Waypoint Claims | P&C Claims Automation

My Open Claims 📋

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Overdue Follow-Ups ⚠️

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Due Today 📅

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My Closed Claims ✅

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📅 Today's Diary

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My Claims

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👤 Adjuster Performance

🕐 Claim View History

🗺 State Resources

Texas DOI - TDI Florida OIR California CDI New York DFS NAIC Resources

✅ No claims in queue — all claims are assigned.

No communications logged yet.

No coverage determinations on file.

0

Pending Approval

0

Awaiting Manager

0

Approved — Ready

$0

Total Pending ($)

No payment requests on file.

⚖️ Illinois Tolling Calculator

Calculate tolled deadlines under 215 ILCS 5/154.6 — IL allows suspension of deadlines when investigation is ongoing

Loading compliance deadlines…

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First Contact ≤ 24hrs

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Reserve Set ≤ 3 Days

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ACK Letter ≤ State Req.

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Missed Deadlines

SLA Performance by Adjuster

⚠️ Bad Faith Risk Indicators

No bad faith risks detected.

Screen Individual or Entity

Full Name / Entity Name *

Date of Birth (optional)

Country (optional)

Claim / Reference Number

📋 Screening History

No screens run yet.

🔌

Carrier API Integration

This page fetches live declarations from your carrier system via API. Enter a policy number above to retrieve declarations. Configure your API endpoint in Settings.

No policy loaded

Coverage	Coverage Limit	Deductible	Premium	Status
Loading coverage data…

📄

No Policy Loaded

Enter a policy number above and click Fetch Declarations to retrieve policyholder information from your carrier API.

Request ISO Report

Claim Number or Policy Number *

📋 Request History

No ISO requests yet.

Show per page

Insured Information

Name

Phone Number

Email

Policy Number

Client Claim Number

Address

City

State

Zip Code

Loss location is the same as the insured address

✅ Loss location set to the insured address:

Loss Location Address

City

State

Zip Code

Policy & Agent Information

Policy Effective Date

Policy Expiration Date

Agent Name

Agent Email

Agent Phone

Additional Insured

Loss Details

Date of Loss

Loss Type

Loss Severity

Policy Type

Reported By

Loss Description

CLM-48291-0401-26

S. Rodriguez — Wind/Property Loss

Date of Loss: 03/31/2026 State: Texas Adjuster: Roddrick D. Reserve: $15,200 Status:

Loss Details

Policy Info

File Notes

Diary

Payments

Documents

Email

Letters

Claim Contacts

Audit Summary

QA / Closure

Invoicing

Claim Details

Claimant

Phone

Loss Type

Loss Location

Claimant Address

Policy Number

Loss Severity

Loss Description

⚖️ Attorney Representation

No attorney representation on file.

📄 Declarations Summary

Not Loaded

📄

No declarations loaded.

💰 Reserves

Coverage	Reserve	Paid	Outstanding
No reserves set. Click "+ Set / Update" to establish reserves.
Total	$0	$0	$0

Claim Number	Date of Loss	Loss Type
No prior claim history available.

Coverage	Reserve	Payments	Remaining
Coverage A — Dwelling	$12,000	$0	$12,000
Coverage B — Structures	$1,800	$0	$1,800
Coverage D — ALE	$1,400	$0	$1,400
Total	$15,200	$0	$15,200

Select Letter Type

📩 Acknowledgment

📋 Request for Information

⚠️ Reservation of Rights

🚫 Coverage Denial

💰 Payment Tender

✅ Closure Letter

🏗️ Claim Contact Assignment

🎙️ Recorded Statement Notice

⚖️ Subrogation Demand

🏥 HIPAA Authorization

📋 Generated Letters

No letters generated yet.

Pending Approval

38

$284,000 total

Issued This Month

247

$1.82M

Avg Payment Cycle

4.2d

vs 6.1d benchmark

Pending Payments — Approval Queue

Claim #	Claimant	Type	Amount	Authority	Requested By	Action
Loading payments…

⏳ Pending Vendor Requests 0

No pending requests.

No claim-contacts added yet. Click + Add Claim Contacts to get started.

Select State

Account Information

Email

Role

Phone

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Extension

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Reports To

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Status

Active

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Assignment/Billing History

View my history

Claims Management System

Waypoint Claims

Platform Access & Permissions

Loading permissions...

To update your role, permissions, or access — contact your System Administrator or use the Waypoint Administrator Portal.

