Claim Guardians
ClaimsCalQL8ter
Claim Guardians · 0796775807
Guided Claim Workspace
Continue the claim by choosing what came in next instead of editing the whole file structure by hand.
The customer summary remains the expert output. This workspace is the simpler intake layer that helps Cynthia move through the claim one real-world item at a time.
Claim Snapshot
Workflow progress
6
paths with saved data
Needs Review
2
active review items
Workflow State
This panel uses the new workflow records so the processor can see the current stage, what is blocking progress, and what should happen next.
Who Has the Ball
Customer
Medium LowOverdueWaiting for the customer phone number so the claim file has a working primary contact.
Aging
14
business days
Due
Within 10 days
follow-up overdue
Review Queue
0
open items
Current Stage
Client Onboarding
Set up the claim file, contacts, mortgage path, and first intake item.
75% complete
Current Stage Tasks
Capture basic claim information
Save the claim number, insured, address, carrier, and date of loss if known.
Record the primary customer contact
Save the insured phone number and email if available.
Confirm the mortgage-company path
Record whether a mortgage company is involved and confirm the customer disclosure if needed.
Capture the first received item
Start the guided intake based on what document, check, or update arrived first.
Next Best Action
Record the primary customer contact
Save the insured phone number and email if available.
Current Blockers
No hard blockers are currently recorded for this stage.
Management Review
0
open workflow review items
Resume Step
update-note
recommended guided intake path
Needs Review
If something is unclear, the claim should keep moving, but the issue still needs to be visible and easy to escalate.
Deductible may be unaccounted for
Total received funds exceed net claim after deductible. Confirm deductible handling.
May affect: Checks, payments, or vendor disbursement
Claim costs diverge from carrier estimate
Total claim costs are materially different from carrier RCV estimate.
May affect: Estimate or invoice history
Customer Summary Target
This remains the holy grail. The intake flow can simplify the work only if the output stays accurate and easy for the customer to understand.
Claim Snapshot
Robert Covert
0796775807
Carrier estimate history
8 carrier estimate entries imported from the current claim.
$13,095.92
Current contract total
3 vendor records and their revisions rolled into one total.
$31,198.46
Carrier funds credited
4 check or payment records contribute to this total.
$24,052.87
Actually paid to vendor
Derived from the real money-flow lines marked paid to vendor.
$0.00
Carrier holdback still expected
Claim-level holdback still expected from the carrier or mortgage release.
$0.00
CGPA fees
Derived from the real fee lines in the claim payments.
$2,405.30
Deductible applied (net)
Claim-level deductible tracked from the current claim file.
$1,000.00
Estimated homeowner responsibility
Prototype approximation using current contract total minus actual vendor-paid amounts and expected holdback.
$31,198.46
Vendor 1
Abatemasters
Service Type: mitigation
Current Contract Total
$5,207.24
Contractor / Vendor Name
Abatemasters
Service Type
mitigation
Original Estimate
$5,207.24
Carrier Funds Credited
$16,711.56
Actually Paid to Contractor / Vendor
$0.00
CGPA Fee(s)
$1,671.16
Estimated Homeowner Responsibility
$5,207.24
Vendor 2
Rapid Refurb
Service Type: rebuild
Current Contract Total
$5,173.87
Contractor / Vendor Name
Rapid Refurb
Service Type
rebuild
Original Estimate
$5,173.87
Carrier Funds Credited
$0.00
Actually Paid to Contractor / Vendor
$0.00
CGPA Fee(s)
$0.00
Estimated Homeowner Responsibility
$5,173.87
Vendor 3
Roto-Rooter
Service Type: mitigation
Current Contract Total
$20,817.35
Contractor / Vendor Name
Roto-Rooter
Service Type
mitigation
Original Estimate
$20,817.35
Carrier Funds Credited
$2,428.16
Actually Paid to Contractor / Vendor
$0.00
CGPA Fee(s)
$242.82
Estimated Homeowner Responsibility
$20,817.35
Resume Workflow
Choose the real-world item that came in next. Each path tells the user what it will ask, what it updates, and where to correct it today.
Selected Path
This is the plain-language intake definition the user should see before they start entering information.
What came in
Update / Note
This should become a plain-English timeline event tied to urgency.
Customer summary impact
Does not usually change the customer math directly, but it keeps follow-up and claim story understandable.
What the user should be asked
What is already on file
Nothing is saved on this path yet.
Artifact Intake
Update / Note supporting document
Upload the real file here. The system classifies it, stores the artifact record, and later routes it to the claim’s OneDrive case folder automatically.
On file for this path
0
Recent files for this path
Saved Claim Timeline
The next processor should be able to understand the claim story by reading plain-English events tied to the saved data.
Timeline item 1
Contractor estimate captured
Abatemasters entered as the active mitigation vendor.
Timeline item 2
Invoice captured
Abatemasters invoice stored for customer-summary comparison.
Timeline item 3
Carrier check captured
Check 1 entered for mitigation.
Timeline item 4
Carrier check captured
106793876 entered for Roto-Rooter / mitigation.
Timeline item 5
Contractor estimate captured
Roto-Rooter entered as the active mitigation vendor.
Timeline item 6
Invoice captured
Roto-Rooter invoice stored for customer-summary comparison.
Timeline item 7
Carrier check captured
Check 3 entered for Abatemasters / mitigation.
Timeline item 8
Carrier check captured
284197080 entered for Roto-Rooter / mitigation.
Timeline item 9
Contractor estimate captured
Rapid Refurb entered as the active rebuild vendor.
Timeline item 10
Invoice captured
Rapid Refurb invoice stored for customer-summary comparison.
Timeline item 11
Carrier estimate captured
Abatement added for abatement.
Timeline item 12
Carrier estimate captured
Mitigation added for mitigation.
Timeline item 13
Carrier supplement captured
Mitigation added for mitigation.
Timeline item 14
Carrier supplement captured
Mitigation added for mitigation.
Timeline item 15
Carrier supplement captured
Mitigation added for mitigation.
Timeline item 16
Carrier supplement captured
Mitigation added for mitigation.
Timeline item 17
Carrier estimate captured
Rebuild added for rebuild.
Timeline item 18
Carrier supplement captured
Mitigation added for mitigation.
Timeline item 19
Deductible / holdback update captured
Customer responsibility and holdback status were entered from the claim file.
Workflow Snapshot
This quick panel makes it obvious how the current saved claim data lines up with the new guided structure.
Carrier estimates
8
Vendor records
3
Checks on file
4
Claim Guardians Fee
$2,405.30