Disability income claim

How do we take a disability income claim from the claimant or the employer with the attending physician statement, the employer statement and the authorizations collected, so it reaches the examiner complete?

Run the three statements as three chases on one claim. Callvu opens the claim from the claimant's or the employer's report, classifies it (individual or group, short or long term, the elimination period, the definition of disability, the ERISA status), sends the claimant their statement, the authorizations (HIPAA and the employer and financial releases) and the identity and payment details on their phone, sends the attending physician the statement request with the authorization through the provider's channel, sends the employer the statement (the occupation, the earnings, the last day worked, the other benefits) through their link, chases each on the clock the plan's rules and ERISA set, reads and checks each on arrival, routes a definition, occupation or offset question to the claims examiner in the Decision Desk, and writes the complete claim to the claims system with the elimination period and the benefit computed. Live at Phoenix Insurance, under national rules outside the US.

Live at PhoenixComplex: multi-party handoffsCallvu moves: chase and verify, classify, decide, write back

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Last updated November 7, 2026.

The problem today

The claimant's benefit started six weeks late because the employer's statement sat in a human resources inbox and the physician's office wanted a different release.

Today, without Callvu

A disability claim needs three people to say three things: the claimant what happened and what they cannot do, the physician the diagnosis, the restrictions and the prognosis, the employer the occupation, the earnings and the last day worked. Each is a form sent by mail or email, each comes back incomplete or late, and the claimant lives without income while the examiner waits. The ERISA clock for a group claim runs regardless.

The HIPAA authorization must be valid before the physician's records can be requested; the ERISA claims procedure rules set the periods for the decision and the extensions, the notice of an adverse decision and the appeal rights for group claims; the plan's definition of disability, the elimination period, the pre-existing condition clause and the offsets (social security, workers compensation, other income) set what the examiner must compute. The three statements are chases; the computation is a rule.

The examiner should open a claim with all three statements checked, not a file with one.

How it runs

From the requestto the system of record.

A claimant or their employer reports a disability claim in any channel. Callvu opens the claim and classifies it.

Claimant: Completes their statement, signs the authorizations, provides identity and payment details on their phone.
Attending physician: Returns the physician statement and the records under the authorization.
Employer: Completes the employer statement through their link.
Claims examiner: Receives the complete claim and decides definition, occupation and offset questions in the Decision Desk.
Callvu: Classifies, sends each party their part, chases on the clock, reads and checks, routes and writes.

Classify the claim
The policy or the plan, the coverage (short or long term, individual or group), the elimination period, the definition of disability (own occupation, any occupation, the transition date), the pre-existing condition look-back, the offsets, the ERISA status and the state's rules classify the claim, its requirements and its clocks.
Chase and verify the three statements
The claimant receives their statement, the HIPAA authorization and the employer and financial releases, and the identity and payment details on their phone; the attending physician receives the statement request with the authorization and the specific questions (diagnosis, restrictions and limitations, treatment, expected duration) through the provider's channel; the employer receives the statement (the occupation and its duties, the earnings and the basis, the last day worked, the other benefits and the leave status) through their link; each is chased on the clock, read on arrival and checked (the dates agree, the occupation's duties support the restriction analysis, the earnings match the plan's benefit basis, the authorization is valid).
Decide
A claim with the three statements complete and inside the rules proceeds to the benefit computation by rule; a definition question (own occupation versus the duties), a pre-existing condition flag, an offset to be verified, a conflict between the statements, or an independent medical examination decision goes to the claims examiner in the Decision Desk with the statements and only the allowed outcomes, with the ERISA notice generated from a denial.
Write back
The complete claim with the statements, the classification, the elimination period and the benefit computation (the basis, the offsets, the taxability) is written to the claims system, the approval or the adverse determination with the appeal rights goes to the claimant within the period, the first payment is scheduled, and the continuing proof process is set on its review date.

Where it ends: The three statements were chased from the people who hold them on the clock, checked on arrival, and the examiner decided only the questions, so the claimant's benefit started on time with the claims system holding the complete claim and the computation. The Decision Trace shows the classification, each statement's checks and any decision; the Audit Trace shows each request, chase and arrival with time.