Insured Information

Name

Phone Number

Email

Policy Number

Address

City

State

Zip Code

Policy & Agent Information

Policy Effective Date

Policy Expiration Date

Agent Name

Agent Email

Agent Phone

Claimant Information

Name

Phone Number

Email

Address

City

State

Zip Code

Loss Type

Loss Details

Date of Loss

Reported By

Loss Location Address

City

State of Loss

Zip Code

Loss Description

👤 Injured Worker & Employer

Injured Worker — Full Name

Date of Birth

Phone

Email

Address

City

State

Zip Code

SSN (last 4)

Gender

Employer / Company

Policy / Account Number

Job Title / Occupation

Hire Date

Avg Weekly Wage (AWW)

State of Employment

📄 Policy & Agent Information

Policy Effective Date

Policy Expiration Date

Agent Name

Agent Email

Agent Phone

🏭 Incident Details

Date of Injury

Time of Injury

Date Reported to Employer

Incident Type

Body Part Injured

Nature of Injury

Lost Time?

Treating Facility

Supervisor on Duty

Witnesses

Incident Location — Address

City

State

Zip Code

Incident Description

💊 Medical Management & Benefits

Initial Treatment

Estimated Disability Period

Work Status at Time of Report

Modified Duty Available?

🤖 AI Workers' Comp Triage — MAX Protocol

Submit Workers’ Comp claim for AI-powered compensability analysis, TTD benefit calculation, medical management flags, litigation risk, and state compliance deadlines.

Workers’ Comp Quick Reference

🦺 Separate claim # prefix: WC-

⏱ First report of injury auto-filed

📅 TTD benefit period tracked by state

💊 Medical panel / MPN controls apply

📋 IME triggers at 90 days by default

⚖️ Litigation flags monitored via MAX

📊 AWW → benefit rate calculated by AI

⚡ Instant Deadline Calculator

Claim Number

State of Loss

Date of Loss

Insured / Claimant

📋 Active Claim Compliance Auto-sorted by nearest deadline

Claim #	Insured / Claimant	State	DOL	Acknowledge By	Accept/Deny By	Pay By	Status	Days Until Next

🤖 AI Compliance Review — Ask Claude

Ask about any state's compliance requirements, penalty provisions, or get a compliance audit of the current diary.

Inbound Taken

0

today

Outbound Made

0

today

Total Calls

0

this session

Avg Handle Time

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mm:ss

FNOLs Created

0

from calls

Call Type: 📲 Inbound — Caller is calling in 📤 Outbound — Adjuster is calling out INBOUND Adjuster: Roddrick D.

Ready — Awaiting Inbound Call

00:00

📞

Waypoint Virtual Call Center

Simulate an inbound caller to begin the intake process

📋 Collected Intake Data

Populates as call progresses…

📜 Call Transcript

Transcript appears here…

📋 Call History — Roddrick D.

Call ID	Direction	Path	Answered	Ended	Duration	Avg Handle	Outcome
No calls yet this session

🔌 Nextiva Integration

Simulated inbound call · AI transcript · Auto FNOL · Connect live credentials in Settings

🟢 Available

NEXTIVA

Contact Center · Waypoint Claims Queue

Queue: 4 Agents Online: 3 Avg Wait: 1:24 00:00

📵

Waiting for Inbound Call

Nextiva will route the next call from the Waypoint Claims queue to this agent

🔌 Integration Status

Nextiva API ⚠ Simulated

Claude AI ✅ Connected

Auto FNOL ✅ Enabled

Webhook URL mcs.claims/api/nextiva

Speech-to-Text ⚠ Simulated

Go Live: Replace simulated webhook with your Nextiva API credentials at developer.nextiva.com to activate real inbound call processing.

