Case study
Every claim moved at the speed of the hardest one
A short-term insurer asked for a faster claims system. Data entry was never the delay: simple, low-risk claims sat in the same queue as complex ones, waiting on manual triage.
- Claims straight through
- 25%Claims straight throughUp from under 10%, with no human touch
- Faster claim turnaround
- 45%Faster claim turnaround
- Lower cost per claim
- 30%Lower cost per claim
What they asked for
"Give us a faster claims system. Our processing is too slow."
Speed wasn't a typing problem, it was a decision problem. A cracked windscreen queued behind a total loss. Nothing cleared itself.
The challenge
Every claim followed one path: intake, manual triage, adjuster review, approval. The adjusters were competent and busy; the queue was the constraint. The work was being done properly; it was simply being done in the wrong order.
One queue for every claim. No segmentation by risk or complexity, so a simple claim inherited the wait of the hardest claim ahead of it.
Triage and fraud checks done by hand. Eligibility, policy and fraud checks ran sequentially, by a person, even where the answer was never in doubt.
Customers chased the process. With no automated status updates, "where is my claim?" calls consumed the very adjusters causing the backlog.
What we built
Segment at intake. Claims land in Salesforce and are scored on risk and complexity the moment they arrive, before anyone touches them.
Let the simple ones clear themselves. Low-risk claims passing every policy, eligibility and fraud gate auto-approve end to end. Anything flagged routes to an adjuster with the evidence already attached.
Keep the customer informed. Automated status updates at every stage, so adjusters work claims instead of answering calls about them.
The win wasn't a faster form. It was the simple claims clearing themselves, so people could work the hard ones.
Recognise any of this in your own estate?
Start with the problem rather than the technology, and we will tell you honestly whether it is ours to solve.
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