters

View As

Status

Peril

Show per page

Insured Information

Name

Phone Number

Secondary Phone

Address

City

State

Zip Code

Loss location is the same as the insured address

✅ Loss location set to the insured address:

Loss Location Address

City

State

Zip Code

Policy & Agent Information

Claim Number

Policy Number

Policy Effective Date

Policy Expiration Date

Agent Name

Agent Email

Agent Phone

Additional Insured

Mortgagee Name

Loss Details

Date of Loss

Loss Type

Loss Severity

Policy Type

Reported By

Loss Description

CLM-48291-0401-26

S. Rodriguez — Wind/Property Loss

Date of Loss: 03/31/2026 State: Texas Adjuster: — Reserve: $15,200 Status:

Loss Details

Policy Info

File Notes

Diary

Statutory Requirements

Features / Reserves

Payments

Documents

Messages

Letters

Claim Contacts

Financial Data

Litigation

Invoicing

Claim Details

Insured

Insured Name

Phone

Employer Contact

Address

Policy Number

Claimant

Claimant Name

Phone

Claimant Address

Loss

Loss Type

Loss Location

Loss Severity

Loss Description

Market / Bordereaux Fields

Certificate Reference

Prior Claim Reference

Carrier File Number

Sums Insured

Amount Claimed

Jurisdiction

Cause of Loss Code 1

Cause of Loss Code 2

Litigation Status

Risk Location Address

Risk Location City

Risk Location State

Risk Location Zip

Date First Advised

Date Coverage Confirmed

Proof of Loss Complete

Demand Received

More-Time Notice Sent

⚖️ Attorney Representation

No attorney representation on file.

🔌 Vendor Services

plug-and-play — live when a provider contract is signed

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Select Letter Type

📩 Acknowledgment

📋 Request for Information

⚠️ Reservation of Rights

🚫 Coverage Denial

💰 Payment Tender

✅ Closure Letter

🏗️ Claim Contact Assignment

🎙️ Recorded Statement Notice

⚖️ Subrogation Demand

🏥 HIPAA Authorization

📄 Declarations Summary

Not Loaded

📄

No declarations loaded.

Policy Information

Basic Information

Policy Number
Policy Type
Effective Date
Expiration Date
Cancellation Date
Original Effective Date
Status

Insured

Name
Name
Address

Policy / Endorsements

No data to display

Additional Insured

No data to display

Agent

Name
Code
Address
Email
Phone

Financial / Underwriting Company

Mortgagee(s)
Underwriter
Financial Company
Updated Financial Company
Underwriting Company

Policy data is populated from FNOL intake or the carrier data-system API. Fields show "—" until that integration delivers data for this claim.

Claim History

Prior claims associated with this policy / insured. Click a claim number to open it.

Claim Number	Date of Loss	Loss Type
No prior claim history available.

💳 Create Payment

Payee Name *

Payment Type *

Feature

Payment Sub-Type

Amount *

Payment Method

Payment Date

Description / Memo *

Mailing Address

City

State

ZIP Code

Tax ID Type

EIN / SSN

Encrypted. Required for 1099 reporting.

Payment will be logged to diary and audit trail

💰 Payment Recovery

Recovery Source / Payee

Recovery Type

Feature

Recovery Reserve (Expected)

Recovery Amount (Received)

Check / Reference Number

Method

Recovery Date

Description / Memo

Original Payment Reference (optional)

Recovery will be logged to diary and audit trail

Recovery Reserve Ledger

Coverage	Recovery Reserve	Recovered	Remaining
No recovery reserves yet.

Recovery History

No recoveries recorded yet.

💵 Recoveries (Salvage / Subrogation)

No recoveries recorded.

🛡️ Sanctions Screening (OFAC)

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Payment History

No payments issued yet.

Parties on this claim — from the shared contact master

Loading parties…

Claim Contacts & Vendors

No claim contacts assigned yet.

This letter composer now lives inside each claim, under the Letters tab. Open a claim to write letters.

No claim-contacts added yet. Click + Add Claim Contacts to get started.

Select State

Account Information

Role

Phone

—

Extension

—

Reports To

—

Account

Active

My status

Assignment/Billing History

View my history

Claims Management System

Waypoint Claims

Organization

My Team

My Reporting Line

Full Org Chart

Loading\u2026

Insured Information

Name

Phone Number

Policy Number

Address

City

State

Zip Code

Policy & Agent Information

Policy Effective Date

Policy Expiration Date

Agent Name

Agent Email

Agent Phone

Claimant Information

Name

Phone Number

Secondary Phone

Address

City

State

Zip Code

Loss Type

Loss Details

Date of Loss

Reported By

Loss Location Address

City

State of Loss

Zip Code

Loss Description

👤 Injured Worker & Employer

Injured Worker — Full Name

Date of Birth

Phone

Address

City

State

Zip Code

SSN (last 4)

Gender

Employer / Company

Employer Contact

Employer Phone

Employer Email

Policy / Account Number

Job Title / Occupation

Hire Date

Avg Weekly Wage (AWW)

State of Employment

📄 Policy & Agent Information

Policy Effective Date

Policy Expiration Date

Agent Name

Agent Email

Agent Phone

🏭 Incident Details

Date of Injury

Time of Injury

Date Reported to Employer

Incident Type

Body Part Injured

Nature of Injury

Lost Time?

