Opening the conversation about scale and context

• Tell me about the claims volumes and the scale your team handles today, including typical monthly FNOLs and open in-flight claims.
• On average, how many FNOLs does your organization receive per month across personal and commercial lines? Options: <1,000, 1,000-10,000, 10,000-50,000, 50,000-200,000, >200,000
• Who on your team typically owns an in-flight claim when a system migration is being discussed, and how do they communicate status today? Options: Claims VP, Claims Operations Manager, IT/Engineering, Business Transformation Lead, Third-party administrator, Other
• Describe a recent claim that took significantly longer than expected to close, what your team learned, and which part of the process caused the delay.
• Which roles in your organization must sign off before a change to the claims core system is approved? Options: VP of Claims, CIO, CFO, Head of Transformation, Legal/Compliance, Procurement, IT Security, Line of Business Head, Other

Where the current process is costing you time or money

• If a single operational failure could make your leadership stop the migration, what would that failure be?
• How often do your automated reserve calculations drift beyond acceptable tolerance and trigger manual correction? Options: Daily, Weekly, Monthly, Quarterly, Rarely or never
• Estimate the average time an adjuster on your team spends handling a claim today, and the business impact if that time fell by 20 percent.
• Who in your organization feels the most operational pressure when the claims backlog grows, and what immediate actions do they take? Options: Claims leadership, Adjusters, Customer service, Finance, IT, Vendors, Other
• What breaks downstream in your finance, payment, or vendor processes when payments are delayed by integration failures?

Why configuration feels harder than it should

• Why do your current claims workflows require custom code rather than being handled by configuration in a modern rules engine?
• Which claim types or lines of business in your book resist standardization the most, and what patterns make them unique? Options: Personal auto, Commercial auto, Homeowners, Commercial property, General liability, Workers compensation, Specialty lines
• Tell me about the last regulatory change your team had to implement, how long the change took, and what the real cost in time or dollars was for your organization.
• On a scale, how configurable must a rules engine be so your business users can model exceptions without engineering involvement? Options: Low: vendor support required for changes, Medium: admin configuration for common scenarios, High: line-by-line configurability without code, Very high: non-technical users model exceptions directly
• If you could remove one policy or legacy constraint that limits automation for claims handling, which one would it be and why?

Regulatory gates and the risks that pause projects

• Name the state regulatory requirement that, if unmet during migration, would force your organization to pause the program.
• How mature are your audit and regulatory reporting processes for claims, and who in your organization owns that maturity? Options: Well defined with automation, Defined but partially manual, Ad hoc and manual, Missing
• Are there pending regulatory reviews, rate filings, or compliance audits in the next 12 months that could block or restrict migration windows for your team? Options: Yes, within 3 months, Yes, 3 to 12 months, No, not expected, Unsure
• Describe the consequences your team has faced when historical claims data was incomplete or inaccurate during a system change.
• What single unresolved legal or compliance gap would stop this project outright?

The other paths your stakeholders are weighing

• List the alternatives stakeholders are actively considering right now, including staying with the incumbent, building internally, or choosing another vendor. Options: Remain with incumbent system, Replace with another vendor, Build internally, Partner with a systems integrator, Use best-of-breed point solutions, Unsure
• Under what concrete conditions would your organization choose to remain with the current system rather than replace it?
• Has anyone on your transformation, engineering, or claims operations teams proposed an internal-only solution instead of contracting an external partner? Options: Yes, engineering proposed it, Yes, transformation proposed it, No internal proposal yet, Unsure
• Assuming a pilot meets your targets, name the one remaining barrier inside your organization that could prevent a rapid contract.

Practical readiness: integrations, data, and teams

• Point to the integration dependency in your landscape that is most likely to derail the timeline and explain why it is risky for your team. Options: Policy administration system, Billing system, Payment processor, Third-party data vendors, Document management, Subrogation and legal systems, Telematics or IoT providers, Other
• Do your policy administration, billing, and payment systems expose APIs for real-time sync, or are batch feeds the only option your teams can rely on? Options: APIs available for real-time sync, APIs available but limited, Only batch feeds available, Unsure
• Estimate the number of dedicated technical resources your organization can commit to integrations and data migration during pilot and cutover. Options: None, 1-2, 3-5, 6-10, >10
• Identify which team in your organization owns API keys and endpoint documentation and whether they can provide test credentials within two weeks. Options: Yes, team and credentials available, Yes, team available but credentials delayed, No team assigned, Unsure
• Would your organization proceed with a pilot if accessible test data and APIs are not available within the pilot window, and what constraints would that impose? Options: Yes with emulated data, No, pilot cannot proceed, Only a limited scope pilot, Depends on timeline

