The injured worker
Reports once, in their own words
- Opens a secure single-use link on their phone — no account, no password, no app to install
- Describes the injury by voice or typing, in English or Spanish; the agent extracts the facts — no forms
- Picks a network doctor ranked by distance and tier, books the appointment, confirms it in the same session
- The DWC-1 claim form is prepared from what they said and tracked to signature
vs. the usual claims systemWorkers are usually a data subject: a paper FROI, a phone tree, then silence. Here the worker drives their own intake in one sitting — and every step they complete is one the adjuster never has to chase.
The adjuster
Works the queue — the AI handles everything after
- Incoming documents — uploaded PDFs, scanned faxes, email attachments — are ingested, summarized, and reviewed in the context of the claim; the actions they require, reserve adjustments included, surface on the queue
- Each item opens as a plain-language brief: what to decide, why, what in the claim led here — everything relevant presented, summarized, and organized, with the originals one click away
- After the decision, the AI does the follow-up: documents it, sends the letters and notices, completes the diary, sets the next ones, files the FROI/SROI state reports — all of it logged and auditable
- What's left for the human is exactly what should be: the impactful decisions, and taking care of the people on the claim
vs. the usual claims systemLegacy systems are passive ledgers: the adjuster reads raw PDFs, recalls the code section, drafts each notice, calendars deadlines, and keys state reports by hand. Here the contract is simple — work the queue and the timelines are met, the penalties avoided, the reporting filed.
The employer
Files in minutes, sees everything
- HR files the first report of injury in the portal; payroll wage data pulls automatically and the benefit rates compute themselves
- The worker's intake link goes out immediately — the claim is moving the same day
- Watches claim status, deadlines, and decisions in real time instead of calling for updates
- Pulls loss runs and OSHA-ready reporting self-serve at renewal — with reserves honestly labeled as adjuster-approved or pending
vs. the usual claims systemThe usual experience is a fax, a week of silence, and a quarterly report. Here the employer sees the same live claim the adjuster does — scoped to their own data and nothing else.
