Auto Claims
Complex multi-party engagements where risk, regulation, and claim resolution require coordinated action.
This interactive experience is the shipped product itself — the same application code customers run in production, mounted read-only in your browser over a real sample journey. Not a video, not a mockup: because the demo and the product are one codebase, it can never drift from the real thing.
Inside this journey
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Outcome Discovery
Align on target KPIs (cycle time, LAE, supplement rate, CSAT), current claims workflows, data sources, and the decision-makers who will evaluate the solution.
Discovery Questions
Starting point, in one sentence
- How would you summarize your current photo-first claims capability in one sentence?
- How many first-notice-of-loss photo claims do you process per month for repairable passenger and light commercial vehicles?
- Which parts of the estimate and repair workflow are already automated versus handled manually by adjusters or partners?
- Tell me about the last claim where a photo-based estimate materially missed, what happened and why it stood out?
- If leadership asked you to pick the single KPI that a 20% improvement would trigger an immediate pilot approval, which KPI would you name and why?
Where the process frictions show up most
- Where in your claims flow do you most frequently see unexpected cost or delay that roadblocks straight-through processing?
- How often do supplements increase the original estimate by more than 15%?
- Which vehicle segments, claim types, or damage patterns generate the highest variance between initial photo estimate and final payout?
- Walk me through a recent claim where a photo estimate would have caused an overpayment risk, what indicators or missing data pointed to that risk?
- Name the single downstream failure, for example chronic supplement spikes or shop rejection, that would make you refuse a vendor-led pilot right now.
Who decides and who drives execution
- Who has final approval authority for running a pilot and who must sign production contracts?
- Describe how budget owners and operational leaders trade off faster cycle time against any tolerance for estimation variance.
- How many full-time adjuster equivalents would you realistically reassign or expect to change role if straight-through processing met your target?
- List the teams and roles that must participate in weekly governance during a pilot, and who coordinates that cadence.
- If your executive sponsor pulled support mid-pilot, what specific trigger or missing result would most likely cause that?
Integration, data, and the practical gates
- Identify the core systems that must integrate before a pilot can run, and specify the owning team or role for each (claims system, shop management, parts catalog, payment rails).
- How accessible are your historical claims photos and paired final estimates for model calibration, and who approves extraction for a pilot?
- What percentage of your claims management workload is served by systems with API access versus batch file transfer only?
- Do you have test environments and anonymized datasets ready to support a vendor-led pilot, and if not, what is the blocker?
- Name the one integration failure that would force you to halt the project before pilot completion, for example inability to write estimates back into claims or missing shop acceptance.
Alternatives on the table and why you might stay
- Who else are you actively evaluating for damage estimation, repair workflow, or total loss valuation, including incumbents and internal projects?
- List the incumbent or external options you have reviewed and one specific strength and one specific weakness you observed for each.
- Describe the measurable condition that would have to be true for you to keep your current approach instead of switching, for example a supplement rate below X or implementation cost under Y.
- Has anyone inside your organization proposed building this capability internally, who would lead it, and what timeline did they suggest?
- Name the single factor that would make you choose an internal build over an external partner.
Pilot design that proves value quickly
- Would a pilot that demonstrates estimation accuracy within 5% to 10% of your desk adjusters accelerate your decision to sign production agreements?
- Outline the financial acceptance criteria you would apply to the pilot, for example target LAE reduction, supplement rate change, or net savings per claim.
- How long do you view as a reasonable pilot window to produce statistically credible results for estimation accuracy and cost metrics?
- Provide the KPIs you require instrumented and available in near real time during the pilot, and indicate which must be owner-reviewed daily versus weekly.
- Assuming the pilot hits your acceptance targets, who must approve the move to production and what is the maximum legal or procurement review window that would allow contract signing within 30 days?
Operational risks, controls, and shop adoption
- What operational guardrails must be in place to prevent overpayments when automated estimates are used in production?
- How will you introduce, train, and incentivize body-shop partners to accept photo-based estimates and reduce rework?
- Outline the monitoring cadence and metric thresholds that would trigger a rollback or expanded manual review during rollout.
- Provide the number of adjusters you plan to include in early adopter groups and the role that decides inclusion.
- Identify any regulatory or state approval that, if not obtained, would stop you from deploying virtual photo-based claims at scale.
Commitment signals, contract essentials, and next steps
- If your CFO had to name the top two commercial terms that would accelerate a signed agreement within 60 days, what would they be?
- Which commercial terms do you view as non-negotiable for moving forward, for example implementation credits, indemnity limits, or performance-based milestones?
- How soon after pilot acceptance would you expect to begin phased rollout, and what internal milestone starts that clock?
- What resources or evidence from the seller would make your legal and procurement teams comfortable shortening their review cycle to meet your desired timeline?
