Resolution Desk
Ingests the claim file, builds the coverage table, coordinates providers with deadlines and escalates only the exceptions to the adjuster with context.
THE CONTEXT
After the notice the file lives scattered and slow
After the notice, the claim file lives split between the CBS, emails, provider portals and the adjuster's spreadsheets. Nobody has the real status. Documents get chased by email and deadlines slip, while the adjuster spends 30% of the time on follow-up instead of deciding.
THE SOLUTION
A desk that resolves and escalates only the doubtful
The agent ingests the file from the CBS, builds the coverage table for the line and coordinates providers in parallel with controlled deadlines. It logs every document and escalates to the adjuster only the exceptions, with the table and reason in view so they decide.
This is how a claim gets resolved — in real time.
Reads the file and policy from the CBS, coordinates providers on their channel, logs documents in the doc manager and escalates to the adjuster's system.
KEY CAPABILITIES
What the desk resolves on every claim file
Coverage table
Builds the coverage table automatically: validity, sublimits, deductibles and exclusions, flagging the event as covered, partial or out.
Parallel coordination
Sends the requests to surveyors, shops and providers at once, on a single cadence, and logs each document that comes back in the file.
Deadline control
Watches each provider deadline, sends reminders to whoever runs late and alerts the adjuster, so no file stalls on a provider's silence.
Escalation with context
Escalates to the adjuster only what falls outside the rules, with the table, documents and explicit reason, so they decide fast.
Before / After
Resolution stops being manual follow-up and becomes a decision on exceptions.
Status scattered across systems
Documents chased by email
Provider deadlines missed
System Integrations
Connects to what the resolution desk already uses
Reads the file and policy from the CBS, coordinates providers on their channel, logs documents in the doc manager and escalates to the adjuster's system.
FAQs
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