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Independent Adjuster Bill Review

Independent adjuster bill review on every fee bill and report, the day it lands

No IA report accepted or fee bill paid until it meets your guidelines.

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See one case, screen by screen ↓
demo38sfor six agents to check a 14-line fee bill against 31 rules, 64 photos, the check-in log and the claim notes
demo26.5hof field time one adjuster billed in an 8-hour-16-minute day — 4.45 hours documented on site
demo6of 14 linesreduced on one fee bill, $741.50 not allowed, each reduction citing its guideline section
target100%of fee bill lines tested against the fee schedule and guidelines — no sampling
In short

What is Independent Adjuster Bill Review?

The check a carrier makes before paying an outside adjusting firm: each fee bill line tested against the fee schedule and billing guidelines, and the adjuster’s report checked against the report guidelines. Independent Adjuster Bill Review does it on every bill and report the day it lands, and adds a check that invoice rules alone do not make: billed field time against the photos and the check-in log.

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Updated

The problem

Why IA fee bills get paid as billed after a storm

In a surge, a carrier hands thousands of claims to outside adjusting firms. Every assignment comes back as a report, an estimate, a photo set and a fee bill — in each firm’s format, of each adjuster’s quality. Someone has to check each bill against the fee schedule and the guidelines, and each report against the photos, before it is accepted or paid. In a bad season the backlog grows faster than the team can read.

So the team samples, and the rest is paid as billed. The over-billing that slips through is the kind only the whole file shows: a re-inspection nobody authorised in the claim notes, clerical time billed by the hour, photos over the cap, a fee from the wrong band. And the hardest to see: a bill that says “field inspection 4.0 hours” when the photo time stamps and the check-in log show 35 minutes on site and the adjuster at the next house by 11:41. Report gaps — a missing rear elevation, no moisture readings — surface months later as a supplement or a re-inspection.

typical100–200adjustersa carrier now asks one IA firm for in a surge, up from dozens
typical6%fewer US claims adjusters, examiners and investigators projected by 2035
demo438fee billswaiting after one hurricane in the working solution, the oldest 9 days
Where one fee bill’s review minutes goestimated
By hand39 days
With the solution8.5 days
  • Reading the bill and tying every line6 → 0.5 d
  • Testing each line against the fee schedule8 → 1 d
  • Matching billed time to photos and check-ins10 → 1 d
  • Checking the report against the guidelines8 → 3 d
  • Writing the return note to the firm5 → 1 d
  • Deciding and signing2 → 2 d

Estimated minutes for one time-and-expense fee bill and its report, checked by hand and with the solution.

How it works

How a fee bill moves

Six specialist agents check every bill line, photo time stamp and report item; the IA program manager decides and signs.

What comes in
Bill and report inbill · report · photos · any firm's format, plus claim notes
Agents at work
Fee bill readerlines and totals
Then
Photo and time cross-checker
Report reviewer
Then
Guideline checkerallowed amount
Then
Return note writerone note
A person decides
IA program managerdecides and signs
What comes out
Allowed amount
Return note to the firm
Firm scores
One case, step by step

One fee bill, from received to paid

Hurricane Marisela made landfall in Sandhaven, TX on 21 September. Two weeks later Gulfstar Claims Services bills Northmere Mutual $2,619.90 for the Ames claim. Here is what happens next, screen by screen, in the working solution.

  1. 01Wed 7 Oct, morning

    The bill stack, and the bill already checked

    Priya Raman · IA program manager

    Priya opens CAT 26-14: 438 fee bills waiting, $1.21M billed, $118.4K not allowed so far. The first in the stack is Gulfstar’s GCS-26-07714 for Carol and Dwight Ames — 14 lines, $2,619.90. The gross loss is $187,460, over $150,000, so it is billed as time and expense under guideline §3.2. Lines over guideline are already struck through, the allowed amount written beside them.

    “6 agents checked this bill at 08:53 — 14 lines · 31 rules · 64 photos · check-in log · claim notes · 38 s”

  2. 02Replay the audit

    Every line tested, one check at a time

    The agents

    Replay shows the run on the bill itself. The fee bill reader ties every quantity × rate to the $2,619.90 total. The guideline checker confirms the billing basis, then cuts mileage from 142 to 92 miles — the first 50 miles of a round trip are not billable (§5.3) — pays 40 photographs at $1.50 instead of 64 at $2.00 (§5.5), and strikes file set-up and postage as overhead (§4.6, §5.8).

  3. 03One click on T-03

    Four hours billed, 35 minutes on site

    Photo and time cross-checker

    Travis Kell billed 4.0 hours of field inspection, $380.00. His field app’s GPS check-in at 1418 Heron Point Drive is 10:35 and check-out 11:10; his 64 photos run from 10:42:17 to 11:03:05; his next photo, on another claim at 77 Bayshore Road, is at 11:48. Field time is documented on-site time: 35 minutes, rounded up to 0.6 h — $57.00 allowed.