- What would be the single decisive next step, if completed this week, that accelerates the project to a pilot kickoff within 30 days?
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Pilot Evaluation
Run a pilot that validates AI damage-estimation accuracy against human adjusters, integration with the claims and shop systems, and financial/operational acceptance criteria.
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Solution Scope
Define modules (estimation, triage, repair workflow, total-loss), integration endpoints, responsibilities, data needs, and measurable success criteria.
Scope Configuration
- Photo-Based Damage Estimation
- Virtual and Photo Appraisal
- Automated Claim Triage and Routing
- Repair Order Generation and Estimate Export
- Parts Sourcing and Alternative Parts Recommendation
- Supplement Tracking and Management
- Total Loss Valuation with Real-Time Market Pricing
- Claims Management System Integration
- Body Shop Management System Integration
- Payment and Settlement Integration
- Repair Facility Onboarding and Connectivity
- Rental Car Authorization and Coordination
Scope Questions
Photo-Based Damage Estimation
- Do you accept photo-only estimates for low-complexity bumper, fender, and glass claims?
- What is the minimum acceptable estimation accuracy versus your human adjuster baseline (for example within 5% of parts and labor totals)?
- Which claim groups should be excluded from photo-only straight-through processing (e.g., commercial fleet, salvage candidates, rental claims)?
- Describe the photo submission standards you will require from claimants (minimum resolution, required views, VIN visibility, odometer photo).
- Who will own final sign-off on AI-produced estimates for repairable claims during rollout (title or role)?
Virtual and Photo Appraisal
- Which roles in your organization should be enabled to initiate guided video or live virtual appraisals (desk adjuster, field appraiser, vendor partner)?
- List the appraisal artifacts you require per virtual inspection (photo angles, sequential video, inspector notes, VIN capture, mileage).
- How do you currently record supplemental damage found in-shop and how should the platform capture in-shop supplement evidence (photo timestamps, technician notes, line-item additions)?
- Are there state regulations or insurer licensing rules that affect use of virtual appraisals in any of your operating states?
- Specify the mobile OS versions and minimum camera capabilities you expect claimants and adjusters to use for guided captures.
Automated Claim Triage and Routing
- Identify the claim attributes that should trigger straight-through processing versus desk review (for example: low estimated repair cost, single-area damage, photo quality score).
- What thresholds for estimated repair cost or severity should route claims to field appraisal rather than desk processing?
- Do you require automatic tagging to distinguish commercial versus personal auto and to capture policy limits or deductibles at triage?
- Who will manage and approve routing rule updates and business logic changes for claim queues (title or team)?
- List the integration endpoints where triage events must be posted (claims management webhook, audit log, notification queue).
Repair Order Generation and Estimate Export
- Select the repair estimate export formats required by your shop network and claims system (standard repair order, OEM-compliant estimate, CSV export, PDF only).
- Is alignment required with a specific labor time guide and version for line-item hours (for example a particular labor guide edition)?
- Describe the field mapping you require when exporting parts, labor, operations and labor rate to your claims management system.
- How should supplements be appended to an existing repair order in your workflow (add line items, create separate supplement RO, or attach supplement packet)?
- Are there file size or attachment format limits for estimate payloads into your claims system?
Parts Sourcing and Alternative Parts Recommendation
- Provide the parts catalogs or vendor classes you expect the platform to query (OEM dealers, aftermarket distributors, salvage pools).
- Define the part matching rules you require for recommending alternative parts (price delta threshold, OEM equivalence, fitment allowance).
- Are remanufactured or aftermarket parts permitted by vehicle class or policy on your book, and if so which classes?
- How should parts lead times and estimated arrival (ETA) be surfaced on the repair order and to the claimant?
- Identify the owner for parts vendor onboarding and API credentialing within your organization.
- What business rules should govern automatic substitution of alternate parts (max price delta, required approvals)?
Supplement Tracking and Management
- Specify which events should spawn a supplement workflow (shop discovery during teardown, post-repair inspection, parts arrives incorrect).
- Define the maximum time window after the initial estimate you will accept for filing a supplement (days from FNOL or estimate approval).
- Will you require automated supplement reason codes and root-cause tags for each supplement entry?
- Indicate how supplement approvals should be routed (auto-approve under threshold, adjuster review, manager escalation).
- Assign who in your organization will own supplement reconciliation and closeout tracking.
- What audit trail or evidence (photos, technician notes, timestamps) do you require stored with each supplement?
Total Loss Valuation with Real-Time Market Pricing
- What validation criteria will confirm total loss valuations against market comps and auction data (for example allowable variance in dollars or percent and sample size)?
- Which market data sources do you require for salvage and retail comps (auction lanes, private-party listings, trade guides)?
- Explain how you want salvage value and repair cost presented when determining statutory total loss thresholds.
- Provide the total loss decision thresholds by state or program you currently use (for example repair cost > 70% of actual cash value).
