Simple claims go straight through; adjusters get the disputed

The question this file answersIs it normal that a windscreen claim waits behind a total loss because both landed in the same queue?

Fits: insurers and brokers handling hundreds to thousands of claims a month where every file, simple or complex, is opened and routed by a handler

Not for: lines where every claim is large and investigated — there is no simple track to take off the handler's screen

Typical day

What the desk looks like today

Typical, from the finance playbook. Hundreds to thousands of claims a month, depending on the line of business, all entering one queue. A handler opens each file, checks documents and photos are complete, confirms the policy covers the event, looks at the estimate and routes it to an adjuster — the windscreen and the total loss get the same handling. The adjuster's queue fills with files that needed no adjuster. It hurts in a month when claim volume spikes and the genuinely complex file waits behind them.

What changes

What Monday looks like after

Thursday morning in the claims team. The handler's queue is not every claim that arrived; it is the files that failed a check — a policy that lapsed the week before, a photo that does not match the description, an estimate above the limit. The simple in-policy claims are prepared for settlement and waiting for the approval you require. Adjusters open files with a summary on top and the documents behind it. Nobody in the team has been removed; the sorting has. You can see, per line of business, how many claims went straight through. Accenture's (2023) cycle-time figure sits in the metric block below — their study, not our result.

Typical, not a measured client result. Every figure here comes from the playbook source named below.

~40–50%

shorter cycle on standard claims — Accenture (2023)

Before: a windscreen file waits behind a total loss in one queue. After: Accenture (2023) reports 40–50% shorter cycles on standard claims — the grey files still get an adjuster.

Where this number comes from

Accenture claims study (2023) reports that AI-powered triage reduces cycle time by 40–50% on standard claims; McKinsey “Insurance 2030” (2023) puts 50–60% of claims activities as automatable. Playbook range 35–55%. Industry benchmarks, not our measurement.

What we install

What we put in front of the systems you already run

Your policy administration and claims systems stay — SAP, Oracle, FIS or whatever you run; Salesforce or Dynamics keeps the customer contact. Between intake and the adjuster we add a triage step:

each claim's documents and photos are classified and the key facts extracted — policy number, date of loss, cause, estimate
coverage is checked against the policy record
a claim in policy, under the value limit you set and free of fraud indicators is prepared for straight-through settlement, the decision logged with its reasoning
large, unusual or disputed files go to the adjuster with a one-page summary
fraud indicators go to investigation, never to payment.

Nothing is paid without your existing approval rule. First scope: the line with the most small claims.

What stays human — and what this will not do

Complex investigation. Large-value adjudication. Customer disputes. Fraud. No model writes the cheque on a grey file.

What can go wrong — and what we do about it

If the policy record is incomplete — endorsements not keyed, a lapsed policy still showing active — coverage checks pass or fail wrongly; the pilot surfaces that first. Photos and repairer estimates come in every format; a new one fails reading and goes to the handler. Where the claims system cannot accept a prepared settlement through an API, a handler keys the payment — a shorter cycle, but not touchless. The playbook's 35–55% is the range on claims activity; complex investigation, large-value adjudication, disputes and fraud are outside it, and no model pays a grey file.

How long it takes, and what we need from you

Audit, about two weeks (€1.5–3K): we sit with the claims team, count a month of claims by line and value, agree in writing what “simple” means, and test whether the claims system can take a prepared settlement. Pilot, 6–10 weeks (€10–20K) — the finance playbook rates claims high complexity: one line of business, every straight-through candidate reviewed by a handler before payment. Production: further lines, then photo estimates. From you: access to the claims system and policy records, a month of closed claims, your fraud rules.

The path: free 60-second estimate → free 20-minute review → paid audit of this one process (€1.5–3K, typically two weeks) → pilot with your people in the loop (€10–20K, weeks, not quarters). No transformation programme. Prices are public, on the services page →

This is about you if…

Do all claims — small and large — enter one queue and get opened by a handler?
Is there a written rule for what counts as a simple, in-policy claim?
Is coverage checkable in a system, or does a handler read the policy document each time?

What does this mean in euros?

That depends on your volumes and wage costs — this page will not invent the number. The free 60-second estimate runs that calculation from your answers, with every multiplier sourced.

Get your free savings estimate 60 seconds · no sales call Or write first → Map a finance process like this one — free, 60 seconds →

Not a named Aperanda client. Process file · Finance.

Deep-dive process file. Volumes, weeks and sources come from the industry playbook; nothing here is a named client.

All process files