First Notice of Loss Router
Captures a loss once, establishes urgency, and routes the claim to the correct response path.
A voice note at midnight, a photo set, a sensor alert from a connected home: the notice arrives in whatever form the customer had to hand, and it has to become one verified claim record either way. Identity and policy linkage first, then the signals that change the route (a live power line, an injured claimant, a catastrophe footprint), then approved emergency assistance and an evidence hold. Coverage determination waits for the specialists.
Authority
Monitor and intervene
Team role
Routes work to specialists
Handoffs
Named collaborators
The role
What it owns and where its authority ends
Desk
Claims & Recovery
Desk workflow
Capture the loss and route it on urgency and line, reconstruct the policy at the date of loss and analyze coverage and liability, test the integrity signals and refer what carries, then assemble reserves, payments and a settlement recommendation for the authority level that can commit them.
Collaboration
Calls several specialists in parallel
Decision boundary
Monitors continuously and intervenes only within stated limits.
Systems and capabilities involved
Policy search API
Claim setup API
Catastrophe and geospatial feed
Emergency assistance network
Coverage analysis agent
Handoffs
What this role gives and receives
Capabilities offered
First notice and claim routing
Creates a verified claim event and routes urgent, specialist, and standard work.
- Receives:
- Loss notice, claimant identity, available policy references, media, and contact consent
- Returns:
- Claim identifier, verified facts, urgency, preservation actions, and assigned routes
Delegates
Analyze potentially applicable coverage and immediate evidence needs. Trigger: A policy candidate and minimum loss facts are available. Returns: Coverage issues, required facts, reservations, and confidence.
Delegates
Assess fraud signals under restricted SIU handling. Trigger: Defined fraud, identity, provider, or network indicators fire. Returns: Risk signals, evidence basis, and SIU referral recommendation.
External handoff
Licensed adjuster assigned in the loss state
External handoff
Claims supervisor holding emergency assistance authority
External handoff
Emergency mitigation and temporary housing vendors on the approved network
External handoff
The insured or claimant reporting the loss
Context
What the role needs to do the work
- Current work
- Loss facts, claimant identity, policy candidates, urgency, injuries, location, media, and routing state.
- Prior interactions
- Prior notices and contact preferences for the claimant and insured object.
- Policies and reference
- Catastrophe, emergency, line-of-business, litigation, and fraud routing rules.
- Working method
- Not specified for this role.
Illustrative workflow
How the work moves
Starting point
A homeowner sends photos and a voice note reporting storm damage and a fallen live power line.
- 01
Verify identity and policy candidate while extracting time, location, damage, occupancy, and safety facts.
- 02
Trigger the electrical-hazard emergency script and approved temporary-assistance route.
- 03
Create the claim, preserve media, and fan out coverage and catastrophe review.
Result
Urgent claim routed with safety actions started and the evidence ledger opened; coverage stays an open question for the specialists.
Checks and boundaries
What must be tested or reviewed
- 01Emergency and catastrophe recall is tested on injury, displacement, environmental hazard, cyber containment, and vulnerable-customer cases.
- 02A run that states or implies coverage, liability, a fraud finding or a settlement figure before specialist review is graded as a fail, however well the routing itself scored.
- 03The acknowledgment clock is armed from the date the notice was received rather than the date the file was opened, so a weekend intake does not quietly consume two of the fifteen days Model #902 Section 6 allows.
Human authority
- The licensed adjuster assigned in the loss state makes the first substantive contact and signs anything that states a coverage position, because a routing note a customer reads as an answer is the answer.
- The claims supervisor authorizes emergency assistance outside the approved playbook and any customer commitment beyond it.
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