# ClaimVision > ClaimVision is an AI claims intelligence platform for US property carriers. It turns every page of a claim into structured data before your team opens the file, and lets them question that data with the evidence attached. Last updated: 2026-10-09 ClaimVision is built by Decision Agency. The outcome it is bought for is claims cycle time: the reading is done before the file is opened, so the days a file waits come off the clock, inside the state prompt-payment and fair-claims-practices deadlines. The reading goes to the machine; the judgement stays with your people. ClaimVision is not a replacement claims system. It is an intelligence layer that sits on top of the systems a carrier already owns, reads what is already there, and hands back judgement. The carrier's core system remains the system of record; the carrier's people keep the decision. ClaimVision started with the AI rather than adding it to an existing claims platform. What it does, in business language: every page of the claim file read before the file is opened; a one-page view of a several-hundred-page claim; claims data your team can question in plain English ("are the solar panels covered at replacement cost?") that answers with the specific clause, the reasoning, and the dollar impact; coverage checked carefully and consistently on every claim; the fine print read together and explained in plain terms; figures held steady from the estimate to the letter; and a complete audit trail of every recommendation and every human override. The reading goes to the machine; the judgement stays with your people. ## The honest proof point ClaimVision did a full day's reconciliation work on a real large-loss claim, done exactly, in under a minute. This is the only quantified claim ClaimVision makes today. Every finding ClaimVision returns is cited to its clause and page, and carriers can test it first on closed files they have already decided (the closed-file benchmark). It is built on real policies, inspection reports and claims, from first notice of loss to the decision letter. Broader results (leakage recovered, cycle time returned) are being measured on real, undecided claims alongside the human process; they will be published when measured, not before. ## Status - Runs on Microsoft Azure and is built to SOC 2 principles. Decision Agency is working towards a SOC 2 Type 2 audit; ClaimVision is not yet SOC 2 certified - A carrier's claim data never trains another carrier's models; each carrier's models learn from its own data - ClaimVision is a product of Decision Agency. Legal entity: Decision Agency OÜ · Ahtri tn 12, 15551 Tallinn, Estonia · Registry code 17184257. Decision Crew is the separate consulting and integration firm. ## Pages ### Start here - [ClaimVision: AI Claims Intelligence for US Property Carriers](https://claimvision.ai/): AI claims intelligence for US property carriers: every page of every claim read before the file is opened, each finding tied to its clause. No core swap. - [What Is AI Claims Intelligence? Property Carrier Guide](https://claimvision.ai/ai-claims-intelligence): AI claims intelligence is software that reads every document in a claim file and returns findings with the evidence. How it differs from claims automation. ### Platform - [Keep Guidewire, Duck Creek or Sapiens: Add an AI Layer](https://claimvision.ai/integrations): Add AI claims intelligence alongside Guidewire ClaimCenter, Duck Creek, Sapiens or in-house systems. ClaimVision reads the documents they hold. No migration. - [AI Property Claims Review: Every Page Read](https://claimvision.ai/platform): ClaimVision reads the adjuster report, estimate, policy, endorsements and photos before your team opens the file, citing clause and page for each finding. - [Ask Your Claims Data in Plain English](https://claimvision.ai/platform/ask): Ask questions of a property claim file in plain English. Every answer from ClaimVision carries its source clause, page and dollar impact, not a chatbot guess. - [AI Claims Audit Trail for Regulators](https://claimvision.ai/platform/audit): An AI claims audit trail that keeps every finding, source, recommendation and human override, so carriers can answer regulators and defend each decision. - [AI Coverage Checking for Property Claims](https://claimvision.ai/platform/coverage): AI coverage checking for property claims: the policy and every endorsement read together, each finding with its clause and dollar impact. - [Security: Azure Hosting & Claims Data Handling](https://claimvision.ai/security): How ClaimVision protects claims data: Microsoft Azure in the US, isolated per customer, encrypted in transit and at rest, no cross-customer training. ### Solutions - [AI for Property Adjusters: Training & Capacity](https://claimvision.ai/solutions/capability): Help new desk and field adjusters learn coverage faster: ClaimVision shows the policy clause behind every finding, so judgement grows on live claims. - [Catastrophe Claims Surge: Hurricane & Hail AI](https://claimvision.ai/solutions/cat): Handle a hurricane, hail or wildfire claims surge with the same team: ClaimVision reads every file first so adjusters keep the same care at storm volume. - [Reduce Property Claims Cycle Time](https://claimvision.ai/solutions/cycle-time): How property carriers cut claims cycle time inside state prompt-payment deadlines: remove the days a file waits to be read. With the NAIC deadline reference. - [Claims Leakage in Property Insurance: Causes & Fixes](https://claimvision.ai/solutions/leakage): Claims leakage comes from missed exclusions, unapplied deductibles and figures that never reconcile. The five sources, each with a worked dollar example. ### Who it is for - [AI Claims Tool for Property Claims Managers](https://claimvision.ai/for/claims-managers): For property claims managers: every overnight claim already read and sorted by what it needs, so desk adjusters spend the day deciding, not reading. - [AI Claims Software for Claims Executives](https://claimvision.ai/for/executives): The P&L case for AI claims intelligence: shorter cycle time inside the prompt-payment clock, leakage and LAE that move with it, and no re-platforming. - [AI Claims Platform for IT Leaders: Azure, No Migration](https://claimvision.ai/for/it-leaders): An Azure-hosted AI layer on your core claims system: no data migration, no new system of record, data isolated per carrier. What your security review needs. ### Comparisons (competitor facts from their public pages, checked 4 Oct 2026) - [ClaimVision and Guidewire ClaimCenter: Add, Not Replace](https://claimvision.ai/compare/guidewire-claimcenter): Keep Guidewire ClaimCenter as your system of record and add AI that reads the whole property claim file. What stays in ClaimCenter and what the layer adds. - [ClaimVision vs Shift Technology for Property Claims](https://claimvision.ai/compare/shift-technology): ClaimVision vs Shift Technology: a multi-line AI agent and fraud platform, or a property-only reader of the claim file that sits alongside your fraud stack. - [ClaimVision vs Sprout.ai: Property Claims Compared](https://claimvision.ai/compare/sprout-ai): ClaimVision vs Sprout.ai for US property carriers: multi-line claims automation or a reader of the whole property file. Sourced side-by-side, checked Oct 2026. - [ClaimVision vs Tractable: Auto Photos or the Whole Claim?](https://claimvision.ai/compare/tractable): ClaimVision vs Tractable: photo-based auto appraisal, or the whole property claim, with photos read alongside the policy, estimate and reports. Sourced. ### Resources - [AI in Property Claims Ebook: From Hindsight to Foresight](https://claimvision.ai/resources/ebook): Free 26-page ebook for property insurers: the pressures on claims, where AI pays back and how to move from pilot to production. Every figure sourced. - [ClaimVision FAQ: 100+ Questions Answered](https://claimvision.ai/resources/faq): Direct answers about ClaimVision: what it is, whether it replaces your claims system, data and security, cycle time, leakage, CAT surge and cost. - [Property Claims Glossary: 36 Terms with Examples](https://claimvision.ai/resources/glossary): Plain definitions of US property claims terms (ACV, RCV, recoverable depreciation, proof of loss, wind/hail deductible and more), each with a dollar example. - [AI Claims ROI Calculator for Property Carriers](https://claimvision.ai/resources/roi): Model AI claims ROI on your own assumptions: claim volume, review hours, adjuster cost, leakage rate and price. Worked example included. Not a quote. - [Property Claim Walkthrough: Wind & Hail Example](https://claimvision.ai/resources/walkthrough): Follow one wind and hail claim on an HO-3 policy through ClaimVision in six screens, from upload to coverage findings to the decision letter. ### Guides and essays - [Blog: Property Claims, AI and Adjusters](https://claimvision.ai/blog): Guides and essays on AI in property claims: unstructured documents, claims automation vs intelligence, CAT surge, coverage judgement calls and audit trails. - [Property claim example, upload to letter](https://claimvision.ai/blog/a-property-claim-walked-through): A property claim example, start to finish: one fictitious wind and hail claim in Oklahoma, its seven coverage traps, and the calls its adjuster makes. - [Claims Automation vs Claims Intelligence: Key Differences](https://claimvision.ai/blog/claims-intelligence-vs-claims-automation): Claims automation moves the claim; claims intelligence reads it. What each does, where automation stops, and which a property carrier needs first. - [What a claim file should remember | ClaimVision blog](https://claimvision.ai/blog/file-memory): Most claim files keep the conclusion and lose the reasoning. Why that costs twice, in disputes and lost know-how, and why ClaimVision's record is append-only. - [Ambiguous Policy Language: What AI Should Do](https://claimvision.ai/blog/judgment-calls): When policy wording reads two ways, AI should not decide silently. Present both readings with their dollar impact and let the adjuster rule. - [Alternatives to Manual Review of Claims PDFs and Notes](https://claimvision.ai/blog/manual-claims-review-alternatives): Three alternatives to manual claims file review: more reviewers or outsourced desk review, extraction tools, or an AI layer that reads the whole file. Compared. - [The most human we've ever been | ClaimVision blog](https://claimvision.ai/blog/most-human): The scarce resource in claims was never judgement or care. It was time, eaten by reading. What claims work looks like when the machine does the reading. - [Why we publish exactly one number | ClaimVision blog](https://claimvision.ai/blog/one-number): AI vendor sites are walls of round statistics. Ours quotes one measured result and labels the rest as still being measured. Why claims auditors deserve that. - [What 400,000 Retirements Cost a Claims Team](https://claimvision.ai/blog/retirement-wave): The claims workforce is retiring faster than it can be replaced. Why the real loss is judgment, not headcount, and what a claims team can do before it leaves. - [Hurricane Claims Surge: You Can't Hire Your Way Out](https://claimvision.ai/blog/september): A hurricane multiplies the claims queue within days. Why CAT staffing plans answer volume but not variance, and what breaks first in surge week. - [Unstructured Claims Documents: Insight Without a Core Swap](https://claimvision.ai/blog/unstructured-claims-documents): How property carriers turn unstructured claims documents (PDFs, estimates, notes, policies) into decisions without replacing Guidewire or Duck Creek. ### Property claims glossary (one page per term) - [Actual cash value: definition](https://claimvision.ai/resources/glossary/actual-cash-value): Actual cash value (ACV) is what damaged property was worth at the time of loss, usually calculated as replacement cost minus depreciation. On a property. - [Adjuster: definition and example](https://claimvision.ai/resources/glossary/adjuster): An adjuster is the professional who investigates a claim, establishes the facts, applies the policy and recommends or makes the payment decision. On a. - [Bad faith: definition and example](https://claimvision.ai/resources/glossary/bad-faith): Bad faith is the legal exposure a carrier faces when it handles a claim unreasonably, for example through unreasonable delay, an inadequate investigation. - [CAT event: definition and example](https://claimvision.ai/resources/glossary/cat-event): A CAT event is a catastrophe, such as a hurricane, hailstorm or wildfire, that produces a surge of claims across a region in a short window. It matters. - [Claim file: definition and example](https://claimvision.ai/resources/glossary/claim-file): The claim file is everything the carrier holds on a claim: the first notice, the policy and endorsements, reports, estimates, photos, correspondence. - [Claims leakage: definition and example](https://claimvision.ai/resources/glossary/claims-leakage): Claims leakage