Use cases

Spot the big claims on day one, not at the reserve review

Reads the first notice and early notes for serious injuries, a total loss or a business stopped, and how large it could get. A senior handler reads alerts.

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Example · Employers' liability: a scaffold lift gives way, one worker airlifted with a spinal injury

Class of business from the policy: Employers' liability, scaffolding contractor

First notice of loss and the claim notes to date, in date order

14/04/2026 08:52 FNOL by phone from the insured, Greyfield Access Ltd, scaffolding contractor. Caller Dean Pollard, contracts manager. Incident 13/04/2026 at about 15:20 at a residential block being refurbished on Linacre Road, Stockport. A lift of the scaffold on the north elevation gave way while two of the insured's employees were striking (taking down) the top lift. One employee, a scaffolder aged 34, fell about 7 metres to the ground. The second, a labourer, fell onto the lift below and hurt his wrist. Ambulance and air ambulance attended. The scaffolder was airlifted to the regional major trauma centre. Caller says colleagues at the scene heard he had 'a bad back injury' and 'couldn't feel his legs'. The labourer went to A&E by road, had his wrist put in plaster and was sent home the same evening. An HSE inspector attended this morning and told the insured that HSE is investigating. The north elevation scaffold is taped off. Insured says work carries on at the other elevations and at their other sites. Main contractor on site is Brookway Construction. The scaffold was built to the insured's own standard layout; caller not sure whether it had a design check. No property damage reported apart from the scaffold itself. 15/04/2026 10:10 Spoke to the insured's HR manager. The scaffolder's partner told HR he had surgery on his spine overnight and is in intensive care. The hospital has not yet given the family a prognosis. HR has visited the family. 15/04/2026 16:40 A local news website ran a story this afternoon with a photo of the scaffold, headed 'Worker airlifted after scaffold collapse'. Insured asks what they should say if the press call. 16/04/2026 09:15 No letter of claim received yet. The insured has asked its own solicitor to help with the HSE investigation. Insured has sent the scaffold inspection register; last weekly inspection recorded 9 April, no defects noted.
  1. Do the notes say enough about what happened, who was hurt and what was damaged to judge how large the claim may become?Yes92%
  2. What is the most serious injury to any person that the notes describe?Spinal injury100%
  3. Where does the information about the most serious injury come from?Injured person or family86%
  4. Do the notes describe more than one injured person, or more than one other party who may claim?Yes98%
  5. Do the notes describe a building, vehicle or major piece of equipment destroyed or beyond repair?No87%
  6. Do the notes say a business has stopped or cut back trading because of the loss?No87%
  7. Do the notes mention the press, a regulator, a police investigation or an inquest?Yes99%
  8. From the notes, how large could this claim become?Potential major loss99%

These are real answers stored from one run on this example.

The prism behind it

Spot the big claims on day one, not at the reserve review8 questions

Fields

  • Class of business from the policy
  • First notice of loss and the claim notes to date, in date order

Context

We are a UK commercial insurer writing liability and property business. Our claims administrator records the first notice and the notes of every new claim. Each claim is read here when it is reported and again whenever a note is added in its first 30 days. The answers tell our major loss team and our reinsurance team about a potentially large claim early, instead of when a handler raises the reserve weeks later. Nothing here sets a reserve, judges liability or cover, or assesses an injury medically. The notes are what people have said so far, and early notes are often wrong. An alert asks a senior handler to look; that handler decides what happens next. Code compares the answers with the notification clauses in our reinsurance treaties, and applies reserves and money thresholds. Our casualty treaties ask to hear early about these injuries, whatever the reserve: death, brain injury, spinal cord injury, amputation, severe burns and loss of sight. The exact wording is in each treaty.

Questions

  1. Do the notes say enough about what happened, who was hurt and what was damaged to judge how large the claim may become? Yes / No

    Short notes are enough if they say what happened and who or what was harmed. Yes: The notes describe the incident and the people hurt or the property damaged, clearly enough to judge its size. No: The notes are too short or vague to tell, such as "incident at site, details to follow".

