Claims Intake (FNOL)

Claim Intake Summary

A one-look roll-up of the reported claim - reference, line of business, loss-notice form type, date reported, who reported it and how, and a one-line loss description - so an intake adjuster can orient before running any check.

Claimant and Party Identification

The insured and claimant and how they relate to the policy, including whether the named insured on the loss notice matches the policy - the identification every downstream coverage check and notice depends on.

Policy and Coverage Verification

The policy facts the coverage checks run against - policy number, carrier, effective and expiration dates, in-force status, coverages and limits, deductible, and coverage basis / exclusions.

Loss Details

The core FNOL facts of the loss itself - date and time of loss, location, cause/peril, type of loss, a factual description, point of impact/damage, and any stated role or fault - kept distinct from the date reported.

Loss Occurred Within Policy Period

The first bright-line coverage gate - true only when the date of loss falls within the policy's effective-to-expiration window and the policy is in force.

Coverage Applies

A preliminary read on whether coverage appears to respond - applies, likely applies, a coverage question for manual review, does not apply, or insufficient information - as triage support, never a coverage decision or denial.

Parties, Injuries, and Witnesses

Every person connected to the loss, one row each, with role, whether injured, injury and treatment reported, and attorney involvement - how the adjuster sees injury and third-party exposure at a glance.

Official Reports and Authorities

Whether the authorities responded and whether an official report exists - report type, number, agency, whether obtained, and any citations or arrests - which corroborates the loss and supports subrogation.

Damage and Loss Estimate

What was damaged and any early loss amount - property/item, damage description, estimated amount and its basis, drivability/habitability, ALE/business-interruption, and third-party exposure - recorded as a preliminary FNOL indication, not a settled figure.

Estimated Severity Tier

A preliminary severity tier - low/fast-track, moderate, high, catastrophic/major, or undetermined - driven first by injuries and liability exposure, then by property-damage size, so the claim routes to the right level of adjuster.

FNOL Completeness Checklist

The completeness gate - each required FNOL data element marked Present, Missing, or N/A for the line of business - so an incomplete notice is caught before it is assigned.

All Required Intake Fields Captured

A single completeness flag - true only when every applicable required FNOL element is present - that separates a workable claim from one that must go back for more information.

Fraud and SIU Indicators

The early fraud red flags an intake adjuster screens for at FNOL - timing anomalies, inconsistencies, missing reports, jump-ins, provider/attorney patterns, inflated amounts, prior-claim hits - each an indicator for review, not an accusation.

SIU Referral Recommended

A single flag recommending referral to the Special Investigation Unit when a high-severity indicator or a pattern of indicators is present - a recommendation for investigation, not a finding of fraud.

Preliminary Reserve Guidance

A suggested opening reserve basis - whether to reserve, the reserve lines, preliminary indemnity and expense ranges, and the assumptions - as decision support, with every dollar figure a carrier-configured placeholder, not an actuarial calculation.

Claim Triage and Routing

The single triage outcome - fast-track, standard adjuster, major/complex-loss, refer for coverage decision, refer to SIU, or incomplete - combining coverage, completeness, severity, and fraud signals, as a recommendation for a human.

Intake Summary and Next Step

A tight narrative of the claim as intaked, the coverage and severity read, the routing outcome and its driver, and the single next action - decision support for a licensed adjuster, not a coverage decision.