is the difference between what a carrier should have paid under the policy and what it actually paid, through overpayments, missed. - [Coverage determination: definition and example](https://claimvision.ai/resources/glossary/coverage-determination): A coverage determination is the decision on whether, and to what extent, a policy responds to a loss, based on the policy wording and the facts of the. - [Cycle time: definition and example](https://claimvision.ai/resources/glossary/cycle-time): Cycle time is the elapsed time from first notice of loss to resolution, usually measured to first payment or to closing. It is the measure families feel. - [Declarations page: definition and example](https://claimvision.ai/resources/glossary/declarations-page): The declarations page is the summary page of a policy that lists the named insured, property address, policy period, coverage limits, deductibles and the. - [Deductible: definition and example](https://claimvision.ai/resources/glossary/deductible): A deductible is the part of a covered loss the insured bears before the policy pays, set either as a flat dollar amount or as a percentage of the dwelling. - [Depreciation: definition and example](https://claimvision.ai/resources/glossary/depreciation): Depreciation is the reduction in an item's value from age, wear and condition, applied line by line to turn replacement cost into actual cash value. It. - [DP-3 policy: definition and example](https://claimvision.ai/resources/glossary/dp-3-policy): A DP-3 is a dwelling fire policy form commonly used for rental and other non-owner-occupied homes, covering the dwelling on an open-perils basis. Personal. - [Endorsement: definition and example](https://claimvision.ai/resources/glossary/endorsement): An endorsement is a written change to an insurance policy that adds, removes or narrows coverage, or changes how a loss is settled. On a property claim. - [Endorsement chain: definition and example](https://claimvision.ai/resources/glossary/endorsement-chain): An endorsement chain is the full set of endorsements on a policy, read together, to see which amendment controls a given loss and what is left of the base. - [Exclusion: definition and example](https://claimvision.ai/resources/glossary/exclusion): An exclusion is policy language that removes coverage for specific causes, property or circumstances, such as flood, earth movement, wear and tear or. - [First notice of loss: definition](https://claimvision.ai/resources/glossary/first-notice-of-loss): First notice of loss (FNOL) is the first report to the carrier that a loss has happened, usually from the family, their agent or a contractor. It opens. - [Fraud signal: definition and example](https://claimvision.ai/resources/glossary/fraud-signal): A fraud signal is a pattern in a claim that warrants a closer look before payment, such as damage that does not match the reported cause, no recorded. - [HO-3 policy: definition and example](https://claimvision.ai/resources/glossary/ho-3-policy): An HO-3 is the most common US homeowners policy form: it covers the dwelling and other structures on an open-perils basis, meaning anything not excluded. - [Independent adjuster: definition](https://claimvision.ai/resources/glossary/independent-adjuster): An independent adjuster (IA) is a licensed adjuster who works for an independent adjusting firm or on contract, handling claims on a carrier's behalf. - [Large loss: definition and example](https://claimvision.ai/resources/glossary/large-loss): A large loss is a claim big enough to need senior review or specialist handling, often six figures or more, with hundreds of estimate lines, several. - [Loss run: definition and example](https://claimvision.ai/resources/glossary/loss-run): A loss run is a report of an insured's or a property's claims history, showing dates, causes of loss, amounts paid, reserves and status. Underwriters use. - [Ordinance & law coverage: definition](https://claimvision.ai/resources/glossary/ordinance-and-law-coverage): Ordinance or law coverage pays the extra cost of repairing or rebuilding to meet current building codes, which the base dwelling coverage otherwise limits. - [Peril: definition and example](https://claimvision.ai/resources/glossary/peril): A peril is a cause of loss, such as wind, hail, fire, lightning, water or theft. Coverage often turns on exactly which peril caused the damage, because. - [Prompt-pay laws: definition and example](https://claimvision.ai/resources/glossary/prompt-pay-laws): Prompt-pay laws are state statutes and regulations that set deadlines for acknowledging, investigating, deciding and paying claims, with interest or. - [Proof of loss: definition and example](https://claimvision.ai/resources/glossary/proof-of-loss): A proof of loss is a signed, sworn statement from the insured setting out the amount claimed and the facts behind it, such as the date, cause and value of. - [Public adjuster: definition and example](https://claimvision.ai/resources/glossary/public-adjuster): A public adjuster is a licensed adjuster hired by the insured, not the carrier, to prepare and negotiate their claim, usually for a percentage of the. - [Recoverable depreciation: definition](https://claimvision.ai/resources/glossary/recoverable-depreciation): Recoverable depreciation is the depreciation held back from the first actual cash value payment that the insured can collect once repairs or replacement. - [Replacement cost value: definition](https://claimvision.ai/resources/glossary/replacement-cost-value): Replacement cost value (RCV) is the cost to repair or replace damaged property with materials of like kind and quality, with no deduction for. - [Reserve: definition and example](https://claimvision.ai/resources/glossary/reserve): A reserve is the carrier's running estimate of what a claim will ultimately cost, set early and adjusted as the facts develop. Reserves are not payments. - [Salvage: definition and example](https://claimvision.ai/resources/glossary/salvage): Salvage is the carrier's right to take damaged property it has paid for in full and recover its remaining value, usually by selling it. The amounts are. - [Scope of loss: definition and example](https://claimvision.ai/resources/glossary/scope-of-loss): The scope of loss is the itemized description of what was damaged and what work is needed to repair it, the factual base under the estimate. It matters. - [Statement of loss: definition and example](https://claimvision.ai/resources/glossary/statement-of-loss): A statement of loss is the document that sets out what the carrier proposes to pay: the gross loss by coverage, depreciation, the deductible, prior. - [Straight-through processing: definition](https://claimvision.ai/resources/glossary/straight-through-processing): Straight-through processing (STP) is when a claim moves from report to payment without manual handling because every check has passed: coverage is clear. - [Subrogation: definition and example](https://claimvision.ai/resources/glossary/subrogation): Subrogation is the carrier's right, after paying a claim, to recover that payment from the third party who caused the loss, such as a negligent contractor. - [Supplement: definition and example](https://claimvision.ai/resources/glossary/supplement): A supplement is an addition to an approved estimate for damage or costs found after the first inspection, such as rotted decking discovered when a roof is. - [Wind/hail deductible: definition and example](https://claimvision.ai/resources/glossary/wind-hail-deductible): A wind/hail deductible is a separate deductible for wind and hail losses, usually set as a percentage of the dwelling limit rather than a flat dollar. ### Company and policies - [About ClaimVision and Decision Agency](https://claimvision.ai/about): Why ClaimVision exists: AI that does the reading so claims people keep the judgement. Who builds it, how we work and what we have proven so far. - [Compare AI Claims Software for Property Carriers](https://claimvision.ai/compare): ClaimVision compared with Sprout.ai, Shift Technology, Tractable and Guidewire ClaimCenter: sourced, dated, and honest about where each one fits better. - [Book a ClaimVision Demo: Bring a Closed Claim](https://claimvision.ai/contact): Book a 30-minute ClaimVision demo on a closed claim you already know, or start with the closed-file benchmark: decided files, no integration required. - [Cookie policy](https://claimvision.ai/cookies): The ClaimVision website sets cookies only if you accept analytics: Google Analytics, by consent, with each cookie listed by name, purpose and lifetime. - [AI Vantage: The Newsletter on AI in Property Claims](https://claimvision.ai/newsletter): AI Vantage is the free ClaimVision newsletter for property claims leaders: what changed, what it means for a claims operation, and what to do on Monday. - [Privacy policy](https://claimvision.ai/privacy): How the ClaimVision website handles your data: what we collect, why, how long we keep it and your rights under GDPR and CCPA. Claim data is under contract. ## Machine-readable data - [FAQ as JSON](https://claimvision.ai/api/faq.json): 103 questions and answers. - [Glossary as JSON](https://claimvision.ai/api/glossary.json): 36 US property claims terms with definitions and worked examples. - [Full text for language models](https://claimvision.ai/llms-full.txt): this file plus every FAQ answer and every glossary term. - [Sitemap](https://claimvision.ai/sitemap.xml) ## Full FAQ (103 questions) ### What is ClaimVision? ClaimVision is an AI claims intelligence platform for US property carriers. It turns every page of a claim into structured data before your team opens the file, and lets them question that data with the evidence attached. Built by Decision Agency, it reads the adjuster's report, the estimate, the policy and all its endorsements, and the photos; checks coverage carefully on every claim; ties each finding to a specific clause with its dollar impact; and keeps a complete audit trail. It does not make the decision; it makes sure the person making the decision has everything in front of them. ### Does ClaimVision replace my claims system? No. ClaimVision is an intelligence layer that sits on top of the systems a carrier already owns. Your core claims system remains the system of record; ClaimVision reads the documents it already holds and hands back judgement: findings, reasoning, and reconciled figures. Nothing is migrated, and your team keeps working where they work today. Carriers don't have a software shortage; they have an intelligence shortage. ### How does ClaimVision handle endorsements? By reading them the way they were written to be read: together. Real policies are layers of amendments that change each other's meaning. ClaimVision works out what they add up to for each coverage question, and shows the reasoning: the operative clause, why it applies, and the settlement consequence in dollars. That reasoning trail is what lets a claims manager defend a decision, not just make it. ### What documents does ClaimVision read? Every document in the claim file: the policy and its full endorsement stack, the declarations page, adjuster and inspection reports, repair estimates down to the last line item, statements of loss, proof of loss, photos with their captions and labels, and correspondence. If it's in the file, it has been read before the adjuster opens the claim. ### How accurate is it? Here is the result we have proven: ClaimVision did a full day's reconciliation work on a real large-loss claim, done exactly, in under a minute. Every finding is cited to its clause and page, from first notice of loss to the decision letter. Broader accuracy metrics are being measured on real, undecided claims alongside the human process. We publish what we have measured, not what we hope; and when ClaimVision is not confident, it says so and puts the question in front of a person. ### Is it auditable? Yes, completely. Every AI recommendation, every source it cited, every confidence level, and every human override is preserved. Nothing is overwritten. A regulator, reinsurer, or court can see what the system found, what it recommended, what the human decided, and why. Consistency plus documentation is also the strongest practical protection against bad-faith exposure. ### Where is our data stored? In an enterprise-grade Microsoft Azure environment. Claim data is stored in US regions and encrypted in transit and at rest, each user sees only their own company's claims, and a carrier's claim data never trains another carrier's models. Detailed security documentation is available under NDA. ### Is our claims data used to train AI models? Never for another carrier. Each carrier's models learn from that carrier's own data, inside its own isolated deployment, so ClaimVision gets better at your way of working: when your adjusters rule on judgment calls or override a recommendation, those rulings and any reasons they record inform how similar situations