Quaker in Action: A Week in the Life of Claims Management

Each week presents a unique set of challenges for claims managers - whether it's ensuring that reserves are accurately set, that adjusters are on top of their caseloads, or that critical data points aren't missing. For those of us managing bodily injury (BI) claims, there’s always the question of whether something important might slip through the cracks. That’s where Quaker Analytics comes to the rescue.

Take, for example, a recent report from one of our clients - a report we’ve anonymized but left otherwise unedited (See Figure 1). This wasn’t a flashy week for them. No landmark cases or high-profile claims. Just the everyday grind of managing claims. Yet, it’s in these seemingly routine moments that our models prove their worth.

Figure 1

The process was straightforward: the client runs all new and pending BI claims through our CLEAR model every week. The model identified a handful of claims with potential issues - claims that might be under-reserved, where follow-up by the adjuster was delayed (including making timely settlement offers), or where data was missing. This weekly report was automatically sent to the managers, who then reviewed the flagged claims and noted the actions they took. 

In some weeks, the report might show that everything is on track - no managerial intervention needed. But in other weeks, like this one, the report serves as a gentle nudge, highlighting areas where a bit of extra attention could make a substantial difference. For example, one claim was flagged with a simple “make offer” note. On closer inspection, the manager recognized that this was a case where severity might have been underestimated. A prompt decision was made to settle the claim for $4,000, avoiding the involvement of a lawyer - an action that ensured a prompt, fair and equitable payment for the BI, and potentially substantial loss adjustment expense (LAE) avoidance. 

This is what we’re aiming for: consistency in claim handling with fewer surprises and more opportunities for early resolution. Our models are not about micromanaging the claims process; they’re about ensuring that every claim gets the attention it deserves, precisely when it’s needed.

Would this kind of insight be valuable to your organization? The company behind this report has a strong technical team and plenty of tools to manage claims effectively. But even with all that expertise, there’s always the possibility of something slipping through unnoticed. Our tools are designed to catch those moments, giving managers the chance to step in before minor oversights become major issues.

Imagine what your claims department could achieve with a weekly report that highlights the claims needing a second look. The goal isn’t just to prevent mistakes, but to give your team the peace of mind that comes from knowing nothing is left to chance. It’s not about adding more work - it's about making sure that the work you’re already doing is as effective as possible.

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