Claim intake is the point where a loss call becomes a file: who is calling, the date and cause of loss, the carrier and policy number, whether the loss has already been reported, and how quickly someone needs to be on site. Assignment is the decision that follows. A system captures those fields once, applies the routing rules the firm has written down, and opens the file with the representation agreement and the state’s required notices already queued.
Where claim intake falls apart
The first call is taken with nothing in front of the person answering
Whoever picks up writes on a legal pad. Date of loss, cause of loss, carrier, policy number, and claim number arrive in whatever order the caller offers them, and two of the five are missing by the time the note reaches an adjuster.
Nobody asks whether the loss has already been reported
An unreported water loss and one reported three weeks ago with a desk adjuster assigned are different files needing different first moves. When intake does not capture reporting status as a field, the difference gets discovered on the site visit.
Assignment is made by whoever happens to be free
License state, territory, caseload, and whether the adjuster has handled that peril are all real constraints. In practice the file goes to whoever answered the phone, and the constraints get checked after a site visit is already scheduled.
The contract packet goes out after the site visit instead of before
The adjuster inspects, then sends the representation agreement and required notices when there is time. The execution date, which any cancellation window runs from, is never recorded as a field, so reconstructing it means opening an email thread.
Urgency is judged by tone of voice
An active water intrusion and a six-month-old hail claim both sound urgent when the insured describes them. Without a triage rule, same-day attention goes to the most insistent caller rather than the loss where mitigation is still running.
Intake triage and what each combination routes to
This is the triage table we build with a firm before writing any routing logic. The specific rows are yours. The point is that every combination of loss type, reporting status, and policy status has a decided destination, including the combinations that must not be routed at all.
| Loss type | Reporting status | Policy status at intake | Urgency tier | What the file routes to |
|---|---|---|---|---|
| Water, active or within 72 hours | Not yet reported | In force, deductible confirmed | Same day | Adjuster licensed in the loss state; mitigation vendor referral logged; contract packet issued before the site visit |
| Water, dry-out underway by a restoration vendor | Reported, desk adjuster assigned | In force | Within 24 hours | Adjuster covering the territory; the vendor’s work authorization and moisture logs pulled into the file |
| Wind or hail, roof | Not reported | In force | Three business days | Field inspection queued on the roof scope template; aerial measurement order opened |
| Wind or hail, roof | Reported, denied or partially paid | In force | Within 48 hours | Senior adjuster; denial letter, carrier estimate, and any prior photo set requested before a visit |
| Fire or smoke | Reported, no carrier estimate yet | In force, loss of use coverage present | Same day | Adjuster plus contents inventory support; an ALE record opened alongside the dwelling file |
| Any peril | Past a proof of loss date the carrier already requested | In force | Same day, flagged | Held for principal review. A deadline already running is a decision, not a routing rule |
| Any peril | Unknown | Carrier unconfirmed, or policy lapsed | Hold | No assignment. Intake stays open pending the declarations page, and the caller is told nothing proceeds until coverage is confirmed |
How the intake and routing get built
One intake form, used by everyone who answers a call
Conditional sections mean a water loss asks about source and mitigation while a hail loss asks about storm date and roof age. The same form serves the office line and a mobile phone, so nobody keeps a personal version.
Carrier, policy, and claim numbers stored as data rather than notes
Carrier is selected from your list, not typed. Policy number, claim number, date of loss, and reporting status each get their own field, which is what lets a rule read reporting status and decide something.
Routing rules written down before they are built
We get the rules onto paper with the principal: license states, territories, what caseload counts as full, and which perils need a senior adjuster. License state is a hard constraint; the rest are preferences a person can override.
The contract packet is issued from intake, not after the visit
The loss state on the intake record determines which agreement version and which notices are assembled, and the execution timestamp returns to the file as a field. What that packet contains is set by the firm and its counsel.
The file opens with a checklist rather than an empty folder
Declarations page, full policy, prior carrier correspondence, claim number, and desk adjuster contact are each an item with a state. The adjuster taking the file sees what is missing, and so does whoever is chasing it.
What intake hands off to
- intake form design and build — The first-call form carries conditional loss-type sections and lands as a structured record rather than an email.
- signature workflow automation — The representation agreement and state notices go out from the intake record, and the execution date returns to the file.
- CRM automation for contact and file status — The caller becomes a contact record carrying source, carrier, and file state for whoever picks up the follow-up.
Is this a fit for your business?
A good fit when
- First-notice calls are answered by more than one person
- You are licensed in more than one state and the contract packet differs between them
- Three or more adjusters carry files and assignment is currently a conversation
- A file has gone quiet between the first call and the first site visit
Probably not a fit when
- You are a solo adjuster taking a handful of files a year in one state
- You want a platform that also writes estimates and prices line items
- You want help deciding which claims to accept, which is your judgment and your license
What to have ready
- The questions you already ask on a first call, however informal the list
- Your assignment rules, including the ones nobody has written down
- The states you hold licenses in and who covers which territory
Questions we get asked
Can the system decide which adjuster gets a file?
It applies the rules you write. License state and caseload are hard constraints, so it will not propose an assignment that breaks either. Anything ambiguous, such as a peril outside an adjuster’s usual work, lands on a person rather than being decided quietly.
We take claims in more than one state. Does that change intake?
Yes, in one specific way. The loss state captured at intake determines which agreement version and which required notices are assembled into the packet. The system serves whatever mapping your firm and its counsel maintain. It does not determine what any state requires.
What happens when the caller does not know their policy number?
Intake accepts a partial record so the call is not held hostage to a document the caller cannot find. The file is created with missing fields marked open and cannot advance past a gate you define, usually contract issuance or scheduling.
Does this integrate with Xactimate?
Intake sits upstream of estimating. We carry the insured name, property address, date of loss, carrier, and claim number forward so nobody retypes them, and we store the estimate file against the claim. We do not write into estimates or touch pricing.
Related
- scope sheets and field loss documentation
- multi-state contract and disclosure version control
- intake form design and automation
- workflow automation for appraisal and adjusting firms
Tell us what the process looks like now and we will map what a system would need to do. No obligation, and you keep the map either way.