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Finance & compliance

Insurance claim triage

Fast-track simple claims, request what's missing, and send the rest to the right specialist.

Reads a first notice of loss or adjuster notes and decides the path: straight-through processing for simple, complete claims, a request for missing information, a specialist for injuries and complex cases, and special investigations when fraud indicators stack up.

Use this judgeCustomize it

Claims triage support. Decisions to deny or investigate a claim belong to licensed adjusters.

Try it live

Real calls to Jev. Pick an example or paste your own.

Examples
196
No verdict yet

Pick an example or paste your own input, then run it.

Under the hood

Every question and rule, in the open. Fork it to change any of them.

What it asks

Reads claim, then asks 4 questions in one call.

  1. Q1ComplexityPick one

    How complex is the claim?

    SimpleModerateComplex
  2. Q2Missing informationYes / no

    Is information missing that's needed to process the claim (date, location, policy number, photos, or a police report where relevant)?

  3. Q3Fraud indicatorsYes / no

    Does the claim show fraud indicators (an inconsistent timeline, a policy that started very recently, prior similar claims, reluctance to provide documents, or inflated values)?

  4. Q4Bodily injuryYes / no

    Does the claim involve bodily injury?

How it decides

Rules run in code, top to bottom. The first one that matches gives the verdict.

  1. 1
    If Fraud indicators ≥ 0.7Special investigationsreview
  2. 2
    If Missing information ≥ 0.6Request information
  3. 3
    If Bodily injury ≥ 0.6Specialist reviewreview
  4. 4
    If Complexity is ComplexSpecialist reviewreview
  5. 5
    If Complexity is SimpleStraight-through
  6. ·
    DefaultSpecialist review

Call it from your code

Every template runs as-is with an API key, no setup: POST /api/v1/judges/claims-triage/run.

curl -X POST https://tryevally.com/api/v1/judges/claims-triage/run \  -H "Authorization: Bearer $EVALLY_API_KEY" \  -H "Content-Type: application/json" \  -d '{  "input": {    "claim": "Policy #HX-22871. On Sept 12 at about 6pm, a hailstorm cracked the windshield of the insured'\''s 2021 Honda Civic while parked at home in Austin, TX. Photos attached. Repair quote $480. No injuries."  }}'

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