Claims Intake Triage and Reserving Playbook

Claims become expensive when the early workflow is inconsistent.

This playbook installs:

• one intake standard
• triage rules that prevent slow response
• reserve review discipline so incurred does not drift quietly

What you will produce

1. Claims intake form
2. Triage decision rules
3. Reserve review cadence and approval thresholds
4. Weekly open-claims huddle agenda

Beginner-safe definitions

Triage: quickly classifying the claim by severity and urgency.

Reserve: expected future payment for an open claim.

Severity: expected cost impact based on the claim type and facts.

Step-by-step implementation

Step 1: Standardize intake

Claims intake should capture facts, not opinions.

Claims intake form (copy and paste)

Copyable template (TEXT)
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Claims Intake Form

Date of loss:
Reported date:
Line of coverage:
Location:
Business unit:
Description of incident:
People involved:
Immediate actions taken:
Police or incident report available: [yes/no]
Photos or evidence link:
Claim reporter name and contact:
Owner:

Step 2: Apply triage rules

Triage checklist (copy and paste)

Copyable template (TEXT)
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Triage Checklist

Severity signals:
- Injury involved: [yes/no]
- Property damage above threshold: [yes/no]
- Litigation risk indicators: [yes/no]
- Third party involved: [yes/no]
- Vendor involvement: [yes/no]

Routing:
- Standard handling
- Escalate to risk lead
- Escalate to legal

Step 3: Establish reserve approval thresholds

Define who can approve reserve changes.

Reserve change record (copy and paste)

Copyable template (TEXT)
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Reserve Change Record

Claim ID:
Current reserve:
Proposed reserve:
Reason for change:
Evidence link:
Approved by:
Approval date:

Step 4: Weekly open-claims huddle

Weekly claims huddle agenda (copy and paste)

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Weekly Claims Huddle (30 minutes)

1) New claims this week and triage outcomes
2) Top open claims by incurred
3) Reserve changes and rationale
4) Claims with stalled progress and next actions
5) Subrogation candidates and recovery status

Common failure modes

• intake happens through email threads and gets lost
• no triage, so high severity claims sit too long
• reserves change without an approval record
• no weekly cadence, so open claims drift