    §4.3: “Field time is the time on site at the risk, supported by the inspection check-in and check-out and by the photographs, billed at $95 an hour to the next 0.1 hour.”

  4. 04Open Travis Kell’s day

    Seven inspections on one time line

    Photo and time cross-checker

    The cross-checker lays every claim he billed on Saturday 26 September side by side: seven large-loss inspections in Sandhaven between 08:05 and 16:21, each 35 to 41 minutes on site by his own check-ins and 412 photos. He billed 26.5 hours of field time in a day that ran 8 hours 16 minutes; 4.45 hours are documented on site.

    “It reports time, not intent. Whether this is a pattern is for vendor management to decide.”

  5. 05The day as billed

    Billed hours laid end to end

    Priya Raman · IA program manager

    Switch to the day as billed and the seven field-time blocks, laid end to end, run past his 16:21 last check-out, past midnight, to 10:35 on Sunday. One button applies documented time to all seven bills; another refers the pattern to vendor management. A referral asks for a review — it is not a finding.

  6. 06Report check

    Nine of 12 report guidelines met, three to return

    Report reviewer

    The report reviewer checks the first report against the report guidelines: contact 19 hours after assignment, inspection 2 days after contact, first report 3 days after inspection, cause of loss with its evidence, every roof slope with a test square, sketch, estimate tie, mortgagee named. Three items are not met: front, left and right elevations only, no moisture reading in bedroom 2, and a 2 Oct re-inspection with no authorisation in the notes.

  7. 07Report and photos

    The report with margin notes

    Report reviewer

    The report opens as pages with a margin note against each guideline it meets or misses, beside the elevation map and the 64-photo contact sheet. Bedroom 2 has five photos and no moisture reading, although it has the largest drywall replacement, 412 sq ft — and the examiner, Marcus Bell, asked for the readings on 1 Oct.

  8. 08Decision

    Pay what the file shows, return what it doesn’t

    Return note writer

    From billed to allowed: $2,619.90 down to $1,878.40, 28.3% not allowed, the held re-inspection line paid when its evidence arrives. Beside it, one return note to Shawna Delacroix, Gulfstar’s branch manager: three report items and six bill lines, each with its section. Priya can edit it before it goes.

    “Reply here with any evidence we have not seen and we will look at the line again.”

  9. 09Signed · Today 09:14

    Two signatures, then the payment run

    Priya Raman and Lena Ortiz

    Priya approves $1,878.40, sends the note and refers Travis Kell’s 26 September to vendor management. The reduction is over $500 and carries a time flag, so Lena Ortiz, the CAT unit’s claims supervisor, co-signs — from her phone. The bill goes into Thursday’s payment run.

    “Your signature, the evidence for every line and the note are kept with the bill. The agents proposed; you decide.”

Who it’s for

Built for everyone who touches an IA fee bill.

The same bill, seen by the five people who carry it — what their storm season looked like, and what it looks like now.

PR
Priya RamanIA program manager, Northmere Mutual
IA program manager
Before
“I can audit one bill in ten. The other nine get paid as billed.”
Now
Opens every bill already checked, each reduction cited, and sends one return note per bill.
LO
Lena OrtizClaims supervisor, CAT unit
Co-signer
Before
“Show me the evidence, not the accusation.”
Now
Co-signs reductions over $500 and any time flag with the photos, log and section on every line.
MB
Marcus BellClaims examiner
Examiner
Before
“If I didn’t write it in the notes, I didn’t authorise it.”
Now
A re-inspection without his authorisation in the claim notes is held, and his request for moisture readings goes back to the firm.
SD
Shawna DelacroixBranch manager, Gulfstar Claims Services
IA firm
Before
“Send me one note with everything, not five emails.”
Now
Gets one note per bill: every report gap and every bill line, each with its section, and a way to answer with evidence.
JF
Jonah FairleyVendor manager · firm panel and referrals
Vendor management
Before
Sees firm scores that rest on a sample of bills.
Now
Sees six firms and 217 adjusters scored from every bill and every report, and receives referrals with the evidence attached.
Built on the engine

6 agents. Each with one job, and hard limits.

Six specialist agents check every bill line, photo time stamp and report item; the IA program manager decides and signs.

Fee bill reader

Reads each IA fee bill — PDF, e-bill or spreadsheet — codes every line to a task code, ties quantity × rate to the total and attaches every receipt to its line.

  • Never alters a billed figure — reports the difference
  • Cites page and line for every value
Guideline checker

Finds the billing basis from the gross loss — band fee or time and expense — and tests every line against the rates, caps and exclusions of the guidelines in force on the assignment date, proposing the allowed amount.

