Claims / Reserves and payments
The figure on screen cannot drift from the ledger
Total reserve is maintained by the database itself, not by application code, so the total on the file is always the sum of the rows beneath it.
It does not matter which door wrote the last transaction — a screen, an integration, a batch job. They all read the same computed total.
Walk a reserve changeCan a screen and the ledger disagree?
No, because the screen does not hold its own figure. The total is computed by the database from the transaction rows, so there is no cached value in application code to fall out of step and no reconciliation job whose failure would be invisible.
And the authority ceiling
Reserves, payments, recoveries
- 01
Reserves are set per category
Indemnity, expense, legal. A single blended figure hides exactly the movement a reserve review needs to see.
- 02
Every change records why
Old value, new value, actor and reason. Reserve accuracy per adjuster becomes a report rather than an argument.
- 03
Bands flag, they do not block
A reserve outside its configured range is flagged for review. The adjuster’s judgment stands; it just stops being invisible.
- 04
Payments meet an authority ceiling
Inside the adjuster’s limit a payment proceeds. Above it, the request becomes a queued approval on the file rather than an email.
- 05
Recoveries net off incurred
Subrogation, salvage and deductible recovery are tracked against the claim and produce net liability — what the loss actually cost.
The vocabulary
Terms used precisely, because they are not synonyms
Most leakage conversations founder on two people using “incurred” differently. These are the definitions the platform enforces.
| Term | Definition |
|---|---|
| Reserve | Money set aside for an expected liability, by category |
| 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 |
| ALAE | Allocated loss adjustment expense — the cost of handling this specific claim |
Integrity is not adequacy
The platform guarantees the arithmetic. It does not guarantee that the reserve is the right number.
Bands are your configuration
Expected ranges by claim type are yours to set. We ship none, because a band tuned on somebody else’s book flags the wrong files.
Adequacy is judgment
A model can score reserve adequacy. Setting the figure remains an adjuster action, with the reason recorded.
Payment rails are separate
The platform authorizes and records. Actual disbursement runs through your own payment infrastructure.