Designing a pilot that proves value quickly

• Name the single pilot metric that, if unmet, would force a pause or a major redesign of the program.
• Select which lines of business should be included in the pilot so the results are representative for your organization. Options: Personal auto, Commercial auto, Homeowners, Commercial property, General liability, Workers compensation, Specialty lines
• Provide counts for the historical claims and the number of open in-flight claims you want migrated for validation during the pilot.
• List the quantitative thresholds and the owners who will sign off on AI-assisted estimate accuracy, reserve accuracy, and end-to-end cycle time during pilot evaluation.
• Outline the remaining internal approvals or procurement steps that would be required to sign if the pilot demonstrates the savings you expect.

Decision makers, timing, and budget realities

• Identify the executive role in your organization with final sign off and the specific conditions that would accelerate their approval. Options: VP of Claims, CIO, CFO, Chief Transformation Officer, CEO, Board-level committee, Procurement lead
• When is your preferred production cutover window and what blackout dates or seasonal constraints must we avoid for your operations? Options: Next 3 months, 3 to 6 months, 6 to 12 months, 12+ months, Unsure
• In which budget cycle or quarter must this deal close to be included in your fiscal plan? Options: Current quarter, Next quarter, Next two quarters, Next fiscal year, No specific cycle
• Should procurement require a three vendor shortlist, who in your organization would drive that process and how would it change the timeline?
• Do you have preferred contract term lengths and minimum SLAs for claims processing availability that your procurement or legal teams will insist on? Options: 1 year, 2 to 3 years, 4 to 5 years, Multi-year with renewal options, Unsure

If we move forward, what does the first 30 days look like?

• Assuming we could remove one barrier this week, what would you ask us to prove first to give you confidence in a pilot?
• Please name the stakeholders who must attend a technical discovery and provide their availability in the next two weeks.
• Share the documents or materials your team needs to present this proposal to the board, and which of those would move a decision faster. Options: Executive summary, Pilot results and ROI, Security and compliance report, Integration design, Contract terms and SLAs, Other
• Are you prepared to run a pilot under a memorandum of understanding, or will your legal team require a fully executed contract before work begins? Options: MOU acceptable, Full contract required, Depends on risk and legal, Unsure
• When could your organization commit to a pilot start date, assuming the prerequisites and test data are available? Options: Immediately, Within 2 weeks, Within 1 month, 2 to 3 months, Later or unsure

• Solution Experience: End-to-End Claims Scenario Walkthrough

• Confirm the current state and its cost to your team
• You confirm the demonstrated end-to-end workflow eliminates the manual handoffs and rework you described and meets your cycle time expectations.
• Provide three representative in-flight claims and the success metrics you want measured in the sandbox run, including target cycle time, reserve accuracy thresholds, and payment timing expectations.
• Run your FNOL-to-closure scenario end-to-end
• You confirm the reserve calculation and audit trail meet your accuracy and governance requirements.
• Seller to run the provided scenarios in the sandbox and deliver a transaction-level trace that shows cycle time delta, reserve differences, and payment timing before the follow-up session.
• Validate reserve calculation and audit trail
• Provide an integration dependency checklist that lists policy, billing, and payment endpoints and any known customizations.
• You agree on the remaining evidence required to move to Solution Scope, including data extracts and integration dependency validation.
• Identify the technical and compliance stakeholders who will approve the reserve, payment, and reporting validation artifacts.
• Demonstrate payments, reconciliation, and vendor integrations
• Show analytics and regulatory reporting using your success metrics
• Forced validation, confirm alignment

• Solution Experience: End-to-End Claims Scenario Walkthrough
• Solution Experience Deck
• Solution Brief

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• Provision cloud or on-prem platform
• Deploy digital FNOL intake channels
• Configure automated coverage verification
• Enable assignment automation engine
• Deploy document management and imaging
• Configure reserve calculation engine
• Implement payment processing and disbursement
• Integrate with policy administration systems
• Integrate with billing and payment systems
• Migrate historical claims data and convert records
• Implement AI-assisted damage estimation
• Deploy photo-based claims assessment
• Enable straight-through processing for low-complexity claims
• Set up subrogation and recovery tracking
• Configure litigation and legal matter management

