Insurance
Ashworth Mutual
Claims triage, regional insurer
First-notice-of-loss triage was the bottleneck, not the adjusting. We tested routing and severity scoring against ninety days of real claims before anyone committed budget to it.
128
hours returned monthly
2.9
months to payback
89
percent accuracy
94
exceptions a month
Ashworth Mutual’s first-notice-of-loss queue was the bottleneck, not the adjusting downstream. Claims sat unclassified for up to a day before anyone decided how urgent they were.
The confidence floor carried the case
Severity scoring was the part people were nervous about, so we recommended inverting the usual approach. Anything the agent scores below its confidence floor gets no classification at all and 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, below the wholesale engagement and below what the vendor forecast. Ninety-four claims a month still route by hand. The time saved is large enough that payback still lands under three months, and we said so.