FNOL automation and claims triage: every first notice of loss read, sized and on the right desk while the customer is still on the line
Every new claim sized and on the right desk before an adjuster opens it.
See one case, screen by screen ↓FNOL automation takes the first notice of loss — a call, web form, app report, email or agent submission — and turns it into a structured claim without retyping. FNOL & Claims Triage Automation transcribes the call, fills the loss notice with every field cited, matches the policy in force on the date of loss, scores severity and routes the claim, then asks the customer for anything still missing.
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First notices come in by phone, web form, app, email and agent, with photos, police reports and repair quotes attached in any order. On the phone, the first-notice specialist types the caller’s story into the claim screen while searching the policy in another, and the notes end up as free text nobody can sort by.
Severity is guessed, and often late. The injury or the third party comes out at the end of the call, or in an email two days later, while the claim sits in the damage queue or a shared inbox waiting for a supervisor to assign it. A misrouted claim loses days before the right person sees it — and the acknowledgement and investigation clocks started at notice, not when the claim finally reached the right desk.
Estimated split, in hours, for one auto first notice by hand and with the solution.
Six agents listen, fill, match, score and route every first notice while the customer is still talking; the specialist confirms.
Monday 12 October, 08:14. Denise Varga calls the Tallowmere Mutual claims line twenty minutes after a left-turn collision on State Route 61. Here is what happens next, screen by screen, in the working solution.
Marcus sees an incoming call from +1 (614) 555-0182 and a check beside it: the caller ID matches a policyholder. The auto loss notice waits empty — 34 fields across the policy, the loss, the insured vehicle, the other party, injuries and photos — with the severity meter at 0 and the six desks listed under it.
“Answer to start. The transcript, the claim and the severity build as Denise speaks.”
Seven seconds in, the policy matcher ties the caller to named insured Denise Varga on personal auto policy PA 4471-20983, in force on the date of loss, with bodily injury 100/300, collision with a $500 deductible, rental at $40 a day and medical payments of $5,000. As she describes the left turn, the airbags and the tow to Corbett’s, each field lands with the call time of the sentence it came from. Two vehicles, a left turn across traffic, airbags and a tow add up to 41 — the Auto damage desk, Kara Lindqvist.
Ask next: “Was anyone hurt, in either car?” — “Two vehicles and airbags · injury not asked yet”
Marcus asks the suggested question. Denise is fine, just shaking, but the other driver was put on a stretcher. The scorer adds +29 and the meter jumps from 41 to 70. The router strikes through the Auto damage desk and moves the claim to the Injury unit under rule R-07, any injury, and a 24-hour clock to contact the injured party starts while she is still on the line.
“Moved to Injury unit · rule R-07, any injury · Tomás Reyes (31 of 35 open, licensed OH)”
The prompts turn to what is still missing. Denise gives the police report number, MPD-26-118742, and Officer Dunleavy. Her son Eli, 15, says his shoulder hurts where the seatbelt was: +8, the score is 78, and medical payments applies to Eli with a $5,000 limit. She reads the other driver’s details off his insurance card — Kyle Brandt, a gray Honda Civic, Lakemont General — and the other carrier is noted for recovery.
“31 of 34 filled · 3 requested by text · every value cites its source”
Wrap-up lays out the claim before anything is created: collision on the Subaru Outback with Kara Lindqvist for a field appraisal at Corbett’s; bodily injury for Kyle Brandt, property damage on the Civic and medical payments for Eli, all with Tomás Reyes in the Injury unit. Below it, the text to Denise, for Marcus to confirm before it is sent.
“Tallowmere Mutual: Denise, your claim 26-AU-418832 is open. Tomás Reyes will call you today. Rental cover is $40 a day. Please add photos of your car, the other driver’s insurance card and Eli’s doctor here: [photo link]”
Claim 26-AU-418832 opens with “Why 78”: six points, each tied to the call time of the sentence it came from. The assignment history shows the route at each moment of the call, the contact for Kyle Brandt is due by 08:15 tomorrow, and the still-needed list shows damage photos, the other driver’s insurance card photo and Eli’s doctor, all sent. The run log records each agent step.
