Waypoint Claims | P&C Claims Automation

My Open Claims 📋

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open

Overdue Follow-Ups ⚠️

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needs action

Due Today 📅

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on track

My Closed Claims ✅

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all time

Today's Diary

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My Claims

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Adjuster Performance

Open Features by Adjuster

At a Glance

My open claims, overdue follow-ups, due today and my closed claims, as a chart.

Report Tiles

Any report on this portal's Reports page, or a chart you build yourself, drawn here in the kinds you chose on the gear.

Claim View History

🗺 Resources

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

Filters

Adjuster

Loss Type

State

✅ No claims in queue — all claims are assigned.

Claim	Payee	Last Known Address	State	Check #	Amount	Issued	Stale Since	Stage	Check
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Find a Policy

Searches the organization's policy book and its administered policies together. A policy the organization does not hold is not found, not shown as locked. No SSN, as a key or a field.

Results

Policy Number	Insured	Type	Carrier	Status	Effective	Expiration	Locations	Open Claims
Search to list policies.

My Roster

Loading your roster.

Pick a person on your roster to open their profile.

Pending Approval

Awaiting Manager

Approved — Ready

Total Pending ($)

No payment requests on file.

View As

State

Status

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.

Filters

View As

Status

Peril

Claim Type

Insured Information

Name

Phone Number

Secondary Phone

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 & Producer Information

Claim Number

Policy Number

Policy Effective Date

Policy Expiration Date

Producer Name

Producer Email

Producer Phone

Additional Insured

Mortgagee Name

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 Policy: — State: Texas Adjuster: — Reserve: $15,200 Status:

Loss Details

Policy Info

File Notes

Diary

Statutory Requirements

Features / Reserves

Payments

Documents

Photos

SIU

Messages

Letters

Claim Contacts

Financial Data

Litigation

Invoicing

Claim Details

Insured

Insured Name

Phone

Employer Contact

Address

Policy Number

Claimant

Claimant Name

Phone

Claimant Address

Loss

Loss Type

Loss Location

Loss Severity

Loss Description

Market / Bordereaux Fields

Certificate Reference

Prior Claim Reference

Carrier File Number

Sums Insured

Amount Claimed

Jurisdiction

Cause of Loss Code 1

Cause of Loss Code 2

Litigation Status

Risk Location Address

Risk Location City

Risk Location State

Risk Location Zip

Date First Advised

Date Coverage Confirmed

Proof of Loss Complete

Demand Received

More-Time Notice Sent

⚖️ Attorney Representation

No attorney representation on file.

🔌 Vendor Services

plug-and-play — live when a provider contract is signed

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Medicare Section 111

Identity Vault

The number is encrypted in a separate vault under its own key, is read only when a file is built, and every read is logged.

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

💳 Add Payment

Who Is Paid

the payee, joint payees

What Is Paid

line of coverage, cost type, amounts

The Check

what prints, duplicates, issue

Step 1 · Who Is Paid

Every party the claim knows is here. Nothing is typed that the claim already holds.

Pick the payee, or several to pay jointly

Someone the claim does not know yet is added on the claim's Contacts tab first, with their address and tax details, then chosen here.

Pay to, as it prints on the check

Pick a payee

Each person by their complete name, in the policy's own words. The order follows the policy: named insureds first, then additional insureds, then the mortgagee.

Payment Type *

Step 2 · What Is Paid

Each line names the line of coverage as the claim carries it; the reserve left on it is shown before an amount is typed.

Partial or Final

Final closes the coverage line after this check clears.

Payment Date

Currency

Line Items

Line of Coverage	Cost Type	Memo	Amount

0 lines on 0 coverages Payment total $0.00

The lines of coverage are the claim's own features. A line with nothing left is refused by the server and says so.

💰 Payment Recovery

Recovery Source / Payee

Recovery Type

Feature

Recovery Reserve (Expected)

Recovery Amount (Received)

Check / Reference Number

Method

Recovery Date

Description / Memo

Original Payment Reference (optional)

Recovery will be logged to diary and audit trail

Deductible Receivables

What the insured or employer owes back for a deductible taken off a payment. Issuing the invoice starts the organization's reminder ladder; a posted recovery with its deductible slice allocated is the payment.

Coverage	Billed to	Amount	Invoice	Issued	Days	Balance
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Recovery Reserve Ledger

Coverage	Recovery Reserve	Recovered	Remaining
No recovery reserves yet.

Recovery History

No recoveries recorded yet.

💵 Recoveries (Salvage / Subrogation)

No recoveries recorded.

🛡️ Sanctions Screening (OFAC)

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Payment History

No payments issued yet.