Provision cloud or on-prem platform

• Which deployment model do you require for production (cloud-hosted, on-premises, or hybrid)? Options: Cloud-hosted, On-premises, Hybrid
• How many production and non-production environments (for example: dev, test, UAT, pre-prod) must be provisioned? Options: 1 production only, Production + 1 non-prod, Production + 2 non-prod, Production + 3 or more non-prod
• Who is the infrastructure owner for the target environment where the claims database will reside (for example: internal IT, hosting partner)? Options: Internal infrastructure team, Third-party hosting provider, Shared ownership
• Where must data at rest be located to meet regulatory or residency requirements (for example: specific state, country, region)?
• Specify the compliance and certification baselines required for the environment (for example: SOC 2 type II, state Department of Insurance reporting controls).
• List any network or firewall restrictions for integration endpoints (for example: IP allowlist, private peering, VPN requirements).

Deploy digital FNOL intake channels

• Which FNOL channels must be enabled at go-live (First Notice of Loss) for example: web portal claim form, mobile app upload, call-center intake)? Options: Web portal form, Mobile app intake, Call-center form entry, Email ingestion, Third-party aggregator feeds
• How should claimant identity be captured and validated in the FNOL form (for example: policy number + DOB lookup, two-factor verification, digital ID document)? Options: Policy number lookup, Policy number + DOB, Two-factor verification, Upload identity document, No automated identity validation
• What mandatory fields must appear on every FNOL record for your auto and homeowners lines (for example: policy number, claimant contact, loss date, location, vehicle VIN)?
• Where must inbound FNOL attachments and photos be stored and how long must they be retained to meet audit requirements? Options: Platform-managed object store, Carrier-managed storage, Hybrid retention
• Provide the expected daily FNOL volume and peak hourly volume for each intake channel you selected. Options: Less than 100/day, 100-1,000/day, 1,000-10,000/day, More than 10,000/day
• Describe any state-specific FNOL notification obligations you must meet (for example: initial acknowledgment within X hours per state Department of Insurance guidance).

Configure automated coverage verification

• Which policy attributes must be checked automatically on intake (for example: policy effective dates, covered perils, named insured, endorsed limits)?
• How will your policy identifier be provided to the integration endpoint (for example: policy number, external policy GUID, binder reference)? Options: Policy number, External policy GUID, Binder reference, Other
• What tolerance do you require for coverage verification latency during FNOL (for example: synchronous lookup under X seconds vs asynchronous verification)? Options: Synchronous <2s, Synchronous <5s, Asynchronous with reconciliation, Batch verification only
• Which exceptions should trigger manual review during automated verification (for example: multiple policies found, lapsed policy, coverage exclusion flags)?
• Identify the reconciliation artifacts you require when coverage verification fails (for example: failure reason code, policy snapshot, API response log).

Enable assignment automation engine

• Which assignment rules should be supported at baseline (for example: proximity-based adjuster assignment, line-of-business queue, complexity or exposure score)?
• How should vendor and adjuster availability be surfaced to the assignment engine (for example: API roster, calendar sync, manual availability flag)? Options: API roster, Calendar sync, Manual availability, Batch upload
• What threshold or rule should escalate claims to specialized teams (for example: reserve above $X, bodily injury present, CAT indicator)?
• Describe the audit trail required for assignment changes (for example: timestamps, prior assignee, reason code, approver ID).
• Which performance indicators will define acceptable automation behavior for assignment (for example: percentage auto-assigned within SLA, manual overrides per 1,000 claims)?

Deploy document management and imaging

• What document types must be indexed and searchable at go-live (for example: scanned estimates, medical bills, police reports, rental receipts)?
• Which metadata fields are required for each document (for example: claim ID, document type code, received date, uploader name)?
• What resolution and file format requirements do your photo and document vendors enforce (for example: minimum megapixels, JPEG/PNG/PDF)? Options: JPEG, PNG, PDF, TIFF, Other
• How long must historical claim documents be retained to meet audit and regulatory retention schedules for your lines of business? Options: 3 years, 7 years, 10 years, Custom retention
• Describe any redaction or PII masking rules required for documents before external sharing (for example: redact SSN, mask policyholder DOB).