are presented to your team next time. That learning stays yours. What we learn about claims in general improves the product; your documents, data and decisions are never copied into another customer's deployment. ### How long does implementation take? Weeks, not quarters. Because ClaimVision reads the claim documents you already have rather than requiring migration or re-platforming, a carrier can start with a parallel test on real closed or in-flight claims almost immediately. The typical path: closed-file benchmark, then live parallel test, then production use as trust is earned. ### What does it integrate with? With the claims stack you already run, without replacing any of it. ClaimVision works from the claim documents your systems already hold: the policy, the adjuster and inspection reports, the estimate, the photos. How those documents reach ClaimVision is agreed with your team; the first step needs nothing more than a set of claim files. It returns findings, reconciled figures and decision support, and the system of record stays the system of record. ### How is ClaimVision different from other AI claims tools? ClaimVision started with the AI rather than adding it to an existing claims platform, and it does one job: it reads the whole US property claim file and the policy before the adjuster opens it. Practically, that means depth where it matters: the fine print read and reasoned through, figures held steady from the estimate to the letter, findings that always carry their clause and dollar impact, and claims data your team can question in plain English. The adjuster decides; every recommendation and override is kept. ### Can it handle CAT volume? Yes. Surge is where it earns its keep. Every claim gets the same careful coverage check whether it arrives on a quiet Tuesday or in the week after a hurricane makes landfall. Routine claims that check out cleanly arrive ready for a quick decision and a drafted letter, which frees adjusters' time for the complex ones. That is the difference between coping with a CAT event and drowning in it, without proportional surge headcount. ### What policy forms does it support? US property forms: homeowners (HO-3 and related forms) and dwelling fire (DP-3 and related), including carrier-specific manuscript endorsements. ClaimVision reads the carrier's own endorsements together with the national standard forms and the state endorsements, and works out which wording governs where a state or carrier endorsement overrides the national form. It is read, reasoned through, and cited like everything else. ### What does it cost? Pricing is by claim volume and scope, set during the pilot conversation. We'd be inventing a number to print one here. The value calculator at /resources/roi lets you model the economics on your own assumptions (claim volume, review time, leakage rate, loaded cost); it is explicitly labelled as your assumptions, not our promises. ### How do you reduce claims cycle time on property claims? Take the waiting out of the file. Most of a property claim's cycle time is days a file spends unread, waiting for someone to work through the report, the estimate and the policy, and days between a decision and its letter. When the reading is done before the adjuster opens the file and the letter drafts from the decision, those days come off the clock. ### What is the average cycle time for a US homeowners claim? J.D. Power's 2026 U.S. Property Claims Satisfaction Study reports an average of 40.7 days to final payment on homeowners claims. Catastrophe claims usually run longer, because the volume arrives in the same week the staffing does not change. Source (checked 4 Oct 2026): https://www.jdpower.com/business/press-releases/2026-us-property-claims-satisfaction-study ### What are prompt payment laws for property insurance claims? They are state rules that set deadlines to acknowledge a claim, investigate it, accept or deny it, and pay it. The counts differ by state and change often: Florida, for example, requires residential property insurers to pay or deny within 60 days of notice, while Texas counts some deadlines in business days from receipt of the items it requested. Check each state's current statute. Source (checked 4 Oct 2026): https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0600-0699/0627/Sections/0627.70131.html ### Does AI shorten claims cycle time by deciding claims for the adjuster? Not with ClaimVision. The reading goes to the machine; the judgement stays with your people. ClaimVision shortens the wait before a decision and after it, and the adjuster still makes it. ### Does the prompt-payment clock stop during a catastrophe? Rarely, and never for long. Some states allow limited extensions after a declared catastrophe, such as fifteen extra days in Texas or up to thirty more in Florida by regulator order, but the volume rises far faster than the deadlines move. Source (checked 4 Oct 2026): https://statutes.capitol.texas.gov/Docs/IN/htm/IN.542.htm ### What is an AI claims audit trail? An AI claims audit trail is the record of how an AI-assisted claim decision was reached: each finding and the page or photo it came from, what the system recommended and how confident it was at the time, the human decision, the reasoning for any override, and the order it all happened in. A good one is append-only: nothing is edited in place. ### How do insurers defend AI-assisted claim decisions to regulators? With the record made at the time, not a reconstruction. A regulator's first question is how the decision was reached; a carrier that can produce the clause, the recommendation, the confidence and the human ruling, in order and unedited, can answer it in minutes. ### Does an AI claims audit trail help with bad-faith claims? Yes. Bad-faith claims feed on inconsistency: like claims treated unalike with nothing in the file to explain why. The same careful check on every claim, with every deviation reasoned in writing, is the strongest consistency evidence a claims organisation can hold. ### Does ClaimVision make the claim decision? No. ClaimVision reads the file, finds the coverage traps and recommends. The adjuster decides, and when an adjuster overrides a recommendation, both readings stay in the file side by side with the reasoning. ### Does ClaimVision replace our claims system? No. ClaimVision reads the documents your core claims system already holds and hands back findings. Guidewire ClaimCenter, Duck Creek, Sapiens or an in-house system stays the system of record, and nothing is migrated. ### What does the adjuster still do on a claim ClaimVision has read? The adjuster decides. ClaimVision does the reading, surfaces the coverage traps with the clause and dollar impact attached, and drafts the letter from the decision. Approving, adjusting or overriding a recommendation stays with the adjuster, and every override is kept, with the adjuster's reason when they add one. ### How is a claim decision defended in a dispute? With the record. Every finding points at the page or photo it came from, and every recommendation and human override is kept, nothing overwritten. When a policyholder, a public adjuster, a regulator or a court asks why, the answer is already written down. ### What is AI claims intelligence? AI claims intelligence is software that reads every document in a claim file, the adjuster report, the estimate, the policy and its endorsements, and the photos, and returns findings a person can act on, each with the evidence attached. It informs the claim decision; it does not take it. ### Is AI claims intelligence the same as claims automation? No. Claims automation moves the claim: intake, routing, straight-through payment of simple files. Claims intelligence reads the claim and shows its work, so the person deciding a complicated file has the fine print, the numbers and the evidence in front of them. Most carriers need both, for different files. ### What is the best AI claims software for property insurers? It depends on the job you are hiring it for. For photo estimating, use a photo tool; for fraud, a fraud platform; for the system of record, your core claims system. If the job is reading the whole property file and the policy wording before the adjuster opens it, with every finding traceable to its page, that is the job ClaimVision is built for. ### Does AI claims intelligence replace adjusters? No. The reading goes to the machine; the judgement stays with your people. ClaimVision does the reading that eats the working day, and the adjuster decides with everything in front of them. ### Do we need to replace our claims system to use AI claims intelligence? No. You do not need to replace Guidewire ClaimCenter, Duck Creek, Sapiens or an in-house system. An intelligence layer reads the documents the core system already holds; nothing is migrated. ### What is AI property claims review? AI property claims review means software reads every document in a property claim and returns findings for a person to decide. ClaimVision reads the loss report, the photos, the estimate and the policy before your team opens the file. Each finding carries its source and its dollar impact, and the decision stays with the adjuster. ### Does AI claims review replace adjusters? No. The reading goes to the machine. The judgement stays with your people. Adjusters spend their hours on the calls that need a person instead of on locating, re-keying and reconciling. ### What documents does ClaimVision read on a property claim? Every page of the file: the loss report, the inspection report, the photos, the estimate down to its last line, and the policy with everything attached to it. They are read together, so a line in the estimate can point to the clause that limits it. ### How does AI claims review shorten claims cycle time? It removes the wait for someone to read the file. With ClaimVision the file is read before an adjuster opens it, so the first touch starts with the findings, not the paperwork. That takes waiting days off cycle time, inside the state prompt-payment clock. ### Can every AI finding be traced back to the policy? Yes. Each finding names the document and page it came from and the clause that decides it. Every recommendation and every human override is kept in the record, so the file can answer for itself in a review. ### What is policy coverage checking on a property claim? Policy coverage checking is confirming what the policy actually promises for this loss before the claim is paid or denied. That means the base policy and everything attached to it, read against the facts of the claim. ClaimVision does that reading on every claim and shows the adjuster each finding with its clause and dollar impact. ### How do insurers catch endorsements that change a payout? By reading every endorsement on every claim, not only the familiar ones. Misses usually come from time pressure, not from a lack of knowledge. ClaimVision reads the whole policy before the file is opened and flags any limitation with its clause and its dollar impact on the claim. ### Does ClaimVision make the coverage decision? No, the adjuster decides. ClaimVision brings the findings, the clause and the dollar impact, and where language can be read more than one way it sets out the options and leaves the call to a person. Any override is kept in the audit trail, with the adjuster's reason when they give one. ### How does coverage checking reduce claims leakage? It finds the limitation before the payment goes out. Leakage often comes from a clause nobody had time to read or a payment made on the wrong basis. When every claim gets the same careful check, those findings surface with the dollar figure attached, while there is still time to act on them. ### What is claims leakage in property insurance? Claims leakage is the gap between what the policy says a carrier owed and what it actually paid. In property claims it usually comes from missed exclusions, limits and deductibles applied wrongly, figures that do not reconcile, and recoveries nobody pursued. It is rarely one large error. It is many small ones. ### How do insurers reduce claims leakage? Insurers reduce claims leakage by making sure every page of the file is read and every figure reconciles before payment goes out. File reviews and audits find leakage after the money has left. ClaimVision reads every page of every claim first and shows each finding with its clause and dollar impact, so the adjuster can act before payment. ### How much claims leakage will ClaimVision recover for us? We will not invent that number for you, and you should not trust anyone who does. It depends on your book, your policy forms and your team. What we can show is a full day's reconciliation work on a real large-loss claim, done exactly, in under a minute. Model the rest on your own assumptions in the claims AI value calculator. ### Does ClaimVision decide whether a claim is paid? No. ClaimVision finds the exclusions, limits and reconciliation errors and shows where each one