Straight-through claims at a limit your risk owner signed, an adjuster above it, and a worst day that is a number.
For Heads of claims, COOs and risk at insurers and insurtechs, third-party administrators, and the vendors who automate claims.
Claims automation reads the vet bill in a second, then waits a week for an adjuster, because risk will not approve an agent whose payouts nobody can bound. Sampling worked when people paid the claims and a manager checked a few each week. It stops working when a bot pays them by the hour and the sample is read at the end of the month.
The fix is not a better model. It is a limit on the payout itself: a cap per claim, a total per policyholder and per day, a cooling period and an adjuster for everything above the line. The bot pays inside it without waiting for anyone.
Every payout then carries a receipt the insurer checks without the vendor's logs, and an auditor or a reinsurer can check it the same way. The worst day stops being a distribution. It becomes the cap your risk owner signed.
A limit per claim and a total per policyholder and per day, held across the bot, the adjusters and any TPA.
A claim too soon after its incident, or too large, goes to the adjuster the policy names. It is a rule, not a line in a prompt.
An approval above the line is an override with a name on it, and it still counts toward the totals.
Each payout carries a receipt you, your auditor or your reinsurer can verify offline, without the vendor's logs.
An example written for this page, with round numbers. It uses only what the policy format has today, and it is not a customer's policy.
Inside the rules the agent acts alone. Above a line, the named person decides. Every change to the numbers is a new signed version.
Two weeks, a fixed fee, your limits and a named approver, and the method to do the next workflow yourself.
We will email you to find a time for a 25-minute walkthrough with the founder. No slides, no sales script.
Pick a time in the founder's calendar, or tell us about your agent first.