  • Never pays or rejects a bill; reductions are proposals
  • Every reduction cites its section
Photo and time cross-checker

Compares billed field time with the photos’ capture times and GPS, the adjuster’s check-ins and the claim notes — across every claim the adjuster billed that day.

  • Reports time, never motive
  • Uses only what the firm submitted to the file
  • Never calls it fraud; referrals go to a person
Report reviewer

Checks the adjuster’s report against the report guidelines — contact and inspection clocks, elevations, roof slopes, moisture readings, sketch, estimate tie, mortgagee.

  • Never rewrites the adjuster’s estimate
  • Every gap names the photo or page it is about
Return note writer

Drafts one note to the firm with every report gap and bill reduction, each with its section.

  • Never sends without a person
  • Plain words, no accusations
Firm scorer

Rolls every bill and report into weekly firm and adjuster quality scores.

  • Never removes a firm or adjuster from the panel
IA program manager

Approves and sends the note; a supervisor co-signs over $500. The agents propose; a named person decides.

Ask in plain words

Ask about any bill line, guideline, adjuster or firm

The IA team can ask in plain words. Every answer comes from the file and cites it.

Why is the field inspection cut from 4.0 hours to 0.6?

Travis Kell billed 4.0 hours of field inspection, $380.00. His own check-ins put him at 1418 Heron Point Drive from 10:35 to 11:10, and his 64 photos were taken between 10:42 and 11:03. His next photo, on the Haldane claim at 77 Bayshore Road, is at 11:48. Field time is documented on-site time, to the next tenth of an hour: 0.6 h, $57.00.

What else did Travis Kell bill on 26 September?

Seven large-loss inspections, all in Sandhaven: 26.5 hours of field time billed in a day that ran from 08:05 to 16:21, and 4.45 hours documented on site by 412 photos and 14 check-ins — 4.7 hours once each visit is rounded up to the next tenth. Applying documented time to all seven bills would not allow $2,071.00.

What is missing from the Ames report?

Three of the 12 report guidelines are not met: no rear elevation — the slope where the shingles lifted (§2.6); no moisture reading in bedroom 2, which has the largest drywall replacement, 412 sq ft, and Marcus Bell asked for it on 1 Oct (§2.6); and a 2 Oct re-inspection with no authorisation in the notes and no photos (§4.7). All three are in the draft return note to Shawna Delacroix, with the six bill lines.

How does Gulfstar compare with the other firms this storm?

Gulfstar has the lowest score of the six firms, 71, down from 78 in week 1. It billed $3.12M on 1,140 bills; 14.8% was not allowed, against 4.1% at Tidewater and 6.2% at Pelican Bay. 22% of its reports came back, and it carries 41 of the storm’s 68 time flags.

Every screen

The working solution, as it ships.

13 screens from the working solution, on its sample data. Pick one to see it large.

ReviewThe bill stack for the storm on the left; the fee bill in the middle, lines over guideline struck with the allowed amount beside them; photos and time beside it.
The audit, replayedEach agent check runs in view, and lines are struck on the bill one by one as their check finishes.
One line’s evidenceBilled against allowed, the guideline text, the photos and the check-in log on a time line — and a button to restore the line.
The adjuster’s daySeven inspections on one time line: on-site blocks, drives and photo ticks, with a claim-by-claim table of billed and documented time.
The day as billedBilled field time laid end to end runs from Saturday morning to 10:35 on Sunday.
Report checkThe 12 report guidelines, met or not met, each with its evidence and section.
The report with margin notesThe IA report as pages, a margin note against each guideline, beside the elevation map and the photo contact sheet.
The decisionFrom billed to allowed, line by line, the signatures needed and one return note to the firm, ready to edit.
Signed and co-signedThe program manager’s signature, the supervisor’s co-signature and the referral, all on the bill’s activity trail.
Every fee billThe storm’s queue by stage — decide, return report, waiting on the firm, ready to pay — ranked by amount at stake and days waiting.
Firms and adjustersFirm scorecards for the storm from every bill and report, week by week, with each firm’s adjusters lowest score first.
Guidelines and fee scheduleThe fee schedule by gross-loss band, time-and-expense rates, and every section the agents cite, with how often each was applied.
SettingsField-time tolerance, photo rules, auto-approval, second signature, report clocks and the people who sign.
Governance

Built for claims spend you can defend: cited, co-signed, on the record.

