CR
Claims first review Evaluation

Can you trust the route it recommends?

On 26 test claims, it sent 10 of 10 serious claims to an adjuster and none of the 16 simple ones. When it was unsure, it asked for another photo rather than guess. That's a good start, not proof: proof needs your own claims.

10 of 10
serious claims went to an adjuster
None was approved from photos. With so few claims, the real rate could be as low as 72%.
0 of 16
simple claims sent to an adjuster they didn't need
Each one would be an adjuster's time spent for nothing.
23 of 26
recommended the same route as our expert
The other 3 are explained below.
10 sec
and about 4 cents a claim
Runs in the background, so a reviewer rarely waits.
Not measured yet: whether the repair estimate matches what you'd actually pay. That needs your paid claims.

What we tested it on

Are they real claims? No. The photos are real photos of damaged cars, but the claim details (the customer, the policy, the car's value) are made up for testing. None come from an insurer.

Where are the photos from? 8 originals: four real crashes from Wikimedia Commons (a flood, a front-end crush, a van under a wall, a car into a tree), a press photo of a race-car crash, a dented Honda Civic and Toyota Camry I sourced, and one photo with no car in it.

Why 26? The other 18 are built from those 8 to test one thing each. 13 are harder versions of a photo (too dark, blurry, sideways, glare, close-ups): does it ask for a better photo instead of guessing? 5 reuse the Civic photo with a tricky claim detail (an injury, damage on the wrong side, a cheap car, two different cars): do the rules catch it?

Who decided the right answer? I did, as drafts. An estimator should review them before anyone relies on these numbers.

Did any answers change after testing? One. A test claim reuses the Civic photo on a car worth only $2,500, and I'd first labelled it a total loss. The repair is about $1,130, 45% of the car's value and under the 60% total-loss line, so an estimator would repair it. I corrected the label; sending it to an adjuster still counts as reasonable. With your claims, your estimators set the answers before testing.

10 should go to an adjuster, and only 7 should be approved from photos, so the next gap to fill is more simple claims. Every test claim is listed with its photo under More detail, at the bottom.

What we'd need from you to trust it

A few hundred past claimswith photos, where each one went, and what was finally paid
Two of your estimatorslabelling them separately, so we know how often experts agree
Today's numbershow often claims are escalated late, and how long a review takes
A test set we never tune onso every change is checked against it before it goes live

The 3 claims it didn't get exactly right

Every one erred on the safe side
A clean photo, uploaded sideways.Asked for a photo it didn't need
Expert said: Ready to approve · Recommended: Request more evidence
What happened
Sideways, the AI couldn't tell which car it was, so it asked the customer for another photo instead of guessing.
What we'd change
Straighten photos automatically before the AI looks at them. Today this costs the customer one extra photo; it never lets a serious claim through.
Front-corner damage priced close to the $2,500 approval limit.Different answer on repeat runs
Expert said: Ready to approve · Recommended: Ready to approve 3 times, Adjuster / total loss 1 time
What happened
The price sat right around the limit, so on repeat runs it went to an adjuster once and was approved three times. The expert would approve it, but an adjuster is a reasonable call too.
What we'd change
Claims whose price could run well past the limit now always go to an adjuster, so it gives the same answer every time. With your paid claims we'd set that threshold properly.
A blurry, forwarded copy of a photo.Reasonable, not the expert's first choice
Expert said: Ready to approve · Recommended: Request more evidence
What happened
It asked the customer for a better photo. The expert might have approved from it, but asking is reasonable.
What we'd change
Fine as it is. Your reviewers' decisions would tell us whether it asks too often.
More detail: every test claim with its photo, models compared, and how it was scored
Didn't guess when unsure 17 of 17Car identified right make 17 of 24, model 18 of 24, color 24 of 24Review flags raised 5 of 5Same route every run 25 of 26Slowest 1 in 20 14.0 sModel and prompt Claude Opus 5.5, extract-v2

Models and prompts side by side

Same 26 cases, same rules
MeasureClaude Opus 5.5, extract-v2Claude Sonnet 5.5, extract-v2Claude Opus 5.5, extract-v1
Complex claims sent to an adjuster10 of 1010 of 1010 of 10
Same route as the expert label23 of 2623 of 2622 of 26
An acceptable route per the label25 of 2625 of 2623 of 26
Simple claims sent to an adjuster0 of 160 of 161 of 16
Didn't guess when unsure17 of 1716 of 1717 of 17
Make / model / color17/24, 18/24, 24/2417/24, 18/24, 23/2417/24, 17/24, 24/24
Typical time per claim9.7 s7.0 s9.6 s
Cost per case$0.039$0.019$0.038
AI failures000

Recommended route compared with the expert's

Each row is what the expert said; each column is what the AI and rules recommended. Bold is where they agree.
Expert saidReady to approveRequest more evidenceAdjuster / total lossNot assessed: manual triage
Ready to approve4210
Request more evidence0800
Adjuster / total loss00110