- Assign ownership for total loss validation process and who reviews market pricing exceptions.
- What reporting cadence and metrics do you require for total loss model performance (sampled audits per month, dollar variance trend)?
Claims Management System Integration
- What connector coverage must be included for your claims management system versions and endpoints and what acceptance tests will validate each connector?
- Which specific CM system endpoints must we read and write (claim create, claim update, RO attach, notes append, workflow status update)?
- Describe the field-level mappings you will require between our estimate payload and your claim schema (parts codes, labor hours, line-item IDs).
- How should we authenticate to your claims API (OAuth2 client credentials, API key, mutual TLS)?
- Who owns the integration acceptance testing and sandbox signoff within your IT or integration team?
- Are there SLA requirements for synchronous API responses from us into your claims system (max latency in seconds)?
Body Shop Management System Integration
- Which body shop management system classes or vendor APIs do your top network shops use and need to be supported (scheduling, RO sync, parts ordering)?
- How will shops authenticate to our platform or API (shop API key, SFTP, web portal login, EDI)?
- Do you require two-way scheduling with shops (appointment booking and real-time capacity updates)?
- Describe the data elements that must sync to the shop RO (VIN, estimate line items, parts ordered, labor hours, appointment time).
- Who will coordinate API credentialing and connectivity with shop IT or shop network managers?
- What rollback or manual override controls must be in place at the shop level for estimate edits?
Payment and Settlement Integration
- Which settlement rails and payment providers must the platform integrate with for payouts and shop payments (ACH, virtual card, payee check)?
- Describe the settlement workflow you require for final payments to claimants and/or shops (one-time disbursement, staged payments, direct-to-shop).
- Are there regulatory or tax forms tied to payments we must generate (1099, remittance advice, state-specific forms)?
- What approval thresholds should gate automated payouts (e.g., >$X requires manager sign-off)?
- Who will be the finance owner for payment reconciliation and exception handling?
- Are there required remittance fields or attachments your AP system expects with shop payments (invoice number, repair order ID, parts invoices)?
Repair Facility Onboarding and Connectivity
- How many repair facilities do you plan to onboard in phase 1 and by full rollout?
- Which shop network categories must be supported at go-live (franchise dealerships, independent shops, certified OEM repairers)?
- Who will own shop outreach, training, and onboarding logistics on your side?
- What minimum connectivity options must a shop support to participate (email + portal, API, BMS integration)?
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Mutual Commit
Finalize commercial and legal terms, data-sharing agreements, SLAs, acceptance criteria from the pilot, and a governance cadence for rollout.
Agreement Modules
- Subscription Agreement (Order Form)
- Master Services Agreement (MSA)
- Statement of Work (SOW)
- Service Level Agreement (SLA)
- Data Processing Agreement (DPA)
- Data Sharing & Use Agreement
- Pilot Acceptance Report
- Governance & Rollout Cadence Agreement
- Security & Compliance Addendum (conditional for regulated buyers)
- Change Order Agreement
- Termination & Transition Plan
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Deployment
Lock readiness facts and configuration values before execution begins.
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Pre-Deployment Readiness
Capture concrete readiness facts the rollout depends on — test environments, data access, integration owners, body-shop partners, and timeline.
Pre-Deployment Questions
Environment and site access
- Is a non-production test environment available for integration testing? If yes, provide the environment name/ID (we use this to schedule test runs — do not include URLs or credentials).
- Which carrier systems will the rollout integrate with? (select all that apply — used to size integration work)
- What is the readiness status of API access for the identified endpoints? (this determines when our integration work can begin)
Data and configuration
- Is anonymized test data (claims records, photos, repair orders) available for integration validation, and who owns that dataset? (helps us request or generate the correct files)
- Has the field-mapping and canonical data model ownership been decided (who will own mapping sign-off between carrier fields and the platform)? (we need a single owner for mapping approvals)
- Are there required data handling controls for test or production data (masking, on-prem processing, restricted PII handling)? If yes, briefly state the control type required so we can plan compliance gates.
People and ownership
- Please list the primary technical owner(s) for each integration stream (claims, shop, parts, payments). Use 'same as' when one person covers multiple streams. (we will assign tickets to these owners)
- Who is the business acceptance owner (role and name) responsible for pilot-to-rollout sign-off? (this person approves acceptance criteria and go/no-go decisions)
- Are body-shop partners for the pilot confirmed and contractually able to participate? (select the current state so we can plan shop onboarding)
Timing and constraints
- Target date to start integration testing (YYYY-MM-DD). (used to book engineering and test windows)
- Are there known blackout windows or regulatory constraints in the next 90 days that block testing or cutover? (if yes, we'll request exact dates in follow-up)
- Status of contractual and security approvals required before rollout (DPA, SOC/pen test, data-sharing agreement): select the current state so we can sequence legal and security tasks.
