Claim reserve and settlement authority approval

How do we route a reserve change or a settlement above the adjuster's authority to the right approver with the case built, and record the decision in claims?

Build the case from the claim and route it by the authority table. When an adjuster sets a reserve or proposes a settlement above their authority, Callvu reads the claim (the coverage and limits, the current reserves by line, the paid to date, the evaluation, the demand and the offers, the litigation status, the reinsurance threshold), builds the approval case with the adjuster's rationale and the documents that support it, decides the approver from the authority table (the claims manager, the large loss unit, the home office, reinsurance notification), presents the case in the Decision Desk with only the allowed outcomes, applies the state's and the company's timing where a settlement demand has a deadline, and writes the approved reserve or authority to the claims system with the decision and the approver.

In scopeComplex: multi-party handoffsCallvu moves: decide, write back

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Last updated November 7, 2026.

The problem today

The time-limited demand expired while the authority request sat in a manager's inbox under a subject line that did not say it was urgent.

Today, without Callvu

An adjuster evaluates a bodily injury claim and needs authority above their limit to settle. They email the manager a summary. The manager is in meetings; the email is one of a hundred. The claimant's attorney had set a thirty-day deadline on the demand. When the authority comes a week late, the demand is withdrawn and the exposure is now the policy limits and beyond.

Claims organizations run on authority tables: each adjuster level may set reserves and settle up to an amount by line of business, and above it a manager, a large loss committee or the home office must approve, with reinsurance notified at a threshold. A reserve change is a financial event the actuaries and the regulators rely on; a settlement above authority on a time-limited demand is a bad faith exposure if it is late. Both are decisions with a case behind them.

The case should be built from the claim, the approver should be a rule, and the clock should be on the screen.

How it runs

From the requestto the system of record.

An adjuster enters a reserve change or a settlement proposal in the claims system that exceeds their authority. Callvu opens the approval case.

Adjuster: Proposes the reserve or settlement with the rationale and the supporting documents.
Claims manager: Approves, modifies or rejects in the Decision Desk within their own authority, or escalates.
Callvu: Builds the case, decides the approver, routes with the clock, and writes the decision.

Build the case
The claim's coverage and limits, the reserves by line with their history, the amounts paid, the adjuster's evaluation (liability, damages, the medical specials, the wage loss, the comparative fault), the demand and the offers to date, the litigation status and counsel's evaluation, the reinsurance attachment and the prior approvals are read from the claims system; the adjuster adds the rationale and the recommendation on a structured screen, and the supporting documents are attached from the claim.
Decide the approver and the clock
The authority table decides the approver by line of business, the amount of the change or the settlement and the claim's characteristics (litigated, a fatality, a coverage question, a punitive exposure): the claims manager, a second level, the large loss unit or the home office, and whether reinsurance or the excess carrier must be notified; a time-limited demand, a mediation date or a court deadline sets the clock on the case.
Decide in the Decision Desk
The approver sees the case with the evaluation, the history and the documents, and only the allowed outcomes: approve as proposed, approve a different amount with reasons, reject with reasons, or escalate; an approver whose own authority is exceeded cannot approve and the case moves up by rule; the decision is made before the clock runs, with escalation to the next level if the approver does not act in the period the policy sets.
Write back
The approved reserve or settlement authority, the approver, the decision, the reasons and the date are written to the claims system, the reserve posts to the financials, the reinsurance notice goes out where the threshold is reached, and the adjuster is told the authority they now hold and its expiry.

Where it ends: The approval ran on the authority table with a case the approver could decide from, inside the demand's clock, and the claims system holds the reserve or the authority with who approved it and why. The Decision Trace shows the approver determination, the case and the decision; the Audit Trace shows the proposal, the routing, each approver's action and the write with their times.

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

Claims reserving and financial reporting requirements (NAIC Statutory Accounting Principles SSAP 55, the Annual Statement Schedule P, and the Model Audit Rule): Case reserves must represent the insurer's best estimate of the unpaid loss and loss adjustment expense on each claim and be adjusted as information develops; reserve changes are financial events subject to the insurer's internal controls over financial reporting, and the authority to set and change them must be documented and auditable.
State unfair claims settlement practices acts (NAIC Model Act 900) and bad faith law on time-limited demands: The insurer must attempt in good faith to effectuate prompt, fair and equitable settlement of claims in which liability has become reasonably clear; a failure to respond to a reasonable settlement demand within policy limits before its deadline exposes the insurer to liability beyond the limits in most states, so the authority decision must be made inside the demand's period and the record must show the evaluation and the timing.
Reinsurance treaty and excess policy notice conditions: Treaties and excess policies require notice of a claim when the reserve or the exposure reaches a stated percentage of the retention or involves specified injuries; the authority routing applies the threshold and generates the notice.

Company policies

The approver is decided by the authority table, never chosen by the adjuster or the manager.
The case is built from the claims system with the adjuster's structured rationale; no summary emails.
A time-limited demand's deadline is on the case, with escalation by rule before it runs.
The claims system is the system of record for the reserve, the authority, the approver and the reasons.

Controls

Case built from the claim's financials, evaluation and documents.
Authority table determination of the approver and reinsurance notice.
Clock from the demand, mediation or court deadline.
Decision Desk with required outcomes and authority enforcement.
Escalation by rule on inaction.
Claims system write with the financial posting and the notice.

Clocks and deadlines

Time-limited demand: The demand's deadline on the case; the decision is due inside it with the policy's margin.
Approver action: The policy's period for each level; inaction escalates to the next level by rule.
Reinsurance notice: On reaching the treaty's threshold, within the treaty's notice period.

Documents and checks

The adjuster's proposal and rationale
The case with the financials, the evaluation and the documents
The approver determination
The decision with reasons and the approver
The claims system record and the reinsurance notice

In the Decision Trace

The approver determination and the table rule.
The decision, the amount, the reasons and the person at each level.

In the Audit Trace

The proposal with time.
Each routing, action and escalation with time against the clock.
The write and the financial posting.

The handoff

Between the front doorand the back office.

The front door

The adjuster's proposal in the claims system; no email, no form.

The back office

Approvers decide from a built case with the clock visible; the authority table and the escalation rule do the routing.

The Decision Desk

The case goes to the approver the authority table names in the Decision Desk with the evaluation and the documents, and only approve as proposed, approve a different amount with reasons, reject with reasons, or escalate; an approver without the authority cannot approve.

Proof

In scope.Proof at scale, not one process at a time.

The kind of process Callvu runs in production for customers in this industry. Ask for a reference on this exact process. The results below are the industry's published proof; each claim code links to its record on agents.callvu.com.

Phoenix put more than 100 processes live in under 3 months.

Across Callvu customers

More than 1,000 processes are live across Callvu customers.

Across Callvu customers

Questions

What buyers ask next,answered plainly.

Who approves?

The approver the authority table names for the line, the amount and the claim's characteristics: a claims manager, a second level, the large loss unit or the home office, with reinsurance notified at the treaty's threshold.

What does the approver see?

A case built from the claim: coverage and limits, reserves and payments, the adjuster's evaluation and rationale, the demand and offers, the litigation status and the documents, with the deadline on the screen.

What about a time-limited demand?

Its deadline is on the case, the decision is due inside it, and inaction at any level escalates by rule before the clock runs.

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