The team lead's first hour
Every morning the claims team lead opens the new claims from overnight. A cracked phone screen. A burst pipe with a ceiling down. A travel delay. A liability claim from a customer's customer. They read each one, decide how complicated it looks, think about who has capacity and who has handled that kind of claim before, and assign it.
When the team lead is off, allocation slows or becomes random. Simple claims sit in the same queue as complex ones and wait just as long. Experienced handlers get routine claims while a newer handler struggles with a complicated one. Handlers' caseloads drift out of balance, and nobody notices until someone is overwhelmed.
Why allocation is manual
A young claims operation starts with a couple of handlers who take everything. By the time there is a team, allocation is a habit rather than a system.
- First notification data is not used to judge complexity.
- Handler skills and authority levels are known, not recorded.
- Caseloads are not visible in a form that helps allocation.
- Simple claims have no separate route.
- Claims that should go to your third-party administrator or a specialist are identified by reading.
What manual allocation costs
Simple claims take longer than they need to, and those are the claims that shape most customers' view of you. Complex claims sometimes start with the wrong handler and have to be moved. Team leads spend time allocating rather than supporting handlers and reviewing difficult cases. Caseloads become uneven, which hurts both service and morale.
How claims are assessed and settled, and who has authority for what, is for your claims team within your agreements. We build the routing around their decisions.
Triage and routing we build
What we build sorts claims as they arrive and routes them using rules your claims team control.
- Each new claim is scored for complexity from its first notification data: claim type, estimated value, third parties involved, injuries, and any flags your team defines.
- Claims below a level your team sets go to a fast-track queue with a simpler process.
- Handler records hold their skills, claim types and authority levels, maintained by the team lead.
- Other claims are routed to a handler with the right skills and authority, taking current open caseload into account.
- Claims your rules send to a third-party administrator or specialist are passed on automatically with the file.
- Team leads can override any allocation, with the reason recorded.
- A view shows each handler's caseload by complexity and age, so imbalances are visible early.
| Claim example | Complexity signal | Route |
|---|---|---|
| Cracked phone screen, low value | Single item, no third party | Fast track |
| Travel delay with booking evidence | Standard documents, fixed benefit | Fast track |
| Escape of water, ceiling damage | Property damage, trades needed | Experienced property handler |
| Third-party injury | Liability, injury flag | Handler with liability authority or specialist |
Mornings, rearranged
Caseload is the part manual allocation handles worst. A handler with a few complex claims open is busier than one with many fast-track claims, and a simple count hides that. The routing weights open claims by complexity, so the next escape of water claim goes to the property handler who actually has room, not just the one with the shortest list.
New claims are already allocated when the team arrives. Fast-track claims move through quickly. Complex claims reach someone equipped for them. The team lead reviews overrides and the caseload view, and spends the time freed on the claims that need their judgement.
The rules are adjusted as the team learns: if fast-track claims keep being moved to a handler, the threshold changes.
Is claims allocation manual for you?
- A team lead reads and assigns each new claim.
- Allocation slows when the team lead is away.
- Simple claims wait as long as complex ones.
- Caseloads are uneven and hard to see.
- Claims get moved between handlers after starting.