Every case

Highlighted rows disagree with the expert label
PhotoCaseExpectedRecommended routeWhyMake · model · colorEstimate
A_civic
Core outputs on a clear photo
Ready to approveReady to approvenone
Honda ✓
Civic ✓
Silver ✓
$950 to $1,300
under the limit
Expert: $1,000 to $2,500
B_civic_closeup
Doesn't guess the car from a close-up
Request more evidenceRequest more evidenceE2, E3
? ✓ (didn't guess)
? ✓ (didn't guess)
Silver ✓
$1,050 to $1,500
provisional, not scored
B_civic_retake
Customer's retake resolves the evidence request
Ready to approveReady to approvenone
Honda ✓
Civic ✓
Silver ✓
$1,050 to $1,500
under the limit
Expert: $1,000 to $2,500
C_f1
Non-road vehicle with structural damage
Adjuster / total loss
needs an adjuster
Adjuster / total lossS2, S4, P1, E2, E4, E6
? ✕ left blank
? ✓ (didn't guess)
Orange and blue ✓
none
00a_camry
Front-corner damage near the fast-path limit
Ready to approveAdjuster / total lossC4, R1
Toyota ✓
Camry ✓
Grey ✓
$2,500 to $3,450
straddles the limit
Expert: unsure of the band
00b_camry_closeup
Close-up of a different car
Request more evidenceRequest more evidenceE2, E3, R1
? ✓ (didn't guess)
? ✓ (didn't guess)
Dark grey ✓
$800 to $1,150
provisional, not scored
01_low_light
Too dark to judge the damage
Request more evidenceRequest more evidenceE2, E4, R1
? ✕ left blank
? ✕ left blank
? ✓ (didn't guess)
$1,350 to $1,900
provisional, not scored
02_motion_blur
Blurry photo
Request more evidenceRequest more evidenceE2, E4, R1
? ✕ left blank
? ✕ left blank
Grey ✓
$500 to $750
provisional, not scored
03_compressed
Forwarded low-quality copy
Ready to approveRequest more evidenceE2, E4, R1
? ✕ left blank
? ✕ left blank
Grey ✓
$1,650 to $2,300
provisional, not scored
Expert: unsure of the band
04_glare
Glare hides the damage
Request more evidenceRequest more evidenceE2, E4, R1
? ✕ left blank
? ✕ left blank
Dark grey ✓
$1,050 to $1,500
provisional, not scored
05_rotated
Sideways upload should match 00a
Ready to approveRequest more evidenceE2, R1
? ✕ left blank
? ✕ left blank
Grey ✓
$1,350 to $1,900
provisional, not scored
Expert: unsure of the band
06_mirrored_duplicate
Flipped copy of a past claim's photo
Adjuster / total loss
needs an adjuster
Adjuster / total lossI1, E2, R1
? ✕ left blank
? ✕ left blank
Dark grey ✓
$2,150 to $2,950
provisional, not scored
07_headlight_closeup
Close-up in a sensor and lighting area
Request more evidenceRequest more evidenceE2, E3, R1
? ✓ (didn't guess)
? ✓ (didn't guess)
Grey ✓
$1,350 to $1,900
provisional, not scored
08_wheel_closeup
Wheel only; the damaged area isn't shown
Request more evidenceRequest more evidenceE2, E3, R3
? ✓ (didn't guess)
? ✓ (didn't guess)
Dark grey ✓
$450 to $1,350
provisional, not scored
09_no_vehicle
No vehicle in the photo
Request more evidenceRequest more evidenceE1, E4
?
?
?
none
10_race_debris_crop
Partial race-car crop
Adjuster / total loss
needs an adjuster
Adjuster / total lossS2, S4, P1, E2, E3, E4, E6
? ✓ (didn't guess)
? ✓ (didn't guess)
Orange and black ✓
none
11_race_greyscale
Black-and-white photo: colour can't be known
Adjuster / total loss
needs an adjuster
Adjuster / total lossS2, S4, P1, E2, E4, E6
? ✓ (didn't guess)
? ✓ (didn't guess)
? ✓ (didn't guess)
none
V1_injury
Injury on the claim overrides a simple photo
Adjuster / total loss
needs an adjuster
Adjuster / total lossS1
Honda ✓
Civic ✓
Silver ✓
$950 to $1,300
under the limit
Expert: $1,000 to $2,500
V2_wrong_side
Damage doesn't match the customer's description
Ready to approveReady to approveR3
Honda ✓
Civic ✓
Silver ✓
$950 to $1,300
under the limit
Expert: $1,000 to $2,500
V3_low_value
Same damage on a car worth much less (repair under the total-loss line)
Ready to approveReady to approvenone
Honda ✓
Civic ✓
Silver ✓
$950 to $1,300
under the limit
Expert: $1,000 to $2,500
V4_mixed_cars
Folder with photos of two different cars
Adjuster / total loss
needs an adjuster
Adjuster / total lossI2, E2, R1
?
?
?
$2,500 to $3,400
provisional, not scored
V5_asked_twice
Still not enough after two requests
Adjuster / total lossAdjuster / total lossE7, E2, E3
? ✓ (didn't guess)
? ✓ (didn't guess)
Silver ✓
$1,050 to $1,500
provisional, not scored
D_nissan_front_crush
Severe front crush on an ordinary road car
Adjuster / total loss
needs an adjuster
Adjuster / total lossS2, S4, C1, C2, R1
Nissan ✓
Altima ✓
White ✓
$3,250 to $4,450
over the limit
Expert: total loss
12_flood
Flood damage a photo can't price
Adjuster / total loss
needs an adjuster
Adjuster / total lossS4, S5, E3, E4, R4
Mercedes-Benz ✓
230 TE (W124 estate) ✓
Gold/beige ✓
$400 to $600
provisional, not scored
Expert: total loss
13_van_crushed
Roof crushed by a collapsed wall; also a commercial-type van
Adjuster / total loss
needs an adjuster
Adjuster / total lossS2, S4, E3, E4
Hyundai ✓
Grand Starex (H-1) ✓
Yellow ✓
$8,850 to $12,000
provisional, not scored
Expert: total loss
14_vw_tree
Front corner into a tree; possible airbag and structural damage
Adjuster / total loss
needs an adjuster
Adjuster / total lossS2, S3, E3, E4, R1
Volkswagen ✓
Golf ✓
Dark grey ✓
$4,650 to $8,200
provisional, not scored
Expert: total loss

Run the labelled set now

Same route, prompt and rules as the worklist. Each case is one real AI call and costs money.