Which incoming claims should be fast-tracked vs held for full manual triage?
Information
Claim type, policyholder history, and the existing Claims Leakage & Fraud Risk Scoring signal for this claim.
Intelligence
A combined view of claim type and the existing leakage/fraud signal, rather than the signal being checked separately, later in the process.
Decision
Whether this specific claim can be fast-tracked or needs full manual triage.
Action
Route the claim to the fast-track queue, or the standard triage queue.
Business Outcome
Faster, more consistent claims triage · Cost Reduction
Average minutes to triage a claim · baseline 20min · target 8min · actual 9min · confidence: Medium
Hypothesis: Pre-sorting by the existing fraud/leakage signal lets duty officers skip most low-risk claims entirely, cutting average triage time by more than half.
Illustrative estimate for this demonstration dataset, not a measured baseline.
Organisational Adaptation
Recommended intervention
AI assistance — The leakage/fraud signal already exists and is already piloted; a duty officer should still make the final call on anything it flags as uncertain -- this is assistance, not full automation.
Capacity
Set both decision frequency (edit this decision) and review capacity above to see a capacity pressure estimate.
Adaptation outcome
A reported response, not a verified change record — what did the organisation decide after living with this?
Value estimation
Made 300×/year at an estimated cost of 250 per poor instance — every 1 percentage point of improvement is worth roughly 750/year. Scale by your own realistic improvement estimate rather than trusting a single invented number.