Claims File Analysis

One claims file, several formats, no shared order

A claims file brings together a handwritten accident report, an assessor’s report received as a scanned PDF, not always in the same order from one assessor to the next, photos taken at the scene, and email exchanges with the policyholder. The claims handler responsible for the payout decision reconstructs the timeline alone from these mismatched documents, often across dozens of open files at once.

The alert that drowns out the alert

We often see a system that flags every variation between documents quickly produce more alerts than a handler can work through: a letter dated a day apart, a misspelt address, each discrepancy fires a signal. The handler learns to ignore the alerts rather than sort them, and the inconsistency that actually mattered, a repair amount with no matching invoice attached, gets lost in the noise of false positives.

What scanning has to guarantee first

We only take this on if documents arrive in a state an automated extraction can work with: digital text or a scan of decent quality, not a photo of a form taken on a phone and barely legible. We also need someone, from risk or legal, to have already defined what counts as an inconsistency worth flagging, so the system does not surface variations with no real consequence. Below a certain volume of files, we would advise against building this.

The payout decision stays with the assessor

We reconstruct the file’s timeline, extract amounts and attachments, and flag missing documents along with discrepancies judged significant under rules agreed with the insurer. The payout decision, and the judgement call on ambiguous or potentially fraudulent cases, stays with the assessor or handler, who now has a summary to work from rather than a stack of documents.