Waypoint Claims
Waypoint Center / The claim file

Everything about a claim, on one page with 17 tabs

Loss details, policy, file notes, diary, statutory requirements, coverage lines and reserves, payments, documents, photos, SIU, customer messages, email, letters, contacts, financial data, litigation and invoicing — one page, with everything that matters visible the moment it opens.

Opening a claim takes its edit lock, so two people can never overwrite each other’s work. Anyone else may still read it, with a banner naming who is editing.

Walk a live claim How it works
The question this answers
Can a letter, a legal bill or a workers’ comp benefit go out unchecked?
No. A letter is filed on the claim and opens a review item before anything is sent, and denials go to a second signature. On a claim in litigation, a standard expense payment waits until the defense matter has a budget and a litigation reserve. A workers’ comp benefit readout is computed from the state’s rule in force on the day disability began.

What the file carries

Tab by tab
Letters and Email
A library of 64 letters filled from the claim’s facts — values it supplies cannot be typed over, and a missing value stops the letter. Replies come back to a signed address for that claim; uncertain mail is held, not lost.
Litigation
Matters with type, phase, court, demand and counsel. Opening a defense matter starts the litigation gate, and a claim cannot close with an open matter.
Recoveries
Subrogation, salvage, refunds and reimbursements with an expected reserve and what was received. Salvage status comes back automatically, and deductible recovery steps at day 30, 60 and 90.
Workers’ Compensation
Its own record: first report of injury, statutory first report, nurse case management, medical bills decided line by line by the adjuster, Medicare Section 111 — and only the last four digits of a Social Security number on the claim.
Notes and Chats
File notes are permanent and cannot be edited after saving. A chat about the claim is saved on the claim, so the file tells the whole story.
What protects the file

Rules that hold on every claim

Nothing about a claim is ever deleted. “Discard”, “Remove” and “Delete” mark an item and keep it.

Rule
Behavior
Edit Lock
One editor at a time, refreshed every minute; a lock idle for 15 minutes can be taken over
Exit Diary
Leave a claim you own with no diary set and one is set for the next day
Closing
Refused while any reserve, pending payment, open diary, open matter, SIU referral, open subclaim or unreviewed document stands
Reopening
A manager’s act, with a reason of at least 20 characters and a reserve for each line reopened
Masking
Once closed for your set period, personal identifiers are masked for everybody, readable only with a recorded reason
License Line
Correspondence in states that require it carries the adjuster’s license line, which cannot be removed or faked
Where we are honest

Where your set-up matters

The file enforces the rules. Several of the rules are yours to load.

Jurisdiction Rows
A letter for a state with no jurisdiction row is refused rather than printed empty, so the rows for the states you write in must be in place.
Benefit Rules and Gate Tiers
Workers’ comp benefit rules by state, and who may pass a litigation-held payment — $5,000 for a Manager by default — are your organization’s settings.
Vendors Need Contracts
Print and mail, salvage, collections and bill review send nothing until your organization connects a vendor with a contract in place.

Read next

Reserves & Payments Coverage lines, authority and the payment checks. Diary & Deadlines Statutory clocks and the diary on every claim. Waypoint Center The portal the claim file lives in.

Bring a file that went to suit

Open the matter, try to pay an expert and watch the payment wait for the budget and the reserve — then produce a reservation-of-rights letter and watch it route to the second signature.

Book a walkthrough Back to the overview