Outproduce
AI EmployeeBook a call

Claims, policy and case administration

Claim forms, policy documents and case files arrive as attachments, and an experienced administrator reads each one, keys it in, and chases the missing pieces.

Case and claims administration is document work with a deadline attached. The claim form arrives incomplete, the policy sits in another system, and one administrator holds the thread between them. Outproduce maps that thread, installs it inside your existing case and document systems, and makes every file either complete, waiting on a named approval, or raised as a visible exception.

Book a callSee the workflows
  • Case or policy system
  • Shared inbox
  • Document store
  • Letter templates
  • Spreadsheets
  • Calendar

Signals

You recognise this when

  • 01Claim forms and supporting documents arrive by email and are filed by hand into the case system.
  • 02Missing information is chased from a personal to-do list rather than a tracked state.
  • 03Renewal notices and policy changes are typed twice, once in the system and once in a letter.
  • 04Nobody can show, without asking, which cases are waiting on the customer and which are waiting on you.

What we build

The workflows, and how each one runs.

Each trace shows one run with sample records: what runs on its own, what waits for a person, and what is escalated.

Claim intake and completeness check

By hand. The administrator opens each claim form, reads it against the policy, keys the details into the case system, and writes down what is missing.

Installed. We install intake that extracts the claim details, checks them against the policy record and your completeness rules, and raises the gaps as tracked items.

  1. Capture

    The claim form and supporting documents are filed against the case.

    Automated
  2. Read

    Claimant, policy reference, dates and loss details are extracted.

    Automated
  3. Check

    Details are compared against the policy record and the completeness rules.

    Automated
  4. Missing items

    Each gap becomes a tracked item naming what is needed and from whom.

    Escalated
  5. Confirm

    The handler confirms the extracted detail and the case category.

    Human approval
  6. Progress

    The complete case moves into the handling queue with its documents attached.

    Automated

Policy change and renewal notices

By hand. Policy changes and renewal notices are keyed into the system and then written again in a letter, with the wording copied from an older file.

Installed. We install generation that builds the notice from the live policy record and approved wording, then holds it for a person to check and issue.

  1. Trigger

    A policy change or approaching renewal creates the notice task.

    Automated
  2. Draft

    The notice is built from the live policy record and the approved wording set.

    Automated
  3. Non-standard

    A change the approved wording does not cover is raised for drafting.

    Escalated
  4. Issue

    The administrator checks the notice and issues it.

    Human approval
  5. File

    The issued notice is stored on the policy record with its version.

    Automated

Case chasing and deadline watch

By hand. Chasing the customer, the third party and the internal reviewer runs on reminders in one administrator's calendar and inbox.

Installed. We install a chase cadence where every open case shows who it waits on, and each outbound chase is prepared for a person to send.

  1. Watch

    Open cases are tracked with the party they are waiting on and the next deadline.

    Automated
  2. Prepare

    The chase message is drafted naming exactly what is outstanding.

    Automated
  3. Send

    The administrator reviews and sends the chase.

    Human approval
  4. Deadline risk

    A case approaching a deadline without movement is raised to the team lead.

    Escalated
  5. Record

    Responses and received documents are filed against the case and the state updates.

    Automated

What stays with people.

Controls are written into the Operating Map before the build and shown in the system while it runs.

Control rules

  • Claim and case decisions stay with the handler, with the documents that supported them attached.
  • No letter or notice reaches a customer without a person issuing it.
  • An unreadable or contradictory document is raised as an exception, never filed on an assumption.
  • Approved wording is versioned, and a change to it needs a named approval.

Systems connected

  • Case or policy system
  • Shared inbox
  • Document store
  • Letter templates
  • Spreadsheets
  • Calendar

What we measure

Baseline first, then the delta.

Relevant proof

Direct client delivery, identity withheld, acceptance pending

Installable Animation Workflows

Outside work packaged as installable units, swept for defects against every referenced file, verified by running the built artefact rather than the source tree, and designed to fail with a clear message instead of guessing. It shows delivery and verification discipline; client confirmation is pending.

Read the build recordAll build records

Related

Questions about admin.

Does the system decide claims?

No. It reads the documents, checks them against the policy and the rules, and raises what is missing. The decision stays with the handler.

What happens with a badly scanned document?

It is raised as an exception with the original attached. Nothing is filed on an assumption.

Do we need to replace our case system?

No. The install connects the inbox, the document store and the case system you already run.

Start here

Show us the workflow.

Tell us what starts it, who owns the result, which tools carry it, and where it stalls. We will tell you whether it is ready to map.

Book a 20-minute callOr send it in writing
Strong fit

The workflow repeats

One person owns the result

The records exist

Several tools carry the work