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Integration & Configuration
Lock exact configuration values and integration details — API credentials, field mappings, confidence thresholds, escalation rules, and test data specs.
Configuration Details
Integration Environments & Endpoints
- Enter the staging API base URL for the buyer's claims system (format: https://api.example.com/ — this value will be entered in the connector settings)
- Enter the production API base URL for the buyer's claims system (format: https://api.example.com/)
Authentication & Credential Handoffs
- Select the authentication method the buyer will use for the claims-system integration. Default is 'OAuth2 (client ID; secret exchanged via buyer's secrets manager)' — do NOT paste secrets here.
- Provide the integration client/credential identifier that the buyer will register in their system (client_id, API key name, or certificate name). Do NOT paste the secret.
Field Mappings & Shop Integration
- Enter the exact field name in the buyer's claims system that contains the policy number (case-sensitive)
- Enter the exact field name in the buyer's claims system that contains the vehicle VIN (case-sensitive)
- Enter the exact field name the buyer's body-shop system uses for repair facility ID (case-sensitive)
- Select the transport/protocol for the buyer's body-shop management system integration. Default is 'REST API (JSON)'
Thresholds, Test Data & Validation
- Enter the confidence threshold percentage the platform should use to auto-approve AI estimates for straight-through processing. Default is 85 — enter numeric 0-100 (no % sign)
- Specify the number of test claims the buyer will ingest during integration verification. Default is 50 — enter a numeric count
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Rollout Execution
Execute phased rollout with owners, sequencing, monitoring for estimation accuracy, supplement rates, shop adoption, and rollback/escalation paths.
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Operational Success
Conduct recurring outcome reviews, validate ongoing model performance vs KPIs, and maintain a shared channel for issues and enhancement requests.
Success Reviews
- Go-live Health Check (weeks 1-4)
- First Measurement Review (weeks 4-10)
- Acceptance Gate Review (around day 90)
- Monthly Operational Check-in
- Quarterly Outcome Review
Issues & Enhancements
- Create remediation tickets for any SLA breaches with expected resolution dates.
- Produce a documented acceptance decision for the program against the Pilot Evaluation criteria, with a recorded signatory or documented buyer decision.
- Confirm legacy system status and the timeline for decommissioning or retention-read-only.
- Publish the acceptance decision record and archive the meeting evidence.
- If any criterion failed, publish a remediation plan with dates and verification steps.
- Execute the legacy system decommissioning or retention plan and confirm data archival completion.
- Monthly KPI review
- Confirm whether supplement rate and body-shop adoption are stable or improving and document any deviations.
- Close or re-prioritize open operational issues and update the backlog accordingly.
- Update the operational dashboard with the month's KPI results and variance explanations.
- Reconfirm committed success criteria and owners
- Adjust the enhancement backlog priority list based on agreed operational impact.
- Quarterly trend analysis
- Validate whether loss adjustment expense per claim and CSAT are aligned with the program targets and document any gaps.
- Agree the prioritized improvement actions for the next quarter and a verification plan to measure impact.
- Publish the quarterly KPI trend report and the agreed improvement plan for the next quarter.
- Schedule model performance re-evaluation if AI estimation accuracy drift exceeds threshold.
- Update SLA thresholds or reporting cadence where governance adjustments were agreed.
- Confirm the deployment completion checklist is satisfied or itemize outstanding items with resolution dates.
- Establish a prioritized list of critical blockers and agreed remediation actions for the next 14 days.
- Publish the deployment validation summary including integration test results.
- Open tickets for each critical defect with expected resolution dates.
- Circulate user onboarding completion report and identify any training gaps.
- Present first-window outcome data
- Confirm whether average claim cycle time and AI estimation accuracy are moving toward the Pilot Evaluation targets and document the gap analysis.
- Agree a concrete corrective action plan with dates that moves the program toward the acceptance gate.
- Deliver a detailed gap analysis report showing metric variance versus Pilot Evaluation targets.
- Define and document the prioritized fixes required to address the top two root causes.
- Schedule a verification run after fixes to re-measure AI estimation accuracy and cycle time.
- Restate numeric acceptance criteria
- Deployment and integration validation
- Present outcome data against each acceptance criterion
- Compare results to Pilot Evaluation targets
- Incidents, escalations, and SLA breaches
- Persistent blockers and root-cause review
- Enhancement request status and prioritization
- Document pass/fail per criterion and capture signatory decision
- Enhancement request and backlog tidy
- Root-cause diagnosis for gaps
- Early adoption and usage signals
- Open issues burn-down
- SLA and governance cadence review
- Legacy system wind-down
- Agree corrective actions and acceptance timeline
- High-priority defects and blockers
- Agree immediate remediation actions and timelines
- Remediation plan for any failed criteria