Settings
Configure risk thresholds and QA parameters
Risk Thresholds
Define score boundaries for risk tier classification
High Risk Threshold70+
Claims with scores above 70 are flagged as high risk
Medium Risk Threshold40-69
Claims with scores 40-69 are medium risk
Risk Rules
Configure which rules are active and their relative importance
Impact preview: 0 high risk2 medium riskof 60 claims
Settlement Exceeds Limit
Flags claims where payment exceeds typical policy limits for the LOB
Weight25%
Missing Documentation
Flags claims with incomplete or missing required documents
Weight20%
Date Inconsistency
Flags claims closed unusually fast (<3 days) or slow (>60 days)
Weight15%
Low Extraction Confidence
Flags claims with low AI extraction confidence scores
Weight20%
Settlement vs Estimate Variance
Flags claims where final settlement differs >15% from initial estimate
Weight20%
Checklist Weighting
Adjust importance of checklist categories by LOB
Home Claims Weight50%
Motor Claims Weight50%
User Roles
Current team members and their access levels
Sarah Mitchell(You)
sarah.mitchell@company.com
James Chen
james.chen@company.com
Emma Thompson
emma.thompson@company.com
Michael Roberts
michael.roberts@company.com