Claims process mapped
- @claimhelpme published a visual, systematic map of claims sequencing covering insurer and policyholder perspectives. - Their mapping referenced 4,000 claims and 200+ pillars to reduce cycle time, average loss expense and disputes. - The map is linked to a knowledge base intended to operationalise clearer handoffs and audit trails in claims workflows. (x.com)
ClaimHelpMe, a homeowner-claims education company, published a visual map of the insurance claims process that lays out the sequence of steps from both the insurer and policyholder side. (x.com) The company said the map draws on 4,000 claims and more than 200 “pillars,” or process elements, and links each step to a knowledge base meant to guide what happens next in the file. (x.com) ClaimHelpMe presents itself as a consumer-facing claims help business led by founder Mark Grossman, a licensed public adjuster in New York and Florida, with material aimed at homeowners handling property losses. (youtube.com, claimhelpme.com) In insurance, a claim moves through a chain that usually starts with the first notice of loss, then investigation, documentation, coverage review, estimate, payment, and closure or appeal. Breakdowns usually happen at handoffs, when one party thinks the file is waiting on the other. (vcasoftware.com, pacainsurance.com) State claims rules are built around that same problem: insurers are expected to acknowledge communications promptly, investigate on reasonable standards, and explain denials or coverage positions within a reasonable time. (content.naic.org, content.naic.org, law.lis.virginia.gov) Large insurers and vendors have spent years trying to standardize those steps with digital workflows, remote-adjusting tools, and shared claims platforms that keep customers and adjusters on the same record. (verisk.com, deloitte.com) Consulting firms that track the sector frame claims as the biggest operating pressure point in property-and-casualty insurance, because paid losses plus investigation and settlement costs consume most premium dollars. They also describe end-to-end redesign, not one-off tools, as the standard playbook for cutting cycle time and loss adjustment expense. (deloitte.com, mckinsey.com) ClaimHelpMe’s pitch is narrower than a carrier software rollout: it is packaging the sequence itself as a reference model, then attaching a knowledge base so each handoff leaves a clearer trail for homeowners, adjusters, and other participants. (x.com, youtube.com) That makes the post less a product launch than a process argument: if both sides can see the same map, fewer claims should stall in the gray area between “submitted,” “reviewed,” and “waiting.” (x.com, content.naic.org)