Not every first notice is a call. Yusuf Haddad’s web form says he rear-ended a car on Hamilton Ave and the other driver said his neck hurt: +12 for a third party complaining of pain, a score of 36, and the Injury unit under R-07 even though the score is low. The same list holds an attorney letter from Pruett & Lang LLP, a duplicate app and web report merged into one, and a burned stolen BMW flagged for review signals.
Any injury, to anyone, goes to the Injury unit — whatever the score.
Every request to a customer or agent sits in one list: Denise’s photo link sent at 08:16 during the call, Brightwater Agency’s reply with the date of loss for a hail claim, a theft checklist for keys and title, and Travis Kemp’s account of an accident he has not reported, with a call scheduled at 10:00.
“Reminders every 24 hours · after three, the adjuster gets a task to call”
The intake board shows every channel flowing into every desk: 58 by phone, 47 by app, 41 by web form, 23 by email and 17 from agents since midnight, with a 14-minute median to the right desk and 3 moved after routing. Each desk lane shows its newest claims with their scores, and the burned BMW in the Auto damage desk lane carries a copy to special investigations.
Insights puts the desk the router chose against the desk each claim ended on: over 30 days, 4,833 of 4,912 first notices (98.4%) stayed where they were routed, and most moves were Express to Auto damage after photos showed hidden damage. Against the quarter before go-live, the sample carrier’s median to the right desk went from 1.9 days to 14 minutes and injury contact within 24 hours from 61% to 96%.
The same call, seen by the four people who carry it — what their day looked like, and what it looks like now.
Six agents listen, fill, match, score and route every first notice while the customer is still talking; the specialist confirms.
Transcribes the call live, separates the specialist from the caller and stamps every line with the call clock, in English and Spanish.
Fills the loss notice from the call, web form, app, email or agent submission, and reads photos, police reports and repair quotes. Every field cites its sentence or page; it adds the weather at the time and place of loss.
Finds the policy by phone, plate, name or address, checks it was in force and paid on the date of loss, and lists the coverages with limits and deductibles, prior claims and the other carrier for recovery.
Adds up the published severity signals in what was said or written, with the reason and the source sentence for each point.
Applies routing rules R-01 to R-08 in order to the score and the facts, then picks the adjuster with the most room under their cap and a licence in the loss state.
Drafts the acknowledgement and the missing-information request from approved templates, in the customer’s language, with one link for every missing item, and sends reminders every 24 hours.
Confirms the claim and every message. The agents propose; a named person decides.
Supervisors and specialists can ask in plain words why a claim went where it did, find notices, rebalance desks or draft a rule change. Every answer points to its source.
Why did Denise Varga’s claim go to the Injury unit?
Because Denise said “the other driver was taken by ambulance” at 01:01 in the call. That added +29 and took the score from 41 to 70; more importantly, rule R-07 sends any injury, to anyone, to the Injury unit. Tomás Reyes was picked: 31 of 35 open, licensed in Ohio. Her son Eli’s shoulder pain later added +8, so the claim sits at 78.
Which notices today mention an attorney?
One: 26-AU-418765, an email at 06:58 with a letter of representation from Pruett & Lang LLP for Marisol Vega, about a 30 September accident with our insured Travis Kemp. It scored 62 (+22 for the attorney letter, +10 because Travis has not reported it) and went to Grace Whitfield in the Injury unit.
The Injury unit is nearly full — who can take overflow?
The Injury unit is at 65 of 70: Tomás Reyes 32 of 35 and Grace Whitfield 33 of 35, with 11 new injury claims today. Rhea Kapoor on Liability & complex has room (39 of 50) and holds bodily-injury authority in Ohio and Kentucky; she was added as overflow for injury claims scoring under 50, approved by Ines Calloway as the intake supervisor.