Runtime enforcement

What is enforcedwhile the work runs.

The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.

Regulations

US requirements shown. Phoenix runs this process under national rules outside the US; Callvu loads each market's rules as policies the same way.

HIPAA authorization: The attending physician's statement and records are obtained only under the claimant's valid HIPAA authorization (45 CFR 164.508) with the required elements; the authorization is captured on the claimant's phone at the start and carried on the physician request, and the records are protected health information under the insurer's privacy program.
ERISA claims procedure rules (group): For a group disability plan, 29 CFR 2560.503-1 requires a decision within 45 days of the claim, extendable twice by 30 days with notice of the reasons and the information needed, with the clock tolled while the claimant supplies information; an adverse benefit determination must state the specific reasons, the plan provisions, the information needed and the appeal rights, and the appeal is decided by a different reviewer within 45 days (extendable once); the 2018 amendments add the right to the claim file, the rationale for disagreeing with treating physicians and new evidence before the decision.
State disability insurance rules and the policy's definitions and offsets: Individual policies and state-regulated group policies follow the state's claim handling rules and the policy's elimination period, definition of disability, pre-existing condition clause, offsets and taxability; the computation applies the policy's terms to the employer's earnings data.

Company policies

The authorization is captured before the physician is asked; the three statements are chased from the people who hold them, not through the claimant.
Every statement is checked against the others on arrival; the examiner sees conflicts, not stacks.
The ERISA periods and tolling are tracked on the claim; a denial's notice is generated from the decision with the rights.
The claims system is the system of record for the claim and the benefit computation.

Controls

Claim classification with definition, elimination period and ERISA status.
Per-party statements with authorizations.
Chases on the clock with tolling.
Reading and cross-checks.
Decision Desk for definition, offset and examination questions.
Benefit computation, claims system write and notice generation.

Clocks and deadlines

ERISA decision: 45 days from the claim, extendable twice by 30 days with notice, tolled while the claimant supplies information.
Elimination period: The policy's period from the date of disability, computed on the claim.
Statement chases: Reminders to each party on the insurer's schedule within the decision period.

Documents and checks

The classification
The claimant's statement and authorizations
The physician's statement and records
The employer's statement
The computation, the decision, the notice and the claims system record

In the Decision Trace

The classification and the clocks.
Each statement's checks and the cross-checks.
Any decision and the person.

In the Audit Trace

Each request and chase with party and time.
Each arrival with time.
The write, the notice and the first payment.

The handoff

Between the front doorand the back office.

The front door

The claimant or the employer in any channel; the claimant on their phone; the physician and the employer through their channels.

The back office

The examiner opens a complete claim with the computation and decides only the questions; the ERISA notices are generated.

The Decision Desk

A definition question, a pre-existing condition flag, an offset to verify, a conflict between statements or an examination decision goes to the claims examiner in the Decision Desk with the statements and only the allowed outcomes.

Proof

Live at Phoenix.Published results only.

Each result is a published claim, with its code on agents.callvu.com, where its status, source and last verified date are kept.

Phoenix Insurance reaches more than 90% completion without human help.

INS-06 · Self-asserted · verified 2026-11-05

Phoenix Insurance put more than 100 processes live in under three months.

INS-01 · Self-asserted · verified 2026-11-02

PHI masking is tested and live.

ENF-08 · Self-asserted · verified 2026-11-02

Questions

What buyers ask next,answered plainly.

Who completes what?

The claimant their statement, authorizations, identity and payment details on their phone; the physician the statement and records through their channel; the employer the occupation, earnings and last day worked through their link; each chased on the clock.

What are the ERISA deadlines?

A decision within 45 days of a group claim, extendable twice by 30 days with notice, tolled while the claimant supplies information; a denial states the reasons and the appeal rights, and the appeal is decided by a different reviewer.

What does the examiner decide?

Only the questions: the definition against the occupation's duties, a pre-existing condition flag, an offset, a conflict between the statements, or an independent examination; the rest proceeds by rule.

Related processes

Continuing disability proof Waiver of premium claim Claim denial appeal Life underwriting evidence collection Try it in the sandbox All insurance processes

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