Ceded to Reinsurers

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This letter composer now lives inside each claim, under the Letters tab. Open a claim to write letters.

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

Select State

Account Information

Role

Phone

—

Extension

—

Reports To

—

Account

Active

My status

Assignment/Billing History

View my history

Claims Management System

Waypoint Claims

Organization

My Team

My Reporting Line

Full Org Chart

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Insured Information

Name

Phone Number

Policy Number

Address

City

State

Zip Code

Policy & Producer Information

Policy Effective Date

Policy Expiration Date

Producer Name

Producer Email

Producer Phone

Claimant Information

Name

Phone Number

Secondary Phone

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

Address

City

State

Zip Code

SSN (last 4)

Gender

Employer / Company

Employer Contact

Employer Phone

Employer Email

Policy / Account Number

Job Title / Occupation

Hire Date

Avg Weekly Wage (AWW)

State of Employment

📄 Policy & Producer Information

Policy Effective Date

Policy Expiration Date

Producer Name

Producer Email

Producer 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: your organization’s word (Admin Portal → Settings → Claim numbering)

⏱ 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

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today

Outbound Made

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not captured

Total Calls

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on file, voice-FNOL channel

Avg Handle Time

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mm:ss, timed calls only

FNOLs Created

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intakes from calls

Calls on this page are the voice-FNOL channel only. No other channel is captured, so this is not a total of all calls, and outbound calls are not captured.

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

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

Call ID	Direction	Path	Answered	Ended	Duration	Avg Handle	Outcome
Reading the call log…

🔌 Nextiva Integration

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

🟢 Available

NEXTIVA

Contact Center · Waypoint Claims Queue

Queue: 4 Representatives 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

Calls Taken

FNOLs Created

0:00

Avg Handle

Auto-Created

📋 Claims from Calls Today

No claims created yet today

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Super Admin · Waypoint Claims

Performance Score

Open Claims

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FNOLs Created

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Calls Taken

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Claims Closed

—

Avg Cycle Time

—

📋 My Claims

📈 Period-over-Period Trends

🔑 Pending Authority Requests

Loading authority requests…

📈 Portfolio Analytics

Avg Cycle Time

days average

Reopened Claims

claims currently reopened

Received vs Closed

Adjuster Workload

Closed Claims Review Queue

From to

Claim #	Adjuster	Loss Type	DOL	Reserve		Action

Adjusters

Ctrl+click for multiple

Claim Status

Ctrl+click for multiple

Expired Diary Entries

EXPIRED

DUE TODAY

UPCOMING (7d)

Claim #	Entry	Assigned to	Follow-up	Status

Contact Investigation — run any party, any role, across the whole book

Search the party master. Click a result for the full record and every claim it appears on.

🤖 AI Screening — Single Claim

Claim Number

Loss Type

Claim Facts / Description

Reported by

Attorney Represented?

Prior Claims History

Loss Reported Late?

Policy Recently Obtained?

📊 Screening Result

Submit claim facts for AI screening — or Screen All Open Claims above

📋 SIU Referral Queue

🌀

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.

🌀

CAT MODE ACTIVE

Event: —

Claims: 0 FNOLs Today: 0

CAT Claims Open

FNOLs — Last 24h

Adjusters Deployed

Avg Severity

—

Est. Total Exposure

—

⚡ Bulk FNOL Upload Intake

FNOL Type *

One row per claim, comma separated. Choose the FNOL type above and this line will name the exact columns for it — the platform never guesses which column is which.

— or paste the rows below

CAT Event — Admin Portal Deployment

Loss Type

Filed Batch # Promotion is the step that OPENS the claims — they land in the Assignment Queue after this. Discard permanently deletes a filed batch that was never promoted, so a corrected file can be uploaded in its place.

🗺️ Deployment — from the Admin Portal

Affected Areas (Deployment zips)

Assigned Adjusters

🤖 CAT AI Command

Query Fields — Applied to All Selected Reports

Reports

Choose reports to see query options

No reports selected yet.

📊

Choose One or More Reports

Open the Reports field above, choose the reports, then click Run Report

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

Add Diary Entry

Claim # *

Title *

Entry

Assign to *

Follow Up Date *

Filter

View Diary As

Due Date Range

Summary

Diary Log — Overview

No diary entries yet. Add the first entry above.

Add File Note

Assign to

Title *

Note

🔒 Notes are permanent once saved

Filter Notes

All File Notes

No file notes yet. Add the first note above.

Mortgagee(s)
Underwriter
Financial Company
Updated Financial Company
Underwriting Company

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

⚙️ Waypoint Claims Backend Connection

Claim Emails

Compose Email

Attach from Documents

Attach from Documents

Attach from Documents