Insurance — Screen Workflows

Screen Workflows

How a claim moves through InsurOps, end to end.

Claims & Intake Workflow

• FNOL Triage & Loss Intake — log the loss with mobile photo/video evidence, score by risk/priority, auto-validate policy and coverage.
• Claim Files Hub — central repository for every active/closed claim; search, filter, drill into any dossier and its status history.
• Fraud & Risk Scoring — AI/rule-based engine that flags suspicious claims before payout.

Field & Estimate Operations

• Dispatch & Field Calendar — map-based adjuster dispatch with the field inspection calendar; filter by specialty/coverage, assign, track report status.
• Estimate Approvals & Limits — appraisal review with a threshold-based approval workflow, photo compare, escalation and shop auto-approval rules.
• Settlement & Payouts — final payouts to policyholders or shops with deductible deductions and bank/IBAN execution.

Recovery & Analytics

• Subrogation & Recovery — subrogation files and counterparty negotiation in one flow: fault ratios, demand letters, settlement stages, collected balances.
• Salvage & Parts Management — salvage-vehicle auctions and recycled/heavy-damage parts tracking.
• InsurOps Analytics — cycle time (notice-to-payment), active claim/subrogation ratios and adjuster/shop performance scores.

AI Assistant on Roles & Staff

The two governance screens in this add-on — Roles & Capabilities and the Claims & Adjustment Team (Staff) screen — each carry an embedded AI Assistant, opened from the right-edge AI Assistant tab. Both read the live data on screen and reply in Markdown (Turkish or English).

• Staff assistant — summarizes the team by role/branch, flags members with no InsurOps role assigned, highlights role types with no coverage (e.g. no Estimate Approver or Subrogation Officer), and suggests which role fits a described claims job. It works from operational team structure only — never payroll or personal HR data.
• Roles assistant — reviews the permission model for least-privilege and separation-of-duties (see Roles & Capabilities).

On both screens you can tick rows to scope the chat, then Analyze selected / Summarize selected; save any answer with Save as Report, or attach reference material with Add Knowledge.

Pages in this section

• Overview
• Operational Setup & Master Data
• Domain Roles & Capabilities
• Claims & Intake Workflow
• Field & Estimate Operations
• Recovery & Analytics