Complex property · major loss

Your handlers decide the loss.
They shouldn’t be assembling the requirement set.

A major loss engages conditions, warranties and sub-limits 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 handler opens a Case Orientation Report, not a raw file.

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What your handler opens

A Case Orientation Report instead of a raw claim file.

Every requirement the loss engages — policy conditions, warranties, sub-limits and notice requirements, the FCA claims-handling rules, and your own adjustment 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.

One requirement, as it appears in the reportIllustrative

Notice of the loss was given within the period the policy requires, in the form the policy requires.

Policy condition · notice · wording in force at date of loss

Evidenced — inferred

Notification is recorded in the broker’s correspondence inside the period. The date the insured became aware is taken from the first report rather than stated, so the position rests on inference.

Requirements are prepared this way across coverage, conditions, warranties, sub-limits, proof and valuation, and your own adjustment standards.

Two rails, clearly separated. The statutory and regulatory requirements for the jurisdictions you write in, and your own handling standards alongside them. Your handler can see at a glance which findings carry regulatory exposure and which are your house rules.

It reports the file, not the handler. 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 handler. Requirements that did not exist at intake appear with their own deadlines, and evidence that was absent becomes present.

What it returns to the desk

Less manual preparation. More time for the decision.

Outcomer removes the manual work your handler 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 57% 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.

Configured to your work

Configured to your rule book, and signed off before anything runs.

Three sets of requirements govern a major 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 regulatory rail

The FCA claims-handling rules — the conduct and timeliness requirements that apply to every insurer. Public, built once. You review it and sign it off.

Your policy terms

Conditions, warranties, sub-limits, 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.

Your adjustment standards

Adjustment standards, reserve authority, expert instruction criteria and escalation triggers. You confirm the rendering represents your manual.

Maintenance is agreed at the same time — we monitor the instruments, decompose any change, you sign it off, and it applies from the effective date. Requirements are date-gated, so a claim from 2021 is examined against the rules as they stood in 2021.

What changes for the desk

Six things your claims manager sees.

Fewer coverage positions undermined by a condition nobody identified.A warranty or sub-limit that was never surfaced was never in the position taken.
More losses closed per handler without adding desks.The capacity comes out of preparation, not out of the time spent deciding.
Fewer missed periods.Every regulatory and policy period the loss engages is identified before the clock runs.
Fewer reserve surprises.An exposure nobody identified was never in the estimate.
Fewer files back on a supervisor’s desk.The position on each requirement is complete and recorded the first time.
When the file is reviewed, what was considered is already in it.A dated record on every loss, not the sample that happens to be pulled.

How it runs

In your estate, against the requirements in force at the time.

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 handlers 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 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 handler’s existing workflow.

SecurityWhere the software runs, where the model runs, and what does not move.How the boundary works → GovernanceHow the requirements are sourced, versioned and signed off before a claim is processed.How the corpus is controlled →

Your handlers decide the loss. They shouldn’t be assembling the requirement set.