Insurance
Fenwick Mutual
Claims triage at a regional insurer
First-notice-of-loss triage was the bottleneck, not the assessment. Routing and severity scoring moved to an agent, with a hard rule that anything below the confidence floor goes straight to a person.
128
hours returned monthly
2.9
months to payback
89
percent accuracy
94
exceptions a month
Fenwick Mutual’s first-notice-of-loss queue was the bottleneck, not the assessment work downstream. Claims sat unclassified for up to a day before anyone decided how urgent they were.
The confidence floor did the heavy lifting
Severity scoring is the part people were nervous about, so we inverted the usual approach. Anything the agent scores below its confidence floor never gets a classification at all, it goes straight to the duty handler unlabelled. Nobody has to trust a black box to be right, only to know when it is unsure.
Accuracy settled at eighty-nine percent, lower than we would like and lower than the wholesale deployment. Ninety-four claims a month still route by hand. The time saved is large enough that payback still lands under three months.