The Fix List

Claims Operations,
first-quarter planning.

Fernhill Mutual. 34 people across intake, adjusting and partner support.

Inside

  1. What we heard
  2. The fix list
  3. Fixes against this quarter’s goals
  4. The quarter, in order

Prepared by Kasey&Co.

Sample. Fernhill Mutual and everything in this document are invented to show the format. Not client work.

What we heard

Three questions, asked before the session and in the room.

Counts are how many of the 34 people raised each point, in the pre-survey (answers not attributed) or the session.

What’s working?

  • The weekly adjuster huddle21
  • The new intake form17
  • Seniors coaching new adjusters12
  • The partner team answers fast9

What’s a challenge?

  • Claim status lives in three places26
  • Nobody owns the shared claims inbox22
  • Reopened claims are re-entered by hand15
  • The Friday report is rebuilt every week8
  • Priorities change mid-quarter, unannounced14

What’s an opportunity?

  • Route new claims by type, automatically19
  • One status view partners can see16
  • AI summaries of claim emails, reviewed by a person11
  • A named owner for every queue18

Sample. Invented to show the format. Not client work.

2

The fix list

What to do with each, who owns it, and the next step.

OrderFixBreaksBlocksOwnerNext step, or why notGoal
Act owner and first step
1Name an owner for the shared claims inbox Risk reviewedDailyClaimantsIntake leadOwner named at the next team meetingG1
2One place for claim statusDailyThe teamOperations managerMap every place status is written todayG2
3Route new claims by typeDailyClaimantsIntake leadList claim types and today’s routing rulesG1
4A status view for partnersWeeklyPartnersPartner support leadAgree the five fields partners ask aboutG3
Investigate a question and a date to decide
?Decide where AI helps intakeDailyThe teamOperations managerDo summaries hold up on 20 real emails? Decide by week 6G4
?Notice before priorities changeMonthlyThe teamClaims directorCan leadership give a week’s notice? Decide by month 2None
Park the reason, and what brings it back
–Automate the Friday reportWeeklyOne person–One person, no current goal. Revisit if it grows past one personNone

Sample. Invented to show the format. Not client work.

3

Fixes against this quarter’s goals

Most fixes serve a goal. One without a goal still gets a look.

GoalInbox ownerOne statusRoute by typePartner viewAI at intakeFriday reportPriority notice
G1 Faster first contact with claimants
G2 Fewer handoff errors, intake to adjuster
G3 Partner portal live on schedule
G4 A decision on the AI intake pilot
serves the goal   helps it   Shaded columns serve no current goal: one is investigated, one parked.
MonthlyWeeklyDaily Claimants,partnersTeamOne person How often it breaks Inbox owner Route by type Partner view One status AI at intake Priority notice Friday report
Who it blocks, by how often it breaks. Top right comes first. Hollow points serve no current goal.

Sample. Invented to show the format. Not client work.

4

The quarter, in order

Small and owned first. Builds once the basics hold.

Month 1Month 2Month 3
Inbox ownerIntake lead
Map where status livesOperations manager
One place for claim statusOperations manager
Route new claims by typeIntake lead, optional build
Partner status viewPartner support lead
AI intake test, then decideOperations manager, optional build

After the session, if you want it

The two lighter bars are where outside help could build. They are options, not part of the Fix List, and each would be scoped on its own.

Sample. Invented to show the format. Not client work.

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