Configure reserve calculation engine

• Which reserve methodologies must be supported initially (for example: case reserves, incurred but not reported, development factor models)? Options: Case reserves, IBNR models, Development factor models, Proprietary formula
• What inputs from claim records must feed the reserve calculation (for example: severity code, exposure values, indemnity payments, claimant injury codes)?
• What acceptable variance will you allow between legacy reserve values and new engine-calculated reserves during validation (for example: percentage or absolute dollar tolerance)?
• Identify approval routing for reserve changes above defined thresholds (for example: auto-approval under $X; manager approval $X–$Y; executive approval >$Y).
• What reporting cadence and outputs do you require from the reserve engine for actuarial reconciliation (for example: reserve roll-forward, case reserve delta report)?
• What acceptance criteria will confirm the reserve calculation engine is ready for production (for example: reconciliation rate, tolerance to legacy reserves)?

Implement payment processing and disbursement

• Which payment rails must be supported at launch (for example: ACH, virtual card, check generation, third-party disbursement partners)? Options: ACH, Virtual card, Check print, Third-party disbursement partner
• How should payee identity and banking details be validated (for example: account verification API, micro-deposit, manual upload)? Options: Account verification API, Micro-deposit, Manual documentation, Other
• What approval workflow is required before funds are disbursed (for example: single approver, two-step approval, threshold-based approvals)? Options: Single approver, Two-step approval, Threshold-based approvals, Automated for low-dollar payments
• Which remittance and reconciliation artifacts do you require (for example: ACH return codes, payment ledger entries, remittance advice PDF)?
• Describe any state-specific requirements for claimant payments or vendor payments that affect disbursement timing or tax reporting.

Integrate with policy administration systems

• Which policy administration integration surfaces are required at cutover (for example: policy lookup, endorsement history, cancellations feed, policy attachments)?
• Which authentication pattern does your policy system expose for API consumers (for example: OAuth2, mutual TLS, API key)? Options: OAuth2, Mutual TLS, API key, SAML
• What mapping coverage do you require between policy attributes and claim fields (for example: coverage limit mapping count, endorsement mapping percentage)?
• Which reconciliation must pass before policy integrations are accepted (for example: policy match rate, unmatched policy reconciliations under X%)?
• What acceptance criteria will validate the policy administration integration (for example: connector coverage count, successful lookup rate, reconciliation threshold)?

Integrate with billing and payment systems

• Which billing integration outcomes are required (for example: recover premium adjustments, premium audit triggers, invoice status updates)?
• How should payment posting be represented to the billing system (for example: remittance file, API payment posting, daily batch)? Options: API payment posting, Daily batch remittance file, Real-time webhook
• What tolerance is acceptable for timing between claims disbursement and billing ledger posting (for example: within 24 hours, 48 hours)? Options: Within 4 hours, Within 24 hours, Within 48 hours, Within 7 days
• Identify required data elements for billing reconciliation (for example: policy number, invoice ID, payment reference, GL code).
• Which exception scenarios from billing you want surfaced in the claims UI (for example: unapplied payment, duplicate invoice, failed posting)?

Migrate historical claims data and convert records

• Which historical objects must be migrated and searchable at cutover (for example: closed claim records, loss runs, payment histories, scanned documents)?
• What migration completeness threshold will you require to accept converted historical claims (for example: percent of closed claims fully migrated with payments and attachments)?
• What data accuracy tolerance do you require between source and migrated claim fields (for example: 99% field-level match on policy number, claimant name, loss date)?
• How should in-flight claims (claims open at cutover) be handled for cutover continuity (for example: freeze movement, allow parallel processing, phased handoff)? Options: Freeze movement pre-cutover, Parallel processing with reconciliation, Phased handoff by book
• List the source data formats and extracts available for migration (for example: relational DB dump, CSV exports, fixed-width files, scanned document bundles).
• What acceptance criteria will confirm migration readiness for cutover (for example: reconciliation report, sample audit of X records, document accessibility check)?

Implement AI-assisted damage estimation

• Which damage-estimation scenarios should the AI model support at launch (for example: vehicle repair estimate, roof replacement estimate, contents replacement)?
• What training data availability can you provide for model tuning (for example: labeled photos with repair amounts, historical estimate line items)? Options: Rich labeled dataset available, Partial labeled dataset, No labeled dataset available
• How will you validate AI estimate accuracy during pilot (for example: compare to shop estimate, adjudicator estimate, percent within $X threshold)?
• Which explainability artifacts do you require for each AI estimate (for example: feature importance, confidence score, bounding boxes on damage areas)?
• Describe any regulatory or audit requirements for AI usage in claims adjustment in your jurisdictions (for example: record of human override, explanation retained for state DOI audits).

