How ClaimVyne Works

FNOL to adjuster assignment in four steps — measured in minutes.

ClaimVyne runs a structured four-step pipeline on every FNOL. Each step produces a discrete output that feeds the next — no manual handoffs, no queue delays.

Step 01

FNOL Arrives. ClaimVyne Reads It.

The moment a first notice of loss enters any of your intake channels, ClaimVyne begins parsing. No waiting for a team member to open their inbox. No batch processing at the end of the day.

ClaimVyne handles email FNOLs, portal submissions, EDI files, and fax-to-text conversions — extracting structured claim data: loss type, date, location, involved parties, vehicle or property identifiers, and claimant contact information.

Email FNOL Portal submission EDI 278 Fax-to-text TPA data feeds
Intake Channels
Email FNOL — [email protected]
Carrier portal form submissions
EDI 278 / 837 electronic
TPA and ISO ClaimSearch feeds
Average parse time: < 30 seconds
Step 02

Policy Match. Coverage Confirmed in Real Time.

ClaimVyne queries your policy administration system live — not from a daily export or cached snapshot. It matches the FNOL against active policy records, confirms coverage type, limits, deductibles, and checks for applicable exclusions.

Every match returns a confidence score. High-confidence matches proceed automatically. Ambiguous matches (below your configured threshold) are flagged for supervisor review before routing.

Live PAS query Coverage confirmation Exclusion check Confidence scoring
Coverage Match — Live PAS Query
Policy found — 97.3% confidence
POL-CT-881204 · Status: Active
Bodily Injury $100K / $300K
Collision deductible $500
Exclusions triggered None
Query time: 1.2s · PAS: Carrier PolicyBridge
Step 03

Severity Scored. Reserve Baseline Established.

Before the claim enters an adjuster's queue, ClaimVyne generates a preliminary severity score and an initial reserve estimate — based on LOB, loss type, coverage type, and your carrier's historical claim patterns.

This is a starting point, not a decision. Adjusters retain full override authority. The goal is to eliminate the time spent establishing a reserve from zero — by giving adjusters a structured baseline the moment they open the file.

Severity score 1–10 Preliminary reserve SIU referral flag Subrogation indicator
Severity & Reserve Output
6.4
Severity / 10
$18K
Est. reserve
SIU flag Not triggered
Subrogation Possible — review
Step 04

Adjuster Assigned. Queue Pre-Populated. File Ready.

ClaimVyne selects the best-qualified adjuster for each claim — based on LOB specialization, geographic territory, current queue load, and any carrier-defined assignment rules. The assignment happens automatically, without a supervisor triaging a stack of new claims every morning.

When the adjuster opens the claim, they see a fully pre-populated file: parsed FNOL data, confirmed coverage, severity score, reserve estimate, and any flags. No cold starts.

Skill-based routing Queue balancing Pre-populated dossier SLA tracking
Abstract background for how it works routing section — directional flow concept
End-to-End Timeline

From FNOL receipt to adjuster assignment: under 5 minutes on a standard claim.

0:30

FNOL Parsed

Structured claim data extracted from any intake format

1:20

Policy Matched

Coverage confirmed against live PAS with confidence score

2:45

Severity Scored

Preliminary reserve estimate and SIU flag generated

< 5 min
Total time to adjuster assignment
vs. 4+ days of manual triage
See the pipeline on your claims

Request a pilot. We'll run your FNOLs through the full pipeline.

Bring a sample of your FNOL intake from the past 90 days. We'll demonstrate the pipeline end-to-end — parsing, matching, scoring, and routing — against your actual data.