Door one
First party FNOL
The insured reports their own loss. Policy resolution and coverage verification run as the notice is taken, so the adjuster starts with a verified position rather than a promise to check.
The portals / Claims Platform
The claim file stops waiting on people
Intake through closure and recovery: assignment at creation, reserves and payments under authority, statutory clocks computed per jurisdiction, and a file that shows its own history.
Request a Demo0Claims left unassigned overnight — assignment runs at intake
1Editing lock per claim, so no work is overwritten
4Ways a loss can be reported without re-keying it
2×Signatures required before a high-exposure cancellation
Every door into a claim
Door two
Third party FNOL
A claimant who is not your insured. Parties, attorneys and the liability posture are captured from the start, where they belong on the file.
Door three
Workers' comp FNOL
Jurisdictional intake for indemnity and medical, with the statutory reporting the line demands computed from the loss and report dates.
Door four
Agentic and call center
Documents and conversations are read into a draft intake with per-field confidence, then a reviewer confirms before a claim exists. Nothing is created by a model alone.
The claim file
Summary
Status, loss detail, assignment and the exposure figure at a glance.
Policy
Resolved policy, coverages, limits, deductibles and the verification result.
Parties
Insured, claimants, attorneys, vendors and contacts, de-duplicated across claims.
Financials
Reserves by category, payments, recoveries, incurred and net liability.
Payments
Payment requests, approvals and subrogation activity.
Notes
File notes, encrypted, attributed and timestamped.
Documents
Uploaded and generated documents, including the letter package.
History
Every status change and material edit, with who and why.
The money, named plainly
Reserve
Money set aside for an expected liability, by category — indemnity, expense, legal.
Paid
Money actually disbursed against the claim.
Incurred
Paid plus outstanding reserve. The exposure figure.
Recovery
Money coming back: subrogation, salvage, deductible reimbursement.
Net liability
Incurred less recoveries. What the loss actually cost.
ALAE
Allocated loss adjustment expense — the cost of handling this specific claim.
The clock
Claim Compliance
Statutory deadlines, computed
Acknowledgment, contact and decision dates derived per jurisdiction from the loss and report dates — not typed in by whoever opened the file.
Compliance Deadlines
The whole book at once
Every claim’s clock across the operation on one page, so an aging deadline is a queue item rather than a discovery.
Diary
Tasks with an owner
Entries carry a due date, an assignee and a claim, raised by hand or automatically by platform events.
Special units
Referral, investigation and outcome tracked on the claim. Fraud rules and predictive screening raise candidates; the referral blocks closure until it is resolved, which is the point.
Screening results and overrides recorded against the party, so a match is answered on the file rather than in somebody’s inbox.
Event-scoped surge handling: adjusters deployed to an engagement, licensing respected per state, and the fee structure carried into the invoice at the end.
Quality
How the work is checked
Who gets in
What it solves
Auto-assignment runs at creation across every intake door and respects state licensing, so a new loss has an owner before anyone reads it.
A payment inside the adjuster’s authority proceeds; one above it routes to an approver as a queued request on the file, not an email somebody may open.
Total reserve is maintained by the database itself, so the figure on the file is the sum of the rows beneath it no matter which door wrote the last transaction.
Deadlines are computed per jurisdiction from the loss and report dates and shown across the whole book, so an aging clock is a queue item rather than a discovery.
Opening a claim for editing takes a lock; the second person sees it read-only with the holder named on screen.
A claim cannot close while an SIU referral is open. The transition refuses rather than warns.
Volume, cycle time, reserve accuracy and closure rates per adjuster and per team, with file-review scoring alongside and a drill-through to the claims behind every number.
See the Claims Platform on your book
Bring a real claim shape and we will walk it end to end.
Request a Demo