AN ILLUSTRATIVE WORKFLOW
From motor claims intake to an accountable handoff
Fictional motor claim MC-042 has an initial incident report and a repair estimate, but its survey report is missing and two document references do not match. This illustrative process uses synthetic records to show a proposed workflow; it is not a live product demo or a customer case study.
Illustrative example. This is a process walkthrough with sample information, not a live software demo or a customer case study. Confirm available capabilities and configuration with BlissJunction.
- 01
Capture the first notice of loss
- Context
- The intake team receives the synthetic incident report for MC-042 and the available supporting records.
- AI assistance
- Draft a summary with source references and flag fields missing from the agreed intake checklist.
- Human decision
- Check the source details, confirm the scope, and assign a claims handler.
- Recorded outcome
- An intake record with an accountable owner and a list of information still needed.
- 02
Check documents and surface discrepancies
- Context
- The initial packet includes a repair estimate but lacks the survey report; two supplied references differ.
- AI assistance
- Organize document versions and list the missing report and conflicting references for review.
- Human decision
- Verify each issue against its source and decide what clarification to request.
- Recorded outcome
- A reviewed document checklist with unresolved questions linked to their sources.
- 03
Prepare a focused follow-up request
- Context
- The claims handler identifies which permitted contact can supply each missing or corrected item.
- AI assistance
- Draft separate requests describing the information needed and why it is being requested.
- Human decision
- Confirm recipients, information-sharing permissions, wording, and internal target dates before sending.
- Recorded outcome
- Approved follow-up tasks with an owner and expected response for each item.
- 04
Coordinate the surveyor and garage handoff
- Context
- The handler receives the survey report and corrected references, while one repair-estimate question remains open.
- AI assistance
- Draft a handoff brief showing the updated records, open question, and next requested action.
- Human decision
- Check relevance, assign the right reviewer, and route any exception to the responsible person.
- Recorded outcome
- A source-linked handoff with clear responsibilities and the unresolved issue still visible.
- 05
Submit the packet for an authorized decision
- Context
- The designated reviewer has the updated packet and the response to the outstanding question.
- AI assistance
- Prepare a factual summary that distinguishes source information from draft observations.
- Human decision
- An authorized reviewer evaluates the evidence and makes any coverage, liability, settlement, or claim decision within their authority.
- Recorded outcome
- A recorded decision with reasons, or a request for further investigation with an assigned owner.
- 06
Confirm the next action and preserve the review history
- Context
- The review decision identifies the next operational action and who is responsible for it.
- AI assistance
- Draft the internal handoff summary and organize links to the reviewed evidence and decision history.
- Human decision
- Confirm the next owner, approve any communication, and determine whether the workflow can close or needs more work.
- Recorded outcome
- An accountable next step with supporting records available to permitted staff.
FROM PROCESS TO PRACTICE
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