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T53 Current-state process assessment

Current-state process assessment

A process consultant observing an insurance claims team

Client: Marrow Point Insurance Process: Claims intake 3 pain points, high impact Assessment complete

How Marrow Point Insurance's claims intake process works today, where it breaks and the target state we recommend. Prepared by Kettering Transformation for the claims operations leadership team, based on process walkthroughs with 8 staff across intake, adjusting and payments, and two weeks of ticket data from the claims system.

Assessment details
ClientMarrow Point Insurance, personal lines claims
Process ownerInes Tavares, Director of Claims Operations
Lead consultantAaron Blackwood, Kettering Transformation
Assessment windowAug 25 to Sep 5, 2026
ScopeFirst notice of loss through claim assignment to an adjuster

What this assessment covers

This assessment stops at claim assignment to an adjuster; it does not cover adjusting, estimating or payment, which Kettering will assess separately if the intake work is approved. Cycle time and volume figures come from two weeks of claims system data, Aug 25 to Sep 5, 2026, and are labelled as measured or modeled accordingly.

As-is and to-be

Sample template: the firm, people, clients and figures are fictional and shown for illustration only.

Process: as-is versus to-be

As-is: today
flowchart TD
    A[Customer reports loss phone, email or web form] --> B[Intake clerk logs FNOL manual data entry]
    B --> C{Complete info?}
    C -- No --> D[Clerk calls customer back avg 1.8 days later]
    D --> B
    C -- Yes --> E[Clerk checks coverage separate policy system]
    E --> F[Clerk assigns to adjuster by manual round robin list]
    F --> G[Adjuster confirms receipt avg 2.4 days after assignment]

The as-is process runs across three disconnected systems (phone/web intake, the claims system and the policy system) with no automated handoff between them. Average time from first notice of loss to adjuster confirmation is 5.6 days.

To-be: target state
flowchart TD
    A[Customer reports loss any channel] --> B[Intake form validates required fields at entry]
    B --> C[System checks coverage automatically, policy system]
    C --> D[System assigns adjuster by workload and specialty]
    D --> E[Adjuster confirms receipt same business day]

The target state removes the manual callback loop by validating required fields at the point of entry, and removes the manual round robin by assigning on workload and specialty. Target time from first notice of loss to adjuster confirmation is 1.5 days.

Pain points and their impact

Pain pointWhereFrequencyImpactSeverity
Incomplete FNOL requires a callbackIntake41% of claimsAdds 1.8 days average, delays every downstream stepHigh
Manual coverage check in a separate systemIntakeEvery claimAdds 20 to 40 minutes clerk time per claimHigh
Round robin assignment ignores adjuster workloadAssignmentEvery claim3 adjusters carry 60% of open claimsHigh
No system alert when a claim sits unassignedAssignment12% of claimsSome claims wait over 4 days unnoticedMedium
Adjuster confirmation is not tracked automaticallyHandoffEvery claimOps cannot see confirmation status without askingMedium

Handoff analysis

FromToMethod todayDelay introducedRecommended method
CustomerIntake clerkPhone, email, web form, no single queueUp to 1 day before first logUnified intake queue, any channel
Intake clerkPolicy systemManual lookup, separate login20 to 40 minutes per claimAutomated API check, same system
Intake clerkAdjusterPrinted round robin list, updated weekly0.5 to 4 days depending on list accuracyAutomated assignment by workload
AdjusterClaims systemManual confirmation click, no reminder1 to 3 days averageSystem reminder after 4 business hours

Quick wins available now

Quick wins, no system change required
Move the round robin list to weekly workload rebalancing, not a fixed rotation
Add a required-field check on the web FNOL form to cut incomplete submissions
Set a 4-hour internal alert for unassigned claims
Publish a one-page FNOL checklist for phone intake staff
✓Interview walkthroughs completed with all 8 process participants

Risk: adjuster workload imbalance

Three of eleven adjusters currently carry 60% of open claims because the round robin list has not been updated since a March 2026 staffing change. We recommend rebalancing assignment weekly until the automated workload-based assignment ships. Owner: Ines Tavares. If not addressed before the automated fix ships, the imbalance will likely worsen as claim volume rises into Q4.

  1. Approve the quick wins above for immediate rollout, no system change needed.
  2. Scope the automated coverage check and workload-based assignment with IT.
  3. Schedule the adjusting and payments process assessment as the next phase.
Interview notes
  • Intake clerks (3 interviewed): report spending roughly a third of their day on callbacks for incomplete FNOLs and manual coverage lookups.
  • Adjusters (4 interviewed): confirm the round robin list feels arbitrary; two mentioned it has not reflected current staffing since March.
  • Claims operations manager: confirmed no dashboard currently shows unassigned claim age; this is tracked informally by memory.
  • Limitation: interviews covered day-shift staff only; evening intake coverage was not assessed and should be a follow-up if volume patterns differ.
How to use this template

Duplicate this page for each process assessment engagement. Replace every step, figure and pain point from the actual walkthroughs and ticket data; if a cycle time cannot be measured, write Needs review rather than estimating.

VariableMeaningRequired
{{client.name}}Client whose process the assessment coversRequired
{{process.scope}}The process boundary the assessment covers, start and end pointsRequired
{{asis.steps}}As-is process steps and measured cycle timeRequired
{{tobe.steps}}Target-state process steps and target cycle timeRequired
{{painpoint.list}}Pain points with frequency, impact and severityRequired
{{quickwin.list}}Quick wins available without a system changeOptional

Label every cycle time as measured from ticket data or modeled as an estimate; never present an estimate as a measured figure.