Deploy photo-based claims assessment

• Which photo intake flows do you require (for example: claimant upload, adjuster capture, vendor portal, telematics image ingest)?

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• Subscription Agreement (Order Form)
• Master Services Agreement (MSA)
• Statement of Work (SOW)
• Service Level Agreement (SLA)
• Data Processing Agreement (DPA)
• Security & Compliance Addendum
• Data Migration and Cutover Acceptance Agreement
• Go/No-Go Acceptance Sign-off
• Change Order Agreement
• Source Code Escrow and Continuity Agreement

• Go-Live Health Check (weeks 1-4)
• First Measurement Review (weeks 4-10)
• 90-Day Outcome Review
• Quarterly Operational Review
• Annual Success Review and Continuous Improvement Plan

• Publish the quarter's SLA and metric performance dashboard and circulate to governance stakeholders.
• Document which Solution Scope targets are met, which are partially met, and which are unmet at day 90.
• Agree a time-bound remediation schedule for all unmet targets and name governance checkpoints to monitor progress.
• Capture and prioritize enhancement requests required to reach or sustain targets.
• Publish the 90-day outcomes report mapping each metric to Solution Scope targets and gap-status.
• Create a time-boxed remediation tracker for all unmet targets with milestone dates.
• Submit the prioritized enhancement backlog for the next quarterly implementation window.
• Quarterly metrics summary vs Solution Scope targets
• Confirm SLA adherence and whether loss adjustment expense per claim and integration uptime are on target or require intervention.
• Approve the prioritized enhancement list for the next quarter and the associated release window.
• Ensure governance owners are assigned for all active remediation items and upcoming changes.
• Re-confirm agreed success criteria and owners
• Schedule the next release window and add approved enhancements to the delivery plan.
• Update the change-control log with owners and approval dates for planned configuration changes.
• Year-to-date outcomes vs Solution Scope targets
• Confirm the degree to which average claim cycle time and loss adjustment expense per claim achieved the targets in Solution Scope.
• Agree a one-year continuous improvement plan with quarterly milestones and governance owners.
• Document at least three prioritized initiatives that will materially improve the named metrics next year.
• Publish the annual success report mapping realized benefits to Solution Scope targets and distribute to stakeholders.
• Finalize the continuous improvement roadmap with quarter-by-quarter milestones and owners.
• Schedule quarterly follow-up operational reviews to monitor delivery against the roadmap.
• Confirm the deployment completed and the initial migration checks show no critical data loss.
• Document the incumbent wind-down plan with a target retirement or read-only date and archival location.
• Produce a prioritized remediation list for all high-severity issues with owners and target resolution dates.
• Publish the hypercare incident tracker with owners and SLAs within 24 hours.
• Deliver a signed-off incumbent wind-down and data-archive plan including retirement/read-only date and contract steps.
• Run and share a targeted data integrity report for a representative sample of migrated claims.
• Present first dataset against Solution Scope targets
• Establish whether average claim cycle time and weekly active adjuster adoption rate are on track toward Solution Scope targets.
• Assign corrective actions for each gap with owners and target completion dates.
• Confirm integration health does not block KPI recovery, or identify immediate fixes if it does.
• Create a remediation plan for each metric gap with milestone dates and a single accountable owner for tracking.
• Run a connector error-rate drill and publish findings within 5 business days.
• Deliver an adoption improvement plan including targeted training sessions and in-product guidance for adjusters.
• Present 90-day metric outcomes vs Solution Scope targets
• Root-cause diagnosis for metric gaps
• Operational benefits and lessons learned
• SLA and incident burn-down review
• Operational validation per line-of-business
• Deployment and migration validation
• Unresolved issues and root cause detailed review
• Integration and data flow validation
• Enhancement backlog and release prioritization
• Early adoption signals and usage patterns
• Continuous improvement roadmap and governance commitments
• Capture enhancement requests and prioritization
• Incumbent system wind-down status
• Enhancement investment priorities and sequencing
• Open incident and backlog review
• Governance, change control, and training updates
• Agree corrective actions and timeline to baseline
• Blockers, high-severity incidents, and remediation actions
• Agree remediation schedule and governance checkpoints
• Short update on compliance and regulatory reporting readiness
• Agree short-term follow-ups and hypercare schedule