came from. Your adjuster makes the decision, and every recommendation and every override is kept in the audit trail. ### How do insurers handle a catastrophe claims surge? Most carriers handle a catastrophe claims surge by triaging, bringing in independent adjusters and accepting that some care slips. The reading is the part that does not scale: every file still has to be read before anyone can decide it. ClaimVision reads every page of every claim as it arrives, so your team spends the surge week deciding rather than reading. ### Does a hurricane stop the prompt-payment clock? No. Some states allow a fixed extension after a declared catastrophe, but the clock keeps running. Texas, for example, extends its claim-handling deadlines by 15 days after a weather-related catastrophe or major natural disaster declared by the commissioner (Texas Insurance Code section 542.059). Check your own states' rules before the season, not during it. Source (checked 4 Oct 2026): https://statutes.capitol.texas.gov/Docs/IN/htm/IN.542.htm ### Does ClaimVision replace adjusters during a CAT event? No. The reading goes to the machine. The judgement stays with your people. Claims that need judgement reach an adjuster with the evidence assembled and the dollar impact of each choice shown. ### When should a carrier prepare for a CAT surge? Before the season. The worst time to evaluate surge tooling is during a surge. Trust in letting routine claims move quickly is earned against your own team's decisions, so starting early means that trust is in place when the storm lands. ### How can AI help train new insurance adjusters? AI helps train new adjusters when every answer shows its working. ClaimVision shows the clause, the reasoning and the dollar impact behind each finding, so every live claim becomes a worked example. The adjuster still makes the decision. ### Will AI replace insurance adjusters? Not with ClaimVision. The reading goes to the machine. The judgement stays with your people. Investigation, judgement and helping families through their worst week remain the adjuster's job, with more time for each. ### Can a new adjuster rely on ClaimVision's findings? A new adjuster can check every finding, which is the point. Each one points to the page and clause it came from, so the adjuster reads the source before deciding. The same careful coverage check runs on a first-year adjuster's file as on a veteran's. ### How does ClaimVision help adjuster capacity? It takes the reading off the desk. Every page is read before the adjuster opens the file, so their time goes to decisions, calls and inspections. In a storm week, that is the difference between a hard week and a lost quarter. ### Does ClaimVision integrate with Guidewire ClaimCenter? You do not need to replace Guidewire ClaimCenter to use ClaimVision; it stays your system of record. ClaimVision works from the claim documents, so the first step needs nothing more than a set of claim files. Ask us how documents would reach ClaimVision in your environment, and we will answer for your setup rather than with a logo list. ### How long does it take to add an AI layer to a core claims system? Weeks, not quarters, because nothing is migrated and nothing is replaced. The first step is a set of closed claim files, read by ClaimVision and compared with what your team decided. Anything closer to your workflow is scoped after that, at a pace you control. ### Do we have to migrate claims data? No. Your claims data stays in your core system, which remains the system of record. ClaimVision works on copies of the documents it reads and keeps its own record of findings and decisions for audit. ### Can we use ClaimVision with Duck Creek, Sapiens or an in-house claims system? You do not need to replace any of them. ClaimVision reads the claim file, not a particular platform: it works from the claim documents your systems already hold, and how those documents reach it is agreed with your team. ### How does AI claims software reduce claims cycle time? It takes the reading off the critical path. ClaimVision reads every page of a claim before the adjuster opens the file, so the days a file waits to be read come off the cycle. The adjuster still decides, starting from the findings instead of a stack of documents. ### What ROI can a property carrier expect from AI in claims? We will not quote a multiple we have not measured on your book. What we can show is a full day's reconciliation work on a real large-loss claim, done exactly, in under a minute, with every finding cited to its clause and page. The claims AI value calculator lets you enter your own assumptions and see the arithmetic. ### Does AI claims software mean re-platforming our core system? No. ClaimVision is a layer on the systems you already run, so Guidewire ClaimCenter, Duck Creek, Sapiens or an in-house system stays the system of record. That keeps the investment case free of migration risk. ### Will AI replace our adjusters? No. The reading goes to the machine. The judgement stays with your people, who approve, change or override every recommendation, and every override is kept, with the adjuster's reason when they add one. ### How does an AI claims tool help a claims manager? It takes the reading off your team's desks. Every overnight claim is read before anyone opens it and sorted by what it needs from a person, and the hard ones arrive with the judgement calls isolated and the evidence attached. You and your team spend the day deciding. ### Can an AI claims tool help clear a claims backlog after a storm? Yes. The reading is the part of the job that grows with the queue, and it is the part ClaimVision takes. Once your team trusts the findings, routine claims can move straight to letter, and your people spend their time on the claims that need judgement. ### How do new adjusters learn coverage with AI claims intelligence? By asking it. Every answer comes with the clause it rests on and the reasoning that connects them, so each answer teaches the pattern. New adjusters still bring the genuinely hard questions to you. ### What happens when an adjuster disagrees with the AI? The adjuster decides. The adjuster can add a written reason when overriding a recommendation, and both the recommendation and the override are kept in the record, nothing overwritten. ### Where is ClaimVision hosted? In an enterprise-grade Microsoft Azure environment, in US regions. Carrier data is logically isolated per customer and encrypted in transit and at rest, and each user sees only their own company's claims. ### Does an AI claims platform need access to our core claims system? Not to start. The first step works on a set of closed claim files, with no change to your workflow. How documents reach ClaimVision after that is scoped with your team, and your core system stays the system of record. ### What documentation is available for a security review? Detailed security architecture and data-processing agreements are available under NDA, and the public summary is on the security page. Send your questionnaire early; we would rather clear it alongside the pilot than after it. ### Do we need to replace our claims system to use AI on claims documents? No. You do not need to replace Guidewire ClaimCenter, Duck Creek, Sapiens or whichever core system you run. An intelligence layer reads the claim documents that system already holds. Nothing is migrated, and the system of record stays the system of record. ### How long does it take to see value from AI on unstructured claims documents? Weeks, not quarters. The usual path is a closed-file benchmark, then a live parallel test, then production use as trust is earned. ### Who makes the claim decision when AI reads the claims documents? Your people. ClaimVision does not make the decision. It makes sure the person who does has everything in front of them. ### What is the difference between claims automation and claims intelligence? Claims automation performs process steps by rule, such as FNOL intake, routing and straight-through payment of simple claims. Claims intelligence reads the claim's documents, including the policy and its endorsements, and hands the adjuster findings with the evidence attached. One moves the claim; the other reads it. ### Is claims intelligence the same as straight-through processing? No. Straight-through processing pays claims that meet set criteria without a handler. Claims intelligence reads every claim, including the ones that need a person, and shows that person what the file says. A claim that has been read in full is also easier to trust as routine. ### Does claims intelligence make the claim decision instead of the adjuster? Not with ClaimVision. The reading goes to the machine and the judgement stays with your people. Findings arrive with the clause and the dollar impact attached, and the adjuster approves, adjusts or overrides, with every override kept on the record. ### Should a property carrier invest in claims automation or claims intelligence first? Start where the days are lost. If claims wait unread in shared queues or first notice data is rekeyed by hand, fix intake and routing first. If the hours go into claims a person has to decide, the reading is the bottleneck and claims intelligence pays back first. ### What are the alternatives to manual claims review? There are three: more reviewers, in-house or outsourced; rules and extraction tools that pull fields from the documents; and an intelligence layer that reads the whole claim file and returns findings with the evidence attached. The first adds hours, the second adds data, the third adds the reading. The decision stays with your adjusters in all three. ### Is outsourced desk review a good alternative to in-house claims review? It adds capacity when the extra volume is predictable, and good desk reviewers bring real experience. It does not change the speed of the reading, and outside reviewers need time to learn your forms. In a catastrophe week, capacity that grows one reviewer at a time falls behind the queue. ### Can AI read claims PDFs and adjuster notes? Yes. An intelligence layer reads the claim's PDFs, adjuster notes, estimate, policy and photos together and hands back findings with the page and clause attached. It does not decide the claim. The reading goes to the machine; the judgement stays with your people. ### How do you test an AI claims review tool before using it on live claims? Run it on closed claims you already know the answer to. Compare its findings and figures with what your team decided, and check that every finding points to the page it came from. Then run it alongside your process on live claims before anyone relies on it. ### What is a coverage trap on a property claim? A coverage trap is a provision that changes what a claim pays and is easy to miss, such as a limitation on solar panels, a cosmetic damage exclusion or the absence of ordinance or law coverage. Traps sit in the policy and its endorsements, often far from the pages that describe the loss. Missed traps are where claims leakage starts. ### Why does roof age change a wind and hail claim payment? Some policies carry a roof surfacing endorsement that settles older roofs at actual cash value instead of replacement cost for wind and hail. In a fictitious example, a 16-year-old roof settled at actual cash value with a $3,830.41 depreciation holdback, while a 12-year-old roof stayed at replacement cost. The roof's age in the inspection report decides which applies. ### What is overhead and profit on a property insurance claim? Overhead and profit is a general contractor's charge for running a repair, on top of the cost of the work itself. Carriers commonly look for evidence that the job needs a general contractor to coordinate several trades, so the file should document which trades are involved. On the fictitious Vasquez example claim, it needs three-trade documentation. ### Who decides a property claim when AI has read the file? The adjuster. With ClaimVision the reading goes to the machine and the judgement stays with your people: findings arrive with the page and clause attached, and the adjuster approves, adjusts or overrides. Every override is kept, with the adjuster's reason when they add one. ### Is ClaimVision an alternative to Sprout.ai? For US property claims, yes. Both read claim documents and check the claim against the policy, so a property carrier will often shortlist both. ClaimVision is built only for US property and reads the whole file for the adjuster, while Sprout.ai's public pages describe one platform across seven sectors, from health and life to pet and travel (checked 4 Oct 2026). If you want one vendor across many lines, Sprout.ai may suit you better. Source (checked 4 Oct 2026): https://sprout.ai/platform/ ### What is the difference between ClaimVision and Sprout.ai? The difference is focus. Sprout.ai's platform page describes modules for document processing, coding and enrichment, coverage checking, fraud flagging and decisioning, aiming