Pre-Adjudication Document Verification

Catch the gaps before your adjuster does.

Claimloom checks the claim packet before it reaches a human queue — missing police reports, date chains that don't hold, invoices that don't reconcile. The checks your adjuster would run anyway, running first.

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47 min
Adjuster time lost chasing missing documents on a complex claim — before the claim work starts
1 in 4
Claim packets arrive incomplete at FNOL — triggering at least one re-request cycle before adjudication
$12–18
Estimated cost per manual document re-request, including adjuster time and claim cycle delay

What Claimloom Checks

Every field an adjuster would verify — run before the queue.

Forty-plus checks across five categories, covering the document gaps that generate the most re-work in claims intake.

Document Completeness
Verifies that required attachments — police report, ER record, repair estimate — are present before the packet advances.
Date Consistency
Cross-checks incident date, treatment date, and invoice date chain for logical sequence and gaps.
Invoice Reconciliation
Checks line items against totals, flags duplicate charges and amounts that don't reconcile.
Provider Verification
Validates license numbers, NPI format, and provider name consistency across documents in the packet.
Signature & Certification
Confirms that required fields — claimant signature, certifications, dates of execution — are populated.

The Integration

Works where claims already land.

No rip-and-replace of your claims management system. Claimloom runs as a check layer before the packet enters your queue — via REST API or email drop, your choice.

Claim packet arrives at FNOL
Submit via REST API endpoint or forward to your dedicated Claimloom email drop. Documents in any standard format — PDF, TIFF, or structured JSON — are ingested the same way.
40+ checks run in under 60 seconds
Document presence, date-chain logic, invoice reconciliation, NPI format, and signature fields — checked against the rules configured for your claim type and line of business.
Flag summary reaches your adjuster's queue
A structured flag summary — specific gaps, specific fields, severity-ranked — is pushed via webhook or email before the adjuster opens the file.

Built for the whole claims operation.

Whether you're a regional carrier, a TPA managing multiple lines, or an independent adjuster firm — the intake problem looks the same.

Insurance Carriers
Reduce intake cycle time at scale
High-volume claims departments gain a consistent first-pass filter that catches gaps before they reach the adjuster queue — at the pace your volume demands.
Carriers
Third-Party Administrators
Consistent checks across client lines
TPAs managing multiple client programs can enforce check logic per program — one platform, configurable rules per carrier relationship.
TPAs
Independent Adjusters
Start every claim ready to work
Independent adjuster firms eliminate the back-and-forth that erodes the first hour of every complex assignment. The packet is ready when they open it.
Adjusters

"Before Claimloom, our adjusters spent the first part of every complex auto claim chasing the same three documents. Now the packet comes in complete or we know exactly what's missing — before anyone opens the file."

— Claims Operations Director, Regional Property & Casualty Carrier

Stop running the same first-pass checks your adjuster runs every morning.

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