📋 Call Queue 4

📊 Today's Stats

0

Calls Taken

0

FNOLs Created

0:00

Avg Handle

0%

Auto-Created

📋 Claims from Calls Today

No claims created yet today

RD

Roddrick Davis

Super Admin · Waypoint Claims

Performance Score

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Open Claims

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FNOLs Created

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Calls Taken

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Claims Closed

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Avg Cycle Time

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📋 My Claims

📈 Period-over-Period Trends

📈 Portfolio Analytics

Avg Cycle Time

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days average

Reopened Claims

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claims currently reopened

Received vs Closed Ratio

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Adjuster Workload

Closed Claims Review Queue

Claim #	Adjuster	Loss Type	DOL	Reserve		Action

Adjusters

Ctrl+click for multiple

Claim Status

Ctrl+click for multiple

Expired Diary Entries

EXPIRED

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DUE TODAY

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UPCOMING (7d)

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Claim #	Entry	Assigned To	Follow-up	Status

Open SIU Referrals

8

↑ 2 this week

High Risk Claims

14

Score 70+

Under Investigation

5

Active SIU

Confirmed Fraud YTD

3

$184K saved

🤖 AI Fraud Screening — Single Claim

Claim Number

Loss Type

Claim Facts / Description

Reported By

Attorney Represented?

Prior Claims History

Loss Reported Late?

Policy Recently Obtained?

📊 Fraud Score Result

Submit claim facts for AI fraud scoring

🚨 Red Flag Indicators

📋 Late reporting without explanation

📋 Attorney retained prior to loss report

🚨 Multiple prior claims same peril

🚨 Policy obtained shortly before loss

📋 Loss not consistent with reported cause

📋 SIU Referral Queue

Claim #	Claimant	Loss Type	Fraud Score	Top Flag	Referral Date	SIU Status
CLM-37694-0320-26	R. Anderson	Liability / BI	87 — High	Attorney pre-loss + 4 prior claims	03/22/26	Under Review
CLM-84510-0325-26	D. Martinez	Fire	79 — High	Policy 45 days old · late report	03/26/26	Referred to SIU
CLM-73842-0331-26	M. Thompson	Liability / BI	62 — Medium	BI claim + soft tissue only	04/01/26	Monitoring

🤖 Portfolio Fraud Screening

Click "Screen All Open Claims" to run Claude AI fraud analysis across the entire active portfolio.

Active Subrogation

12

files open

Total Demanded

$284K

across all files

Recovered YTD

$96K

↑ $18K vs LY

Recovery Rate

34%

↑ 4pts

🤖 Subrogation Potential Evaluator

Claim Number

Loss Type

Total Paid Amount

Responsible Party Known?

State of Loss

Statute of Limitations

Facts Supporting Recovery

📊 Recovery Analysis

Submit claim details for AI subrogation evaluation

Generate Demand Letter

Responsible Party Name

Demand Amount

📋 Subrogation File Tracker

Claim #	Loss Type	Paid	Demanded	Responsible Party	SOL Date	Status	Recovery
CLM-29473-0328-26	Water — Plumbing	$31,800	$31,800	BuildRight Contractors	03/28/28	Demand Sent	$0
CLM-48291-0401-26	Wind / Hail	$15,200	$0	—	—	Evaluating	$0
CLM-61057-0401-26	Hurricane	$48,500	$48,500	Roofing Co. of TX	04/01/28	Negotiating	$12,000

🌀

Bulk FNOL Upload — Standby

Activate Bulk FNOL Upload to enable bulk FNOL intake, surge resource tracking, and catastrophe-specific workflows. Use for hurricanes, hailstorms, wildfires, floods, or any mass loss event.

📊

Select one or more reports

Check any reports on the left, set your query fields, then click Run Report

Select an assignment to view all approved invoices you submitted on that deployment.

Add Diary Entry

Claim # *

Entry Type

Entry

Assign To

Follow Up Date

Filter

Summary

Diary Log — Overview

No diary entries yet. Add the first entry above.

Add File Note

Title *

Note

🔒 Notes are permanent once saved

Filter Notes

All File Notes

No file notes yet. Add the first note above.

Email Center

All emails sent across all claims

No emails sent yet.

Underwriter
Financial Company
Updated Financial Company
Underwriting Company

Handle every claim from FNOL to closure in one OS.

Today's Operations

Platform

Features

AI-Powered FNOL

Reserve Management

Compliance Tools

Diary System

Document Management

Reporting

Resources

Claim Emails

⏳ Pending Vendor Requests 0

Email Center

Policy Number
Policy Type
Effective Date
Expiration Date
Cancellation Date
Original Effective Date
Status

⚙️ Waypoint Claims Backend Connection

Handle every claim from FNOL to closure in one OS.

Today's Operations

Platform

Features

AI-Powered FNOL

Reserve Management

Compliance Tools

Diary System

Document Management

Reporting

Resources

Claim Emails

⏳ Pending Vendor Requests 0

Email Center

Compose Email

Request New Vendor

Request New Vendor