to auto-adjudicate most claims through straight-through processing (checked 4 Oct 2026). ClaimVision focuses on US property: it reads every page of the file, policy and endorsements included, returns findings with the clause and dollar impact attached, and leaves the decision with the adjuster. Source (checked 4 Oct 2026): https://sprout.ai/platform/ ### Does ClaimVision decide claims automatically? No. ClaimVision recommends and the adjuster decides, on every claim, and every recommendation and every override is kept. Sprout.ai's platform page describes straight-through processing wherever possible, which suits a carrier whose first goal is taking simple, high-volume claims off handlers' desks. Source (checked 4 Oct 2026): https://sprout.ai/platform/ ### Do I need to replace Guidewire ClaimCenter to use ClaimVision or Sprout.ai? No. Sprout.ai announced a Guidewire Marketplace integration in June 2026, focused on policy checking at first notice of loss. ClaimVision reads the documents your claims system already holds, so you do not need to replace Guidewire ClaimCenter. Ask us how documents would reach ClaimVision in your environment. Source (checked 4 Oct 2026): https://sprout.ai/platform/ ### Is ClaimVision an alternative to Shift Technology? Only in part. Shift Technology's public pages describe AI agents for coverage and liability, fraud and risk, subrogation, injury and healthcare payment integrity (checked 4 Oct 2026). ClaimVision does one job: it reads US property claim files and their policies for the adjuster. Many property carriers would run ClaimVision alongside a fraud stack rather than instead of one. Source (checked 4 Oct 2026): https://www.shift-technology.com/solutions/coverage-liability ### What is the difference between ClaimVision and Shift Technology? The difference is the kind of coverage question each is built around. Shift's coverage product, titled Coverage & Liability, describes assessing liability from police reports, insured and witness statements and negligence laws (checked 4 Oct 2026). ClaimVision focuses on first-party property coverage: the policy and its endorsements read against the adjuster report, the estimate and the photos, with the clause and dollar impact on every finding. Source (checked 4 Oct 2026): https://www.shift-technology.com/solutions/coverage-liability ### Can ClaimVision sit alongside Shift Technology's fraud detection? Yes, as a separate layer with a separate job. ClaimVision reads the property file for coverage and the figures; it is not a fraud tool and does not ask you to replace one. The adjuster sees what each tool found and makes the decision. Source (checked 4 Oct 2026): https://www.shift-technology.com/solutions/coverage-liability ### Does Shift Technology focus on property claims? Its public pages describe agents across P&C, healthcare and life, and its coverage page centres on liability: police reports, statements and negligence (checked 4 Oct 2026). Shift says all of the top five US P&C insurers trust it, so ask Shift directly what it offers a property claims desk. Source (checked 4 Oct 2026): https://www.shift-technology.com/solutions/coverage-liability ### Is ClaimVision an alternative to Tractable? Not really, because they solve different problems. Tractable's English pages focus on appraising vehicle damage from photos for insurers, repairers, dealers, recyclers and fleets (checked 4 Oct 2026). ClaimVision reads the whole US property claim file, policy included. A carrier writing both auto and home could use each where it fits. Source (checked 4 Oct 2026): https://tractable.ai/insurers/ ### What is the difference between ClaimVision and Tractable? Tractable estimates vehicle damage from images; ClaimVision reads a property claim's photos together with the rest of the file and the policy. Tractable's insurer page describes FNOL triage, preliminary repair estimates, claim review and subrogation for vehicle claims (checked 4 Oct 2026). ClaimVision reads the adjuster report, the estimate, the policy and its endorsements and the photos together, and returns findings with the clause and dollar impact for the adjuster to decide. Source (checked 4 Oct 2026): https://tractable.ai/insurers/ ### Does Tractable handle property claims? Tractable's Japanese-language property page describes estimating building repair costs and assessing building condition from images (checked 4 Oct 2026), while its English insurer pages focus on vehicle claims. Ask Tractable about property availability in the US. Source (checked 4 Oct 2026): https://tractable.ai/ja/property/ ### Does ClaimVision read claim photos? Yes. ClaimVision looks at every photo in the file, usually supplied inside the PDF reports, reads its caption and label, and checks whether what the adjuster's report says matches what the photos show. The question ClaimVision answers is what the policy pays on this file, and why. Source (checked 4 Oct 2026): https://tractable.ai/insurers/ ### Does ClaimVision replace Guidewire ClaimCenter? No. You do not need to replace Guidewire ClaimCenter. It stays your claims system; ClaimVision reads the documents your claims system already holds, and nothing is migrated. Source (checked 4 Oct 2026): https://www.guidewire.com/products/core-products/insurancesuite/claimcenter-claims-management-software ### What is the difference between ClaimVision and Guidewire ClaimCenter? ClaimCenter runs the claim; ClaimVision reads it. Guidewire describes ClaimCenter as claims management software that handles a claim from intake to closure (checked 4 Oct 2026). ClaimVision is an intelligence layer for US property claims: it reads every page of the file, returns findings with the clause and dollar impact attached, and leaves the decision with the adjuster. Source (checked 4 Oct 2026): https://www.guidewire.com/products/core-products/insurancesuite/claimcenter-claims-management-software ### How would documents get from Guidewire ClaimCenter to ClaimVision? Ask us how documents would reach ClaimVision in your environment, because the answer depends on how your carrier holds its claim files. ClaimVision works from the claim documents themselves (the adjuster report, the estimate, the policy and its endorsements, and the photos), so nothing has to be migrated. Source (checked 4 Oct 2026): https://www.guidewire.com/products/core-products/insurancesuite/claimcenter-claims-management-software ### Does Guidewire ClaimCenter already include AI? Yes. Guidewire describes ProNavigator, an AI assistant embedded inside ClaimCenter, and an agentic framework for building your own agents (pages checked 4 Oct 2026). ClaimVision's focus is narrower: reading the whole US property claim file and its policy for the adjuster. A carrier can use Guidewire's AI and still add a property-only reader on top. Source (checked 4 Oct 2026): https://www.guidewire.com/products/core-products/insurancesuite/claimcenter-claims-management-software ### Can you ask questions of claims data in plain English? Yes. ClaimVision turns every page of a property claim into structured data before anyone opens the file, and your team can question that data in plain English. Each answer comes from the data, with the clause, the page and the dollar impact attached. ### How is ClaimVision different from a chatbot over claim documents? A chatbot reads the documents when you ask and improvises a fluent answer, which can miss the endorsement that changes it. ClaimVision has already turned the claim into structured, checked data: the figures, the dates, the coverage and the endorsements. The language model handles the conversation; the answer comes from the data. ### Where do ClaimVision's answers come from? From the claim itself. Every answer points at the page, the clause or the photo it rests on, and every answer and every human override is kept in the audit trail. ### What happens when the data does not settle the question? ClaimVision says so instead of guessing. Every recommendation shows how confident it is, and financial figures carry a gold, silver or bronze quality label, or are withheld until they can be confirmed. The adjuster decides what happens next. ### Can asking ClaimVision help train new adjusters? Yes. Every answer arrives with the clause and the reasoning, so a new adjuster learns the pattern, not just this claim's outcome, and can ask the questions they would hesitate to ask a senior colleague twice. ## Full property claims glossary (36 terms) ### Actual cash value (ACV) Actual cash value (ACV) is what damaged property was worth at the time of loss, usually calculated as replacement cost minus depreciation. On a property claim it often sets the first payment, so the depreciation figure decides how much a family receives before repairs begin. The value of damaged property at the time of loss: replacement cost minus depreciation. Many policies settle at ACV first and release the depreciation later, once repairs are complete. Roof surfacing endorsements often convert older roofs from replacement cost to ACV, one of the most commonly missed settlement changes in property claims. Example: A 12-year-old roof costs $20,000 to replace, and the adjuster applies 50% depreciation, or $10,000. The ACV is $20,000 − $10,000 = $10,000. After a $1,000 deductible, the first payment is $10,000 − $1,000 = $9,000. Settlement effect: On a replacement cost policy, the carrier typically pays ACV first and holds back the depreciation until repairs are done. If an endorsement settles the roof at ACV only, that depreciation is never owed, so the settlement basis has to be confirmed before the first check. Page: https://claimvision.ai/resources/glossary/actual-cash-value ### Replacement cost value (RCV) Replacement cost value (RCV) is the cost to repair or replace damaged property with materials of like kind and quality, with no deduction for depreciation. It is usually the gross total of the estimate, the starting point from which depreciation, the deductible and any limits are taken. The cost to repair or replace damaged property with materials of like kind and quality, without deduction for depreciation. RCV is what the estimate totals; what the carrier actually owes depends on the policy's settlement provisions, endorsements, and deductible, which is where reconciliation errors creep in. Example: An estimate for a kitchen water loss totals $30,000 RCV, with $6,000 of depreciation and a $1,000 deductible. The first payment is $30,000 − $6,000 − $1,000 = $23,000. Once repairs are finished, the $6,000 of recoverable depreciation is released, bringing the total paid to $29,000. Settlement effect: RCV is the most a replacement cost policy will pay for the damaged items, subject to the coverage limit and the deductible. Most policies pay the full RCV only after the work is completed, so RCV tells you what the claim can reach, not what is paid on day one. Page: https://claimvision.ai/resources/glossary/replacement-cost-value ### First notice of loss (FNOL) First notice of loss (FNOL) is the first report to the carrier that a loss has happened, usually from the family, their agent or a contractor. It opens the claim file and starts the state timelines for acknowledging and handling the claim. The initial report that a loss has occurred: the moment a claim is born. Everything the carrier later knows about the claim accumulates from FNOL onward as documents: reports, estimates, photos, correspondence. Cycle time is usually measured from FNOL to payment. Example: A family reports hail damage on April 3, and the carrier sets an opening reserve of $12,000 at FNOL. The inspection finds $15,500 of damage, so the reserve rises by $15,500 − $12,000 = $3,500. The claim is paid on May 15, a cycle time of 42 days from FNOL. Settlement effect: FNOL does not change the amount owed, but it starts the clocks that govern when it must be paid. Very late notice can also give the carrier a policy defense if the delay hurt its ability to investigate, depending on state law. Page: https://claimvision.ai/resources/glossary/first-notice-of-loss ### Statement of loss A statement of loss is the document that sets out what the carrier proposes to pay: the gross loss by coverage, depreciation, the deductible, prior payments and the net amount payable. It is where the estimate and the policy meet, so any figure that does not reconcile shows up here as an overpayment or an underpayment. The document that itemizes what the carrier proposes to pay: line items, deductions, depreciation, deductible, and net payable. When the statement of loss doesn't reconcile with the estimate and the policy, money leaks. Reconciling it by hand across hundreds of lines is a working session; it is exactly the arithmetic ClaimVision reconciles. Example: A statement of loss shows $42,000 RCV, $9,000 of depreciation and a $2,000 deductible, for a net ACV payment of $42,000 − $9,000 − $2,000 = $31,000. A $5,000 advance was already paid, so the check now due is $31,000 − $5,000 = $26,000. Settlement effect: The statement of loss is the payment instruction, so its net figure is what actually goes out. A missed prior payment or the wrong deductible changes the check directly. Page: https://claimvision.ai/resources/glossary/statement-of-loss ### Proof of loss A proof of loss is a signed, sworn statement from the insured setting out the amount claimed and the facts behind it, such as the date, cause and value of the loss. Many policies require it within a set period after the carrier asks for it, and a late or incomplete proof can delay payment or become a point of dispute. A sworn statement from the policyholder setting out the amount claimed and the supporting facts. Policies typically set a deadline for it, and disputes over its completeness are a common source of friction and litigation in property claims. Example: After a kitchen fire, the family submits a proof of loss claiming $48,000: $35,000 for the dwelling and $13,000 for contents. The carrier agrees with the dwelling figure and supports $10,000 for contents, so the undisputed amount is $35,000 + $10,000 = $45,000. The remaining $3,000 is what stays in dispute. Settlement effect: The proof of loss fixes the amount the insured is claiming, and in many states its receipt starts the carrier's deadline to accept or deny the claim. Undisputed amounts are commonly paid while the rest is worked out, and some states require it. Page: https://claimvision.ai/resources/glossary/proof-of-loss ### Endorsement An endorsement is a written change to an insurance policy that adds, removes or narrows coverage, or changes how a loss is settled. On a property claim the endorsements decide what the base form actually promises, so a coverage answer is only right if every attached endorsement has been read. A document that amends the base insurance policy: adding, removing, or narrowing coverage. Real property policies carry dozens. Because endorsements can override both the base form and each other, coverage cannot be determined from the policy form alone; you must follow the full chain of amendments. Example: A family's policy covers the roof at replacement cost, but a roof surfacing endorsement settles the shingles at actual cash value instead. The roof surface costs $18,000 to replace and carries $9,000 of depreciation, so the endorsement lowers the roof payment from $18,000 to $18,000 − $9,000 = $9,000, before the deductible. Settlement effect: An endorsement can raise or lower what is owed, change the deductible or change when money is released. Missing one leads to an overpayment or an underpayment, depending on which way it cuts. Page: https://claimvision.ai/resources/glossary/endorsement ### Endorsement chain An endorsement chain is the full set of endorsements on a policy, read together, to see which amendment controls a given loss and what is left of the base coverage. Endorsements can modify the base form and each other, so reading any one in isolation can give the wrong coverage answer. The layered sequence of endorsements as they apply to a specific policy and peril: which amendment overrides which, and what remains of the base promise once all layers apply. Following the chain correctly is the difference between reading the policy and understanding it. ClaimVision resolves the chain and shows the reasoning. Example: The base form pays the roof at replacement cost, one endorsement settles roof surfacing at actual cash value, and another adds a 2% wind/hail deductible on a $300,000 dwelling limit, or $6,000. Read together, a $16,000 hail roof replacement with $8,000 of depreciation pays $16,000 − $8,000 − $6,000 = $2,000. Reading the base form alone, with a $1,000 flat deductible, would suggest $16,000 − $1,000 = $15,000 in the end. Settlement effect: The chain decides the settlement basis, the deductible and any sub-limits, so it sets both the amount and the timing of payment. Read in full, it is often the difference between a correct check and a large error in either direction. Page: https://claimvision.ai/resources/glossary/endorsement-chain ### Exclusion An exclusion is policy language that removes coverage for specific causes, property or circumstances, such as flood, earth movement, wear and tear or neglect. On a property claim it can remove all or part of a loss, so it must be applied correctly: missed, it overpays the claim; misapplied, it underpays the family and invites a dispute. Policy language that removes coverage for specified causes, property, or circumstances: wear and tear, neglect, flood, earth movement, and many more. Missed exclusions are a principal source of claims leakage; misapplied exclusions are a principal source of bad-faith exposure. Both failure modes come from reading under time pressure. Example: A storm causes $25,000 of damage: $15,000 from wind tearing open the roof and $10,000 from surface water flooding the basement. Under a homeowners policy with a flood exclusion and a $1,000 deductible, the payment is $15,000 − $1,000 = $14,000. The $10,000 of flood damage falls to a separate flood policy, if the family has one. Settlement effect: An exclusion takes the excluded part of the loss out of the payable total, and the reason must be explained to the family in writing. Applying one that does not fit the facts can turn a payment question into a bad-faith question. Page: https://claimvision.ai/resources/glossary/exclusion ### Declarations page The declarations page is the summary page of a policy that lists the named insured, property address, policy period, coverage limits, deductibles and the endorsements attached. It is the first thing to check on a property claim, because it confirms the policy was in force on the date of loss and shows which parts of the base form have been changed. The front page of the policy: named insured, property address, coverage limits, deductibles, policy period, and, critically, the list of endorsements attached. Experienced adjusters read it first, because it announces which promises in the base form have been amended. Example: A declarations page shows a $350,000 dwelling limit, a $1,000 all-perils deductible and a 1% wind/hail deductible. On a $20,000 hail claim, the wind/hail deductible is 1% × $350,000 = $3,500, so the payment before depreciation is $20,000 − $3,500 = $16,500. Settlement effect: The limits and deductibles on the declarations page cap and reduce every payment on the claim. Reading the wrong policy period or missing a listed endorsement puts the error into every figure that follows. Page: https://claimvision.ai/resources/glossary/declarations-page ### HO-3 policy An HO-3 is the most common US homeowners policy form: it covers the dwelling and other structures on an open-perils basis, meaning anything not excluded is covered, and personal property on a named-perils basis. Because the dwelling is covered unless something is excluded, the exclusions and endorsements usually decide an HO-3 dwelling claim. The most common US homeowners form: open-perils coverage on the dwelling (everything is covered unless excluded) and named-perils coverage on contents. The 'unless excluded' clause is what makes exclusion analysis decisive on HO-3 claims. Example: A tree falls on a house insured under an HO-3 with a $400,000 dwelling limit and a $2,500 deductible. Dwelling repairs are $22,000 and damaged contents are $3,000, both from a covered peril, for a total of $25,000. The payment before depreciation is $25,000 − $2,500 = $22,500. Settlement effect: On an HO-3, the dwelling is usually settled at replacement cost and contents at actual cash value unless an endorsement upgrades them, so one claim can carry two settlement bases. That split decides how much is paid up front and how much is held back as depreciation. Page: https://claimvision.ai/resources/glossary/ho-3-policy ### DP-3 policy A DP-3 is a dwelling fire policy form commonly used for rental and other non-owner-occupied homes, covering the dwelling on an open-perils basis. Personal property is covered only if purchased and on a named-perils basis, and liability is not included unless added, so the answer on a DP-3 claim depends on what was bought. A dwelling fire form commonly used for rental and non-owner-occupied properties. Structurally similar to an HO-3 for the dwelling, but with narrower contents and liability provisions, and its own endorsement patterns. Example: A fire damages a rental house insured under a DP-3 with a $250,000 dwelling limit and a $1,000 deductible. The dwelling repairs are $40,000 and the tenant's furniture losses are $8,000. The DP-3 pays $40,000 − $1,000 = $39,000 for the dwelling; the tenant's $8,000 falls to the tenant's own renters policy, if they have one. Settlement effect: A DP-3 usually settles the dwelling at replacement cost only when the home is insured to a required share of its value, and at a lower amount otherwise. For a rented home it pays lost rent rather than the owner's own living expenses. Page: https://claimvision.ai/resources/glossary/dp-3-policy ### Claims leakage Claims leakage is the difference between what a carrier should have paid under the policy and what it actually paid, through overpayments, missed recoveries and avoidable expense. It is rarely one large error; it builds up from small misses across many claims, which is why it is hard to see from inside a single file. The gap between what a carrier should have paid under the policy and what it actually paid, through missed exclusions, unapplied limits, arithmetic that doesn't reconcile, and coverage granted by default under time pressure. Leakage is rarely one large error; it is thousands of small ones that were never visible. Example: A $30,000 wind claim applies a flat $1,000 deductible when the policy carries a 2% wind/hail deductible on a $300,000 dwelling limit, or $6,000. The claim is overpaid by $6,000 − $1,000 = $5,000. Repeated on 200 similar claims, that one miss comes to $5,000 × 200 = $1,000,000. Settlement effect: Leakage is found after payment, so on any single claim it shows up as a check that was too large, a recovery never pursued or an expense that did not need to happen. Catching it before the check goes out is far easier than recovering it afterwards. Page: https://claimvision.ai/resources/glossary/claims-leakage ### Subrogation Subrogation is the carrier's right, after paying a claim, to recover that payment from the third party who caused the loss, such as a negligent contractor or the maker of a faulty product. It matters on a property claim because the evidence has to be preserved early, and a successful recovery can also return the family's deductible. The carrier's right to recover what it paid on a claim from a third party who caused the loss: a negligent contractor, a product manufacturer, another insurer. Missed subrogation opportunities are a quieter form of leakage: money that was recoverable and never pursued. Example: A water heater fails and causes $40,000 of damage. The carrier pays $40,000 − $1,000 = $39,000 after the family's $1,000 deductible, then recovers the full $40,000 from the manufacturer. The carrier keeps $39,000 and reimburses the family's $1,000 deductible. Settlement effect: Subrogation does not reduce what the family is paid; the carrier pays the claim first and recovers later. Missing it leaves recoverable money on the table, and failing to keep the failed part or other evidence can lose the recovery altogether. Page: https://claimvision.ai/resources/glossary/subrogation ### Deductible A deductible is the part of a covered loss the insured bears before the policy pays, set either as a flat dollar amount or as a percentage of the dwelling limit. It is subtracted on every claim, so applying the wrong one changes the check directly. The amount the policyholder bears before coverage responds. Property policies increasingly carry separate, percentage-based deductibles for wind/hail or hurricane (calculated on the dwelling limit, not the loss), which is a frequent source of settlement arithmetic errors. Example: A family has a $1,500 all-perils deductible and a $14,000 covered water loss. The payment before depreciation is $14,000 − $1,500 = $12,500. Had the loss been $1,200, it would fall under the deductible and nothing would be paid. Settlement effect: The deductible is usually taken once per occurrence, and many policies apply a separate one to wind, hail or hurricane losses. Using the wrong deductible, or taking it twice, leads to an overpayment or an underpayment. Page: https://claimvision.ai/resources/glossary/deductible ### Ordinance & law coverage Ordinance or law coverage pays the extra cost of repairing or rebuilding to meet current building codes, which the base dwelling coverage otherwise limits or excludes. It matters because code upgrades can add a lot to a repair, and the coverage has its own limit, often a percentage of the dwelling limit. Coverage for the extra cost of rebuilding to current building codes rather than to the property's original construction. Many