Before you operate a claim, you have to understand it.
We diagnose claims processes, identify bottlenecks and design the operating model — with or without our technology, with or without our team running it afterward.
The scope of the diagnosis and the operating-model design.
We work with the insurer to understand how it operates today and how it should operate tomorrow. We don't hand over a decorative PDF: the diagnosis ends in a concrete action map and in a model that can then be operated, either by our team or by the internal one.
- End-to-end diagnosis of claims processes. From first notice of loss to payment. We map timelines, roles, handoffs, rework, systems involved, and the points where information gets lost.
- Design of complexity models. Which claims go through the fast track, which need a field adjuster, which escalate to investigation. The classification is built with evidence from the insurer's own workflow, not copied from a manual.
- Regulatory compliance review by jurisdiction. Every country, every line of business, every regulator. We fit the design to what the regulator requires and to what the regulator is starting to require.
- Definition of KPIs and control dashboards. First-response times, SLA closure rate, leakage, cost per claim, reopening rate. Indicators the operations team actually uses, not just exposure.
- Support through digital transformation of the claims function. What to automate first, what to leave as is, where technology doesn't solve the problem. This gets decided with the operations team sitting right there.
- Data governance and case-file traceability. What gets recorded, in which system, and who owns that source. Without this, neither the complexity model nor the KPIs can be trusted.
- Design of the external provider and adjuster network. How workshops, external adjusters and lawyers get vetted, audited and paid. The network is part of the process, not a separate annex.
This isn't desk-bound consulting.
The people who diagnose are the same teams who then run claims operations every day. That's why the diagnosis comes with field evidence — real measured timelines, open case files, concrete cases where the process gets stuck — not just a framework pulled from a slide deck.
When we design a model for an auto insurer in Brazil, we design it based on how a partial loss is settled today, what signal triggers a reopening, and who has to review what. When we design it for a workers' comp insurer, we design it around how the medical team crosses paths with the legal team in week three of the case. Consulting lives or dies in those details.
Once the model is delivered, it lands in one of two hands: the insurer's internal team operates it under our supervision, or Leverbox operates it. Both options exist and are valid; the choice depends on what the insurer wants to build in-house and what it prefers to delegate.
This isn't PowerPoint consulting.
The models we designed for a Brazilian auto insurer were built by looking at real case files. The workers' comp ones came from reviewing how the medical team crosses paths with the legal team in week three of the case.
Is your claims operation being built, or is it being patched?
If the model has already gotten too small for your volume, or if there still isn't a model written down, it's worth a conversation.
Talk to an expert