Route any pedestrian or cyclist struck straight to the Injury unit
Drafted as rule R-09: pedestrian or cyclist struck → Injury unit, ahead of R-01 to R-06. The signal already adds +35. Last week it would have changed nothing on the 1,214 notices — both cyclist claims already reached the Injury unit through R-07. It goes live when Gwen Atherton approves.
13 screens from the working solution, on its sample data. Pick one to see it large.
What differs between carriers is a setting, not a project. Changes to bands and clocks need the claims operations director; signal and rule changes can be tested on last week’s notices before they are sent for approval.
| Setting | Default | Choose from |
|---|---|---|
| Express band | Score 24 or under | Set the score — auto claims at or under it, with no injury, go to photo estimate |
| Liability & complex from | Score 50 | Set the score — auto claims at or over it |
| Any injury → Injury unit | Always on | Locked |
| Injury contact | 24 hours | Set in hours — the Injury unit reaches every injured party within it |
| Acknowledgement clock | 15 calendar days | Kept per state — OH · KY · IN · PA · WV · MI; Tallowmere acknowledges during the call or within one business day |
| Missing-information reminders | Every 24 hours | Then a task for the adjuster after three |
| Text the acknowledgement during the call | On | On · off — the specialist confirms before it is sent |
| Languages | English · Spanish | Transcript, prompts and messages |
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“demo” = seen in the working solution, on its sample carrier’s data · “target” = the design goal, measured in the live solution · “estimated” = our estimate · “typical” = published figures (Strada, FNOL automation benchmarks, vendor-published — 20–30 minutes of handle time on a traditional first-notice call). People, carriers, agencies, law firms and vehicles named on this page are fictional — characters and sample data in the working solution.
FNOL automation takes the first notice of loss — a call, web form, app report, email or agent submission — and turns it into a structured claim without retyping. FNOL & Claims Triage Automation transcribes the call, fills the loss notice with every field cited, matches the policy in force on the date of loss, scores severity and routes the claim, then asks the customer for anything still missing.
The severity scorer adds published signals — two-vehicle collision +18, airbags deployed +8, taken by ambulance or to hospital +29, attorney letter +22 and so on — each with the sentence it came from. The router applies rules R-01 to R-08 in order to that score and the facts, then picks the adjuster on that desk with the most room under their cap and a licence in the loss state.
The claim moves the moment it is heard. In the working solution, the meter jumps from 41 to 70 when the caller says the other driver was taken by ambulance, the route moves from the Auto damage desk to the Injury unit under rule R-07, and a 24-hour contact clock starts — while the caller is still on the line.
No. The policy matcher lists coverages that may apply but never confirms or denies coverage; the scorer never decides fault and never calls a claim fraudulent. Review signals send a quiet copy to special investigations without changing the route or the customer’s experience. Coverage, fault, reserves and payment stay with the adjuster.
Yes. The first-notice specialist confirms the claim and every message before it is sent. Route overrides and over-capacity assignments need the intake supervisor, and changes to severity signals and routing rules apply only when the director of claims operations approves them.
Yes. Web forms, app reports, emails and agent submissions are read with their attachments, scored and routed as they arrive. In the working solution that includes an attorney letter routed to the Injury unit, a duplicate app and web report merged into one, and an agent’s hail notice with the date of loss requested and answered.
Yes. The Express band, where Liability & complex starts, the injury contact clock, the acknowledgement clock kept per state, reminder timing, texting during the call and languages are settings. Signal weights and routing rules can be changed, tried on any sentence and tested on last week’s notices before approval.
The Agentic Solution Engine builds and deploys it from your requirements and documents — your loss notice fields, routing rules, desks and message templates — and it goes live once every quality gate has passed. We will walk you through it on a sample of your own first notices first.
A coverage position on day one, every answer tied to the policy wording.
1-min demoCatastrophe Claims ManagementSurge claims assigned and moving in hours, with no spreadsheet rosters.
1-min demoEstimate & Supplement ReviewEvery line reviewed, not a sample, so inflated labor and parts are caught.
1-min demoWe’ll run FNOL & Claims Triage Automation on a sample of your own first notices and routing rules.