homeowners forms include a limited amount, often a percentage of the dwelling limit, and an endorsement can raise it; either way it carries its own sub-limit. Frequently missed in both directions: not applied when owed, or paid beyond what the policy grants. Example: Wind damages a roof, and the like-for-like repair costs $20,000. Local code now requires new decking and underlayment that add $6,000. With ordinance or law coverage of 10% of a $300,000 dwelling limit, up to $30,000 is available, so the full $6,000 is covered and the total is $20,000 + $6,000 = $26,000 before the deductible. Settlement effect: Ordinance or law costs are paid from their own limit, separate from the cost to repair what was there, and many policies pay them only once the work is actually done. Missing the coverage underpays the family; paying code upgrades beyond the limit overpays the claim. Page: https://claimvision.ai/resources/glossary/ordinance-and-law-coverage ### CAT event A CAT event is a catastrophe, such as a hurricane, hailstorm or wildfire, that produces a surge of claims across a region in a short window. It matters because every one of those claims is owed the same careful coverage review and the same state timelines, usually with far more files per adjuster. A catastrophe (hurricane, hailstorm, wildfire) that produces a surge of claims in a short window. CAT volume is the stress test of a claims operation: the same coverage rigor is owed on a multiple of the usual files, with the same headcount and regulatory clock. Example: A team that normally handles 400 claims a month receives 3,000 in the two weeks after a hailstorm. At an average of $15,000 per claim, that is $15,000 × 3,000 = $45,000,000 in expected payments. An average overpayment of just $500 per claim would add $500 × 3,000 = $1,500,000. Settlement effect: A CAT event often brings special deductibles into play, such as hurricane or wind/hail percentage deductibles, and sometimes state emergency orders that change deadlines. The surge itself is when payment delays and inconsistent decisions are most likely. Page: https://claimvision.ai/resources/glossary/cat-event ### Coverage determination A coverage determination is the decision on whether, and to what extent, a policy responds to a loss, based on the policy wording and the facts of the loss. Every payment rests on it, so it needs to be consistent from claim to claim and documented well enough to explain to the family and to a regulator. The structured judgment of whether, and to what extent, a policy responds to a loss: verifying the loss event, the policy in force, the property and peril, exclusions, conditions, limits, and the resulting settlement basis. Done well it is sequential and consistent; done under pressure it becomes intuition: usually right, expensively wrong. Example: A $28,000 claim includes $20,000 of covered wind damage, $5,000 of excluded wear and tear on old flashing, and $3,000 of mold that falls within a $5,000 mold sub-limit. The coverage determination allows $20,000 + $3,000 = $23,000. With a $1,000 deductible, the payment before depreciation is $23,000 − $1,000 = $22,000. Settlement effect: The coverage determination decides which part of the loss is payable at all, before any depreciation or deductible is applied. A determination that changes later, after new facts or a second reading of the policy, changes the payment and usually the cycle time with it. Page: https://claimvision.ai/resources/glossary/coverage-determination ### Depreciation Depreciation is the reduction in an item's value from age, wear and condition, applied line by line to turn replacement cost into actual cash value. It decides how much of a claim is paid up front, and whether it can be recovered later depends on the policy and, in some states, on statute or regulation. The reduction in property value from age, wear, and condition. In claims it is the bridge between RCV and ACV, and it must be applied line by line: a roof depreciates differently from a water heater. Whether depreciation is recoverable after repairs is governed by the policy and, in some states, by statute. Example: A 10-year-old water heater with a 20-year life costs $1,600 to replace, so 50% depreciation is $800. A 2-year-old floor with a 20-year life costs $6,000 to replace, so 10% depreciation is $600. Depreciation on the two lines totals $800 + $600 = $1,400. Settlement effect: Depreciation is subtracted from replacement cost to set the first payment. On a replacement cost policy it is usually paid later, once repairs are complete; on an actual cash value policy it is not paid at all. Page: https://claimvision.ai/resources/glossary/depreciation ### Recoverable depreciation Recoverable depreciation is the depreciation held back from the first actual cash value payment that the insured can collect once repairs or replacement are completed, within the time the policy or state law allows. It matters because it can be a large share of the claim, and families who are not told it is available may never claim it. Depreciation withheld from the initial ACV payment that the policyholder can claim back after completing repairs within the policy's (or state's) deadline. Whether it was flagged in the decision letter often determines whether the policyholder ever recovers it. Example: A roof claim totals $24,000 RCV, with $8,000 of depreciation and a $2,000 deductible. The first payment is $24,000 − $8,000 − $2,000 = $14,000. When the family sends the roofer's final invoice for $24,000, the carrier releases the $8,000, bringing the total paid to $22,000. Settlement effect: Recoverable depreciation changes when money is paid, not whether it is owed: it is released after the work is done and documented, generally up to what the repair actually cost. If an endorsement makes the item actual cash value only, the depreciation is not recoverable. Page: https://claimvision.ai/resources/glossary/recoverable-depreciation ### Scope of loss The scope of loss is the itemized description of what was damaged and what work is needed to repair it, the factual base under the estimate. It matters because a disagreement about scope (what is damaged) is different from a disagreement about price (what it costs), and treating them as one prolongs the claim. The itemized account of what was damaged and what work is required: the factual foundation under the estimate. Disputes about scope (what's damaged) are distinct from disputes about price (what it costs), and conflating them prolongs claims. Example: The carrier's estimate scopes one slope of a roof at $7,000, while the contractor's scope covers all four slopes at $26,000. Both use similar unit prices, so the $26,000 − $7,000 = $19,000 gap is a scope question, settled by reinspecting the other three slopes rather than by negotiating price. Settlement effect: The agreed scope decides which lines go into the estimate, so it sets the size of the payment before any pricing debate starts. Scope disputes settled early shorten cycle time; unsettled ones tend to come back as supplements, appraisal demands or a public adjuster. Page: https://claimvision.ai/resources/glossary/scope-of-loss ### Bad faith Bad faith is the legal exposure a carrier faces when it handles a claim unreasonably, for example through unreasonable delay, an inadequate investigation or a denial without a proper basis. It matters because damages can exceed the policy limits, and the best protection is a consistent, documented decision on every claim. The legal exposure a carrier faces for handling a claim unfairly: unreasonable delay, inadequate investigation, or denial without proper basis. The strongest protection is a consistent, documented, evidence-backed process: the same careful check applied to every claim, with the reasoning preserved. Example: A carrier denies a $60,000 water claim citing an exclusion that does not fit the facts, and the family sues. Suppose a court finds the denial unreasonable and awards the $60,000 claim, $9,000 of interest and $45,000 of the family's attorney fees. The carrier owes $60,000 + $9,000 + $45,000 = $114,000, nearly twice the original claim, before any further damages. Settlement effect: Bad faith does not change what the policy owes, but it adds costs on top when the handling is unreasonable. Paying undisputed amounts on time and explaining any denial clearly in writing are the plainest protections. Page: https://claimvision.ai/resources/glossary/bad-faith ### Loss run A loss run is a report of an insured's or a property's claims history, showing dates, causes of loss, amounts paid, reserves and status. Underwriters use it to price risk, and on a property claim it can show earlier damage that was paid but never repaired. A report of a policyholder's claims history: dates, causes, amounts paid, and status. Underwriters use loss runs to price risk; claims teams use them to spot patterns. A third claim on the same street in three years is information. Example: A loss run shows a $9,000 hail payment on the same roof two years ago, and there is no record the roof was repaired. On a new $21,000 hail claim, the adjuster checks whether the earlier damage overlaps the new scope. If all of it does, the new damage to consider is $21,000 − $9,000 = $12,000. Settlement effect: A loss run does not change coverage, but it can change what is owed when it shows prior damage that was already paid. A repeat loss is not proof of anything; it is a reason to check the file closely. Page: https://claimvision.ai/resources/glossary/loss-run ### Adjuster An adjuster is the professional who investigates a claim, establishes the facts, applies the policy and recommends or makes the payment decision. On a property claim the adjuster carries both the technical work of coverage and the human work of guiding a family through one of the hardest weeks of their year. The professional who investigates a claim, establishes the facts, applies the policy, and recommends or makes the payment decision. Staff adjusters are employed by the carrier; the role carries both the technical work of coverage and the human work of guiding a policyholder through the worst week of their year. Example: An adjuster inspects a $32,000 kitchen fire loss, confirms a covered peril and a $1,000 deductible, and applies $5,000 of depreciation. The first payment is $32,000 − $5,000 − $1,000 = $26,000. The adjuster explains in writing that the $5,000 can be recovered once repairs are complete. Settlement effect: The adjuster's findings and decision set both the amount and the timing of payment. A clear, well-documented decision shortens cycle time and lowers the chance of a dispute. Page: https://claimvision.ai/resources/glossary/adjuster ### Independent adjuster (IA) An independent adjuster (IA) is a licensed adjuster who works for an independent adjusting firm or on contract, handling claims on a carrier's behalf, most heavily during CAT surges. IAs let a carrier add field capacity quickly, so the carrier's guidelines and coverage standards have to travel with every file they handle. A contract adjuster engaged by carriers, most heavily during CAT surges. Surge volume brings many adjusters onto one book at once, which is precisely when a consistent coverage check earns its keep: every IA file gets the same careful review. Example: After a hailstorm, a carrier assigns 1,000 claims to an IA firm at an average fee of $600 per claim. The fee bill is $600 × 1,000 = $600,000, an expense on top of the claims paid. Every file that needs reinspection adds to that figure. Settlement effect: The IA usually recommends a payment that the carrier's staff reviews and approves, so the carrier keeps authority over what is paid. IA fees are an expense of the claim, and files that must be reworked add both cost and time. Page: https://claimvision.ai/resources/glossary/independent-adjuster ### Peril A peril is a cause of loss, such as wind, hail, fire, lightning, water or theft. Coverage often turns on exactly which peril caused the damage, because the same damage can be covered under one peril and excluded under another. The cause of loss: wind, hail, fire, water, theft. Coverage often turns on the peril's precise identity: wind-driven rain and rising water can produce identical living-room damage with opposite coverage outcomes. Example: Two houses on one street each have $18,000 of water damage in the living room. In the first, wind tore off shingles and rain came through the opening, a covered peril, so with a $1,000 deductible the policy pays $18,000 − $1,000 = $17,000. In the second, rising surface water came in under the door, which a homeowners policy excludes as flood, so it pays $0. Settlement effect: The peril decides which coverage, exclusion and deductible apply, so it has to be identified before any figure is calculated. When more than one peril contributes, the policy wording and state law decide how the loss is treated. Page: https://claimvision.ai/resources/glossary/peril ### Reserve A reserve