Every reduction cites its sectionEach struck line and each return item names the guideline section it rests on, and the evidence behind it — the photo, the check-in, the claim note.
Agents propose; a person approves every billNothing is paid until the IA program manager signs. The agents never pay a bill, reject a bill or send a note on their own.
A second signature where it mattersReductions over $500, or any time flag, need the claims supervisor’s co-signature before the bill goes into the payment run.
Time and gaps, never intentThe photo and time cross-checker reports what the file shows. A pattern goes to vendor management as a referral — a request for review, not a finding.
Only what the firm submittedPhoto times, GPS and check-ins are used only from photos and logs the firm submitted to the file.
Every step on the recordAgent checks, restored lines, signatures and referrals are on the bill’s activity trail with who and when; every settings change is saved as a new rule version.
Configuration

Your guidelines, your tolerances

What the agents check, how much they may propose on their own and who signs are settings — and every change is saved as a new rule version.

SettingDefaultChoose from
Field-time tolerance30 minMinutes, up to 120
Cross-check across the adjuster’s dayOnOn · Off
Photo time sourcePhoto capture timePhoto capture time · Check-in log · The later of the two
Photos billable$1.50 each, up to 40$1.50 each, up to 40 · $1.50 each, up to 60 · Included in the fee
Auto-approve clean bills under$1,500$1,000 · $1,500 · $2,500 · Never
Second signature for reductions over $500 or any time flagClaims supervisorClaims supervisor · CAT unit manager
Contact the insured, from assignment24 hours24 hours · 48 hours
First report, from inspection7 days5 days · 7 days · 10 days
Connections

Works with what the firms already send

Fee bills as the firms send themPDF, e-bill files and spreadsheets, in each firm’s own layout
IA reports and estimatesfirst and final reports, estimates and sketches
Photo setscapture time and GPS of every photo submitted
Field app check-insthe firm’s GPS check-in and check-out log
Claim notes and activity logassignments, authorisations and examiner requests
Your guidelines and fee scheduleeach new edition loaded and cited by section
What it changes

The difference, in numbers.

Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.

target
Sameday
every IA report and fee bill reviewed the day it lands
Sampled by hand1 bill in 10
With agentsevery bill, same day
target
100%
of fee bill lines tested against the fee schedule and guidelines
14 of 14 lines
on every bill
typical
100–200adjusters
a carrier now asks one IA firm for in a surge, up from dozens
A few years agoToday

“demo” = seen in the working solution, on its sample storm data · “target” = the design goal, measured in the live solution · “estimated” = our estimate · “typical” = published figures (Insurance Business, desk adjuster requests, 2026 — carriers asking IA firms for 100 to 200 adjusters in a surge; US BLS Occupational Outlook Handbook, claims adjusters, appraisers, examiners and investigators, 2025 — employment projected to fall 6% by 2035). The carrier, firms, adjusters, insureds, storm, fee schedule and guidelines are fictional; people named on this page are characters in the working solution.

Questions

What IA program and claims teams ask us.

What is independent adjuster bill review?

The check a carrier makes before paying an outside adjusting firm: each fee bill line tested against the fee schedule and billing guidelines, and the adjuster’s report checked against the report guidelines. Independent Adjuster Bill Review does it on every bill and report the day it lands, and adds a check that invoice rules alone do not make: billed field time against the photos and the check-in log.

How does it check billed field time?

The photo and time cross-checker reads the capture time and GPS of every photo the firm submitted, the check-ins from the firm’s field app and the claim notes, and compares them with the hours billed. It lays every claim the adjuster billed that day on one time line, so 26.5 hours billed in a day of 8 hours 16 minutes is plain to see.

Does it reject bills or accuse adjusters?

No. The agents propose reductions with the section and the evidence; the IA program manager decides and signs. Time findings are reported as time, never motive, and a pattern goes to vendor management as a referral for review, not a finding.

Can it handle our fee schedule and guidelines?

Yes. Your guidelines and fee schedule are loaded by edition — gross-loss bands, time-and-expense rates, mileage and photo caps, what is never billable — and every reduction cites the section it applies. A new edition can be loaded when it takes effect.

Does it review the adjuster’s report too?

Yes. The report reviewer checks the report against your report guidelines — contact and inspection clocks, elevations, roof slopes, moisture readings, sketch, estimate tie and mortgagee — and every gap names the photo or page it is about. Report gaps and bill reductions go back to the firm in one return note.

Can clean bills be paid without a manual review?

Only if you set it. Clean bills under a threshold — $1,500 in the working solution, with no flags, report guidelines met and a firm score above 75 — can be approved automatically, or you can choose never. Reductions over $500, or any time flag, need a second signature.

Do people stay in control?

Yes. Nothing is paid until a person signs, the return note is never sent without a person, and any line can be restored with a reason when the firm shows something the file did not hold. Every step is on the bill’s activity trail.

How long does it take to go live?

The Agentic Solution Engine builds and deploys it from your requirements and documents — your IA guidelines, fee schedule and a sample of past fee bills and reports — and it goes live once every quality gate has passed. We will walk you through it on your own bills first.

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your fee bills.

We’ll run Independent Adjuster Bill Review on a sample of your own IA fee bills and reports.

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