faster per claim: 30 to 40 minutes by hand down to a few minutes, fully unattended
of weekly WC intake handled start to finish by the agent
first-pass accuracy
Challenge
Every workers' comp claim started the same way: a First Report of Injury hit an inbox, and someone keyed it into the claims system by hand. That came to thousands of FROIs a year, 30 to 40 minutes apiece, and it was rarely just typing. Each one runs across multiple programs and a multi-tier carrier structure, so the person had to read the form, find the right tier and policy, and assign the correct class code before anything could move. The work took real judgment, but it ran on rote data entry, which kept skilled claims staff off the cases that needed them.
Solution
Avallon began with a proof of value, running real FROIs in a test environment before anything went live. In production, the agent reads each FROI, picks the right tier, policy, and class code, creates the FNOL in the system of record, and emails back a confirmation. It does this inside the existing system, with no templates and nothing to reformat. Clean claims run start to finish without a person in the loop, so the team only handles the exceptions.
Results
Because the agent works inside the existing system, J&A didn't have to switch tools or rebuild their workflow around it. Claims that used to wait in a queue for a free pair of hands now clear in minutes, around the clock, at close to the full weekly volume. And it does more than read a form: it pulls in the surrounding emails and faxes, and turns a Spanish claim form into something adjusters can work in English. A clean claim is filed and confirmed before anyone would have opened the email.
What's Next
WC intake is fully live. General Liability is validated end to end and headed for production next. Auto-Liability is in the works behind it. More initiatives are already being scoped.