A large loss engages conditions, sublimits and proof requirements across a long wording.
Before judgement begins, someone must establish which of them this loss engages — and check whether the file answers each one.
Outcomer prepares the claim for them.
Your adjuster opens a Case Orientation Report, not a raw file.
Every requirement the loss engages — policy conditions, sublimits, proof-of-loss and notice requirements, the state claims-handling rules, and your own handling standards — identified for consideration, with the evidence on the file set against each one. It states the position on each requirement. It never reaches the coverage decision.
Two rails, clearly separated. The statutory requirements for the jurisdictions you write in, and your own handling standards alongside them. Your adjuster can see at a glance which findings carry statutory exposure and which are your house rules.
It reports the file, not the adjuster. It states what the record shows and what it does not — never what anyone did or decided.
It can be run at the beginning, and again whenever the claim is updated, to orientate the adjuster. Requirements that did not exist at intake appear with their own deadlines, and evidence that was absent becomes present.
State claims-handling rules set periods for acknowledging a loss and for accepting or denying once proof is received, and the policy sets its own notice and proof periods on top. Every one of them has to be identified before the clock can be managed. Outcomer removes the manual work your adjuster does before judgement can begin — establishing which conditions and requirements this loss engages, and checking the file against each one. That time returns to the decision you employ them to make. Judgement minutes are unchanged; every minute saved is preparation.
An estimated 36% less time on each claim —
around 56% more capacity from the same team.
Estimated from a task-level decomposition of a large or complex property loss at the point of a coverage and quantum position, taking the conservative end of each range and including the time to run and read the report. Judgement minutes are unchanged — the saving is all preparation. These are our figures, not measurements on your claims; we go through the working against your own case timings in the demo.
Three sets of requirements govern a large loss, and the report names all three. Your standards sit in your own configuration only. Nothing derived from them enters the shared regulatory corpus, and no other client’s configuration can draw on them.
The state claims-handling rules for the jurisdictions you write in — acknowledgement periods, and the period to accept or deny once proof is received. Public, identical for every carrier in that state, and built once. You review it and sign it off.
Conditions, sublimits, exclusions, proof and notice requirements from the wordings you write, with the version in force at the date of loss. This is where coverage is decided, and it is yours.
Adjustment standards, reserve authority, expert instruction criteria and escalation triggers. You confirm the rendering represents your manual.
Maintenance is agreed at the same time — how the matrix stays current, how you tell us when your own standards change, and how each update is recorded. Requirements are date-gated, so a claim from 2021 is examined against the rules as they stood in 2021.
An orientation layer that sits alongside your claims administration system. Outcomer does not replace or write to it. It reads the file and states the position; your adjusters decide and update the record. No migration, no change to how claims are administered.
Outcomer deploys as a container inside your own environment. The software and the model run in your estate, and nothing about the claim — or your policy wordings — leaves your tenancy.
Built to fit your claims workflow. Outcomer can operate as a standalone workflow during evaluation, or integrate with your existing claims-management environment so the Case Orientation Report becomes another part of the adjuster’s existing workflow.
We will show you a Case Orientation Report, walk through how your policy terms and handling standards are decomposed and signed off, and go through the capacity estimate against your own case timings.