Treating Facility

Supervisor on Duty

Witnesses

Incident Location — Address

City

State

Zip Code

Incident Description

💊 Medical Management & Benefits

Initial Treatment

Estimated Disability Period

Work Status at Time of Report

Modified Duty Available?

🤖 AI Workers' Comp Triage — MAX Protocol

Submit Workers’ Comp claim for AI-powered compensability analysis, TTD benefit calculation, medical management flags, litigation risk, and state compliance deadlines.

Workers’ Comp Quick Reference

🦺 Separate claim # prefix: WC-

⏱ First report of injury auto-filed

📅 TTD benefit period tracked by state

💊 Medical panel / MPN controls apply

📋 IME triggers at 90 days by default

⚖️ Litigation flags monitored via MAX

📊 AWW → benefit rate calculated by AI

⚡ Instant Deadline Calculator

Claim Number

State of Loss

Date of Loss

Insured / Claimant

📋 Active Claim Compliance Auto-sorted by nearest deadline

Claim #	Insured / Claimant	State	DOL	Acknowledge By	Accept/Deny By	Pay By	Status	Days Until Next

🤖 AI Compliance Review — Ask Claude

Ask about any state's compliance requirements, penalty provisions, or get a compliance audit of the current diary.

Inbound Taken

today

Outbound Made

today

Total Calls

this session

Avg Handle Time

—

mm:ss

FNOLs Created

from calls

Call Type: 📲 Inbound — Caller is calling in 📤 Outbound — Adjuster is calling out INBOUND Adjuster: —

Ready — Awaiting Inbound Call

00:00

📞

Waypoint Virtual Call Center

Simulate an inbound caller to begin the intake process

📋 Collected Intake Data

Populates as call progresses…

📜 Call Transcript

Transcript appears here…

📋 Call History

Call ID	Direction	Path	Answered	Ended	Duration	Avg Handle	Outcome
No calls yet this session

🔌 Nextiva Integration

Simulated inbound call · AI transcript · Auto FNOL · Connect live credentials in Settings

🟢 Available

NEXTIVA

Contact Center · Waypoint Claims Queue

Queue: 4 Agents Online: 3 Avg Wait: 1:24 00:00

📵

Waiting for Inbound Call

Nextiva will route the next call from the Waypoint Claims queue to this agent

🔌 Integration Status

Nextiva API ⚠ Simulated

Claude AI ✅ Connected

Auto FNOL ✅ Enabled

Webhook URL mcs.claims/api/nextiva

Speech-to-Text ⚠ Simulated

Go Live: Replace simulated webhook with your Nextiva API credentials at developer.nextiva.com to activate real inbound call processing.

📋 Call Queue 4

📊 Today's Stats

Calls Taken

FNOLs Created

0:00

Avg Handle

Auto-Created

📋 Claims from Calls Today

No claims created yet today

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Super Admin · Waypoint Claims

Performance Score

Open Claims

—

FNOLs Created

—

Calls Taken

—

Claims Closed

—

Avg Cycle Time

—

📋 My Claims

📈 Period-over-Period Trends

🔑 Pending Authority Requests

Loading authority requests…

📈 Portfolio Analytics

Avg Cycle Time

days average

Reopened Claims

claims currently reopened

Received vs Closed Ratio

Adjuster Workload

Closed Claims Review Queue

Claim #	Adjuster	Loss Type	DOL	Reserve		Action

Adjusters

Ctrl+click for multiple

Claim Status

Ctrl+click for multiple

Expired Diary Entries

EXPIRED

DUE TODAY

UPCOMING (7d)

Claim #	Entry	Assigned To	Follow-up	Status

Contact Investigation — run any party, any role, across the whole book

Search the party master. Click a result for the full record and every claim it appears on.

🤖 AI Screening — Single Claim

Claim Number

Loss Type

Claim Facts / Description

Reported By

Attorney Represented?

Prior Claims History

Loss Reported Late?

Policy Recently Obtained?

📊 Screening Result

Submit claim facts for AI screening — or Screen All Open Claims above

📋 SIU Referral Queue

🌀

Bulk FNOL Upload — Standby

Activate Bulk FNOL Upload to enable bulk FNOL intake, surge resource tracking, and catastrophe-specific workflows. Use for hurricanes, hailstorms, wildfires, floods, or any mass loss event.

Select an assignment to view all approved invoices you submitted on that deployment.

Add Diary Entry

Claim # *

Title *

Entry

Assign To *

Follow Up Date *

Filter

View Diary As

Due Date Range

Summary

Diary Log — Overview

No diary entries yet. Add the first entry above.

Add File Note

Assign To

Title *

Note

🔒 Notes are permanent once saved

Filter Notes

All File Notes

No file notes yet. Add the first note above.

⚙️ Waypoint Claims Backend Connection

Claim Emails

Compose Email

Attach from Documents

Attach from Documents

Attach from Documents