Claim Severity Triage and Adjuster Assignment Worksheet

Scores incoming claims by complexity and severity to route them to the right adjuster or specialty unit, with documented triage rationale for audit trail purposes.

Submission Notice

• Submitter name
• Submitter role
• Claim reference number
• Submission date

Claim Overview

• Date of loss
• Claim type
• Loss location
• Primary loss outcome

Severity and Complexity Scoring

• Complexity score
  Enter the triage score used by your team. Use a consistent scale such as 1-5 or 1-10.
• Severity level
• Litigation risk
• Special handling flags

Routing Decision

• Assigned path
• Assigned adjuster or unit
  Enter the name or team responsible for next action after triage.
• Routing rationale
  Summarize the observable factors that drove the severity score and assignment decision.
• Target response time

Escalation and Follow-up

• Escalation reason
• Additional information needed
• Supervisor notified
• Follow-up due date

Audit Trail and Attestation

• Triage completed by
• Completion date and time
• Audit notes
  Optional notes for internal review, including any exceptions or manual overrides.
• I confirm the triage information is accurate and the routing decision reflects the documented facts.