  2. What is the most serious injury to any person that the notes describe? Choice

    Consider everyone the notes mention: employees, members of the public, drivers and passengers. Choose from the words in the notes, including an injury they call suspected or likely. This is not a medical judgement; it picks who should look at the claim.

    • No injury The notes say nobody was hurt, or mention no injury.
    • Minor injury Bruising, cuts, sprains, whiplash or shock, treated at the scene or sent home the same day.
    • Hospital treatment Taken to hospital or kept in, with no injury of the kinds below described.
    • Fractures One or more broken bones, with no injury of the kinds below described.
    • Brain injury A head injury with loss of consciousness, bleeding or swelling on the brain, an induced coma, or brain damage.
    • Spinal injury Damage to the spinal cord, paralysis, or loss of feeling or movement in the limbs after a back or neck injury.
    • Amputation Loss of a limb, a hand, a foot or fingers, at the scene or by surgery.
    • Severe burns Burns described as serious or deep, over a large area, or needing a specialist burns unit or grafts.
    • Loss of sight Loss of sight in one or both eyes, or an eye injury that threatens it.
    • Death Someone died, at the scene or later.

  3. Where does the information about the most serious injury come from? Choice

    Take the most serious injury the notes describe. When the information is passed on, such as a relative telling the employer who tells us, choose where it started. When more than one note describes that injury, go by the latest one.

    • Medical source A hospital, a doctor or a medical report.
    • Emergency services Police, paramedics, the fire service or an air ambulance crew.
    • Insured or a witness The policyholder, its staff, or someone who saw the incident, speaking from what they saw.
    • Injured person or family The injured person, or their partner, relative or friend.
    • No injury described The notes describe no injury, so there is no source to name.

  4. Do the notes describe more than one injured person, or more than one other party who may claim? Yes / No

    Count people hurt and other parties whose property or business was harmed. The policyholder itself does not count. Yes: The notes describe two or more injured people, or two or more other parties who may claim. No: The notes describe one injured person or one other party at most.

  5. Do the notes describe a building, vehicle or major piece of equipment destroyed or beyond repair? Yes / No

    Yes: The notes say a building, a vehicle or a major item of plant or equipment was destroyed, burnt out, collapsed or written off, or will not be worth repairing. No: Nothing is described as destroyed or beyond repair. Damage to temporary works, such as a scaffold being replaced, does not count.

  6. Do the notes say a business has stopped or cut back trading because of the loss? Yes / No

    Count the policyholder or any other business. Yes: The notes say a business has closed, cannot trade, or is trading at a reduced level because of the loss. No: The notes say work or trading carries on, or say nothing about it. One area closed off while work carries on elsewhere is No.

  7. Do the notes mention the press, a regulator, a police investigation or an inquest? Yes / No

    Police attending the scene, or taking details as they do at most road accidents, is not an investigation. Yes: The notes say the press or social media is reporting it, a regulator such as the Health and Safety Executive is investigating, the police are investigating, or there will be an inquest. No: None of these is mentioned.

  8. From the notes, how large could this claim become? Scale

    Judge from what the notes describe, for this class of business. Do not weigh amounts or reserves; code applies those. When the notes point to more than one level, choose the higher.

    • Attritional A routine claim for the class: minor injuries, or damage to one vehicle or one part of a building.
    • Moderate Above routine but expected to recover: a hospital stay, fractures, several vehicles, or damage through much of a building.
    • Large Serious injury with lasting effects, a building or major vehicle destroyed, or a business stopped for weeks.
    • Potential major loss One of the injuries the context lists, several people seriously hurt, or damage on a scale that could reach our reinsurers.

Lens columns

enough_information, enough_information_probability, worst_injury, worst_injury_probability, injury_information_source, injury_information_source_probability, several_claimants, several_claimants_probability, total_loss, total_loss_probability, business_interruption, business_interruption_probability, outside_interest, outside_interest_probability, severity_outlook, severity_outlook_average

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