Claims Processing AutomationsPurpose
1.2. Ensures that each claim is automatically and accurately matched to an adjuster with skills and proximity best fitting the claim, automating workflow, reducing administrative bottlenecks, and supporting compliance for professional insurance services.
Trigger Conditions
2.2. Update event to claim data in CRM (such as claim status or location field change).
2.3. Scheduled batch review of unassigned claims for automated assignment.
Platform Variants
• Feature/Setting: Process Builder/Flow — automates routing rules configured to detect claim entry and auto-assign to adjusters based on custom fields (type, zip code).
3.2. Zapier
• Feature/Setting: Multi-step Zaps — automatedly catches claim data from forms/CRM and uses Filter/Paths to assign, emailing the adjuster.
3.3. Microsoft Power Automate
• Feature/Setting: Automated cloud flows — triggers on Dynamics 365 record creation, routes to adjusters via Teams or Outlook integration.
3.4. HubSpot
• Feature/Setting: Workflow automation — sets claim property triggers to re-assign Deal Owner (adjuster) automatedly.
3.5. ServiceNow
• Feature/Setting: Flow Designer — automates claim assignment using business rules and adjuster profiles.
3.6. Pipedrive
• Feature/Setting: Workflow Automations — auto-assigns new Deals (claims) to specific users based on custom field logic.
3.7. Freshdesk
• Feature/Setting: Ticket Automations — assigns tickets (claims) to groups/agents with specified skills, location matched.
3.8. Jira Service Management
• Feature/Setting: Automation Rules — uses custom field inputs to assign claim issues automatically to agents.
3.9. Workato
• Feature/Setting: Recipes — automates claim intake from multiple sources, conditional logic for assignment to adjusters.
3.10. Monday.com
• Feature/Setting: Automations Center — configures claim forms triggering automated assign to board users by column (type/location).
3.11. Google Cloud Functions
• Feature/Setting: Event-driven automated functions — parses new claims, invokes Cloud Firestore and notifies appropriate adjuster.
3.12. AWS Lambda
• Feature/Setting: Scheduled Lambda function — regularly checks unassigned claims, assigns via API integration with adjuster database.
3.13. Smartsheet
• Feature/Setting: Automated Workflows — sends claims for assignment based on conditional column entries.
3.14. Intercom
• Feature/Setting: Inbox Assignment Rules — claims as new tickets assigned to operators based on claim tags.
3.15. Slack
• Feature/Setting: Workflow Builder — automates notification and assignment messages to adjuster channels using claim data.
3.16. Asana
• Feature/Setting: Rules Automation — new claim task auto-assigned to team member with correct label/location.
3.17. Trello
• Feature/Setting: Butler Automation — uses triggers (card moved or created) to assign claims by list or label automation.
3.18. Twilio
• Feature/Setting: Studio Flows — automates SMS intake and assignment notification to local adjuster’s mobile.
3.19. SendGrid
• Feature/Setting: Automated transactional email API — claims trigger personalized assignment emails to relevant adjusters.
3.20. Zoho CRM
• Feature/Setting: Workflow Rules — automates update and assignment of claim records to agents with matching skills/location.
3.21. Airtable
• Feature/Setting: Automations — scripts/logic automatedly distribute incoming claim records to adjusters based on mapped criteria.
3.22. BambooHR
• Feature/Setting: Custom Triggers — HR records/availability used to automate adjuster assignment in real time.
Benefits
4.2. Improves response time by automatedly matching adjuster expertise and geographical proximity.
4.3. Enables scalable claims processing to handle volume spikes through automation.
4.4. Ensures regulatory compliance by maintaining documentation of automated assignment steps.
4.5. Delivers measurable reductions in claims processing costs and resolution times using automatable workflows in business process automation.