is the carrier's running estimate of what a claim will ultimately cost, set early and adjusted as the facts develop. Reserves are not payments, but they feed financial reporting, reinsurance and pricing, so they need to move as soon as the file shows the claim is larger or smaller. The carrier's running estimate of what a claim will ultimately cost, set early and adjusted as facts develop. Inaccurate reserves distort everything downstream (reinsurance, pricing, and financial reporting), and reserves set on unread files are guesses. Example: A carrier sets a $10,000 opening reserve on a roof claim at FNOL. The inspection finds $14,000 of covered damage and a $1,000 deductible, so the reserve rises to $14,000 − $1,000 = $13,000. After a first payment of $10,000, holding back $3,000 of depreciation, the open reserve is $13,000 − $10,000 = $3,000. Settlement effect: A reserve does not decide what is paid, but it should track what is expected to be paid. A large late change usually means something in the file came to light late. Page: https://claimvision.ai/resources/glossary/reserve ### Supplement A supplement is an addition to an approved estimate for damage or costs found after the first inspection, such as rotted decking discovered when a roof is torn off. Supplements are common and usually legitimate, and each one needs the same coverage and pricing check as the original estimate. An addition to the original estimate for damage or costs discovered after initial approval. They are common, legitimate, and a known leakage channel when supplements aren't re-checked against the policy with the same rigor as the original estimate. Example: A roof estimate is approved at $15,000. During tear-off the contractor finds damaged decking and submits a $2,400 supplement, of which $1,800 is supported by photos and the policy. The revised estimate is $15,000 + $1,800 = $16,800. Settlement effect: An approved supplement increases the payable amount and is usually paid as an additional check. Each supplement also reopens the file, so reviewing it quickly keeps cycle time down. Page: https://claimvision.ai/resources/glossary/supplement ### Prompt-pay laws Prompt-pay laws are state statutes and regulations that set deadlines for acknowledging, investigating, deciding and paying claims, with interest or penalties when the deadlines are missed. They vary by state, and they turn cycle time from a service measure into a compliance obligation. State statutes setting deadlines for acknowledging, deciding, and paying claims, with penalties and interest for missing them. They convert cycle time from a service metric into a compliance obligation with a clock attached. Example: A family's $20,000 claim is paid one month after the deadline in a hypothetical state that charges 12% a year, or 1% a month, on late claim payments. The interest owed is $20,000 × 1% = $200, so the carrier pays $20,000 + $200 = $20,200. Settlement effect: Prompt-pay laws do not change the amount owed under the policy; they change when it must be paid and add interest or penalties when it is late. Because the clock often runs from the notice of claim or the proof of loss, depending on the state, delays early in the file count against the carrier. Page: https://claimvision.ai/resources/glossary/prompt-pay-laws ### Salvage Salvage is the carrier's right to take damaged property it has paid for in full and recover its remaining value, usually by selling it. The amounts are small on most homeowners claims, but they add up across a book and are easy to overlook. The carrier's right to take ownership of damaged property it has paid for (a totaled roof's materials, damaged contents) and recover residual value. Small per claim, meaningful at portfolio scale, routinely forgotten. Example: A carrier pays $12,000 to replace water-damaged appliances and furniture. A salvage buyer pays $1,500 for the damaged items, less $300 in handling costs, for a net recovery of $1,500 − $300 = $1,200. The claim's net cost falls to $12,000 − $1,200 = $10,800. Settlement effect: Salvage does not reduce what the family is paid; it reduces the carrier's net cost after payment. Sometimes the family keeps a damaged item instead, and the payment is reduced by its salvage value. Page: https://claimvision.ai/resources/glossary/salvage ### Straight-through processing Straight-through processing (STP) is when a claim moves from report to payment without manual handling because every check has passed: coverage is clear, the figures reconcile and the documentation is complete. In property claims it suits simple, low-value files, and it has to be earned through consistent checks and people reviewing the results. Claims that complete without human touch because every check has passed: coverage clear, figures reconciled, no fraud signals, documentation complete. In property claims it is earned, not declared: ClaimVision proposes, people decide, and the routine tier widens as trust accumulates. Example: A carrier routes small water and window claims under $5,000 with clear coverage to straight-through processing. A $2,800 claim with a $1,000 deductible pays $2,800 − $1,000 = $1,800 the same day. A $4,500 claim with an unclear cause of loss goes to an adjuster instead. Settlement effect: Straight-through processing changes when a claim is paid, not how much is owed. The carrier's rules decide which claims qualify, and every claim outside them goes to a person. Page: https://claimvision.ai/resources/glossary/straight-through-processing ### Claim file The claim file is everything the carrier holds on a claim: the first notice, the policy and endorsements, reports, estimates, photos, correspondence, notes and decisions. It is the record of why the claim was paid or denied, and in a complaint, a regulatory exam or a lawsuit, the file is the evidence. Everything the carrier holds on a claim: FNOL, reports, estimates, photos, policy and endorsements, correspondence, internal notes, and decisions. The file is the institution's memory of the claim. In a dispute, the file is the evidence. Example: A claim file holds the policy, an inspection report, a $35,000 estimate, 120 photos and the decision letter. Two years later a regulator asks why $4,000 of interior damage was denied, and the file shows the exclusion applied, the photos relied on and the letter sent. The $35,000 − $4,000 = $31,000 paid can be explained line by line. Settlement effect: The file does not change what is owed, but every payment has to be supported by it. Missing documents delay payment, and a decision the file cannot explain is hard to defend. Page: https://claimvision.ai/resources/glossary/claim-file ### Large loss A large loss is a claim big enough to need senior review or specialist handling, often six figures or more, with hundreds of estimate lines, several coverages and complex endorsements. It matters because large losses concentrate payment risk and time: more lines, more documents and more places for the figures to drift. A claim large enough to warrant senior review, often six figures and up, with hundreds of estimate line items and complex coverage. Large losses concentrate leakage risk: more lines, more endorsements, more places for the arithmetic to drift. Example: A house fire produces a $240,000 dwelling estimate, $60,000 of contents and $18,000 of additional living expense, a total of $240,000 + $60,000 + $18,000 = $318,000. A 1% pricing error across those lines would be $3,180. Settlement effect: Large losses are usually paid in stages, with advances, ACV payments and later releases of depreciation, so the statement of loss must account for every prior payment. Each stage is another chance for the running total to drift. Page: https://claimvision.ai/resources/glossary/large-loss ### Cycle time Cycle time is the elapsed time from first notice of loss to resolution, usually measured to first payment or to closing. It is the measure families feel most directly, and long cycle times bring complaints, public adjusters and regulatory attention. The elapsed time from FNOL to resolution. Long cycle times are a common source of complaints, and complaints escalate: to regulators, to public adjusters, to counsel. Time spent locating information inside documents is the most compressible part of cycle time. Example: A claim is reported on June 2 and paid on July 2, a cycle time of 30 days. If a carrier closing 1,000 claims a quarter cuts average cycle time from 30 days to 20, each family is paid 10 days sooner. At an average of $15,000 per claim, that is $15,000 × 1,000 = $15,000,000 reaching families 10 days earlier each quarter. Settlement effect: Cycle time does not change what the policy owes, but it decides when families are paid and whether state deadlines are met. Much of a long cycle time is waiting: for documents, for a reinspection, for someone to find the answer in the file. Page: https://claimvision.ai/resources/glossary/cycle-time ### Wind/hail deductible A wind/hail deductible is a separate deductible for wind and hail losses, usually set as a percentage of the dwelling limit rather than a flat dollar amount. It matters because the percentage is taken of the dwelling limit, not the size of the loss, so it is often far larger than the all-perils deductible. A separate deductible for wind and hail losses, typically a percentage of the dwelling limit rather than a flat dollar amount. A 2% deductible on a $500,000 dwelling is $10,000. Applying the standard deductible instead is a four-figure error, per claim. Example: A home has a $400,000 dwelling limit, a $1,000 all-perils deductible and a 2% wind/hail deductible. On a $25,000 hail claim, the wind/hail deductible is 2% × $400,000 = $8,000, so the payment before depreciation is $25,000 − $8,000 = $17,000. Applying the $1,000 deductible by mistake would overpay by $8,000 − $1,000 = $7,000. Settlement effect: On wind and hail losses the percentage deductible applies in place of the all-perils deductible, and it reduces the check directly. Applying the wrong one, or calculating it on the loss instead of the dwelling limit, is a common settlement error. Page: https://claimvision.ai/resources/glossary/wind-hail-deductible ### Public adjuster A public adjuster is a licensed adjuster hired by the insured, not the carrier, to prepare and negotiate their claim, usually for a percentage of the settlement. Public adjuster involvement often signals that the family did not understand or did not trust the first answer, and it changes who the carrier works with on the claim. An adjuster engaged by the policyholder to negotiate their claim. Rising public-adjuster involvement on a carrier's book usually signals that policyholders don't trust the first answer. It's a lagging indicator of cycle time and communication quality. Example: A family hires a public adjuster at a 10% fee on a claim the carrier first valued at $40,000. The claim settles at $55,000, so the fee is 10% × $55,000 = $5,500 and the family nets $55,000 − $5,500 = $49,500. Settlement effect: Once a public adjuster is involved, the carrier generally works through them, and payments are often issued with the public adjuster as a co-payee. The fee comes out of the family's settlement, not on top of what the carrier owes. Page: https://claimvision.ai/resources/glossary/public-adjuster ### Fraud signal A fraud signal is a pattern in a claim that warrants a closer look before payment, such as damage that does not match the reported cause, no recorded storm at the location on the date of loss, or invoices that do not line up. A signal is not an accusation; it is a reason for a person to review the file, sometimes with the carrier's special investigations unit (SIU). A pattern that warrants investigation before payment: losses inconsistent with the reported peril, no corroborating storm activity at the location, patterns across claims. A signal is not an accusation. It is a reason for a human to look closer. Example: A $22,000 hail claim gives a date of loss when no hail was reported near the home, and the roof photos show wear consistent with age. The file is referred for review before payment. If review confirms $4,000 of genuine wind damage and nothing else, the claim pays $4,000 − $1,000 = $3,000 after a $1,000 deductible. Settlement effect: A fraud signal can pause payment while the facts are checked, but state claim-handling deadlines generally still apply and any denial must be explained. Many signals clear on review, and those claims are paid in the normal way. Page: https://claimvision.ai/resources/glossary/fraud-signal ## Contact - Book a demo: https://claimvision.ai/contact. Bring a closed claim and interrogate ClaimVision on a file you already know the answer to. - ClaimVision is a product of Decision Agency. Decision Crew is the separate consulting and integration firm. - Legal entity: Decision Agency OÜ · Ahtri tn 12, 15551 Tallinn, Estonia · Registry code 17184257. - LinkedIn: https://www.linkedin.com/company/claimvisionai