When a Growing Claims Volume Outpaces Your Team
Midland Claims Group is a third party administrator based in Columbus, Ohio, managing workers' compensation and commercial property claims for 14 regional carriers. With a staff of 23 and roughly 400 active claims at any given time, they occupied that difficult middle ground — too large to run on spreadsheets, too small to build a proprietary claims system.
By early 2024, that tension had become a real operational problem. New business was coming in, but the team was already stretched handling claims processing the old way: phone-based FNOL intake, email threads for document collection, and manual follow-up calls to field adjusters.
The Challenge: A Bottleneck at Every Stage of the Claim
Midland's claims manager, Patricia Hensley, described the situation plainly: "We had good people doing work that shouldn't require a person." Her team was spending roughly 35% of each workday on tasks that were purely logistical — calling policyholders for missing documents, leaving voicemails for adjusters, and manually updating claim status fields.
FNOL Intake Was Inconsistent and Slow
First notice of loss calls were handled by two intake coordinators during business hours only. After-hours claims sat unacknowledged until the next morning, and the intake forms were inconsistent — different coordinators captured different fields, which created gaps that slowed coverage verification downstream.
On average, it took Midland 6.2 hours from initial FNOL contact to adjuster assignment. Industry benchmarks put best-in-class at under 2 hours.
Document Collection Was an Ongoing Fire Drill
Requesting medical records, repair estimates, and police reports fell to individual adjusters, who tracked outstanding items in personal email folders. There was no centralized visibility into what was missing, and no automated follow-up. Claims routinely stalled for days — sometimes weeks — waiting on a single document that nobody had formally re-requested.
Policyholders Were Calling In Constantly
Without proactive updates, policyholders called to check claim status. Hensley's team logged an average of 90 inbound status calls per week. Each call pulled a coordinator off more complex work for 8 to 12 minutes.
The Solution: Deploying ClaimRelay Across the Full Claims Lifecycle
Midland implemented ClaimRelay over a three-week onboarding period in March 2024. The integration connected to their existing claims management database and carrier portals, so adjusters didn't need to migrate to a new system — ClaimRelay layered on top of existing workflows and automated the gaps.
Structured FNOL Intake Around the Clock
ClaimRelay's FNOL intake agent replaced the phone-only intake process with a structured web and phone channel that operates 24 hours a day. Policyholders reporting a new claim — whether at 2 p.m. or 2 a.m. — receive a consistent intake experience. The AI captures all required fields, auto-assigns a claim number, triggers coverage verification, and routes to the appropriate adjuster within minutes.
Within the first 30 days, Midland's average time-to-adjuster-assignment dropped from 6.2 hours to 1.4 hours.
Automated Document Requests with SLA Tracking
For each open claim, ClaimRelay generates a document checklist based on claim type and automatically sends requests to the relevant parties — medical providers, body shops, law enforcement agencies. It tracks receipt status and re-sends requests on a configurable schedule when items remain outstanding.
Adjusters can see the document status for every claim in a single dashboard view rather than hunting through email. Hensley noted that "the biggest change was just knowing where things stood at any moment without having to ask."
Proactive Policyholder Updates at Every Milestone
ClaimRelay sends automated status notifications at each claim milestone: acknowledgment, adjuster assignment, inspection scheduled, documents received, reserve set, and payment issued. Policyholders receive these updates via SMS or email based on their preference.
This single change addressed the inbound call volume problem more directly than Midland had anticipated.
The Results: Six Months After Implementation
By September 2024, Midland Claims Group had measurable outcomes across every area they had identified as problematic.
- Claims backlog reduced by 61%. Active claims sitting in a stalled state for more than 10 days dropped from an average of 74 to 29.
- 22 hours per week recovered in staff time. Coordinators shifted from status calls and document chasing to exception handling and complex file management.
- Inbound status calls down 44%. Proactive policyholder updates reduced the call volume from roughly 90 calls per week to approximately 50.
- FNOL-to-assignment time cut by 77%. From 6.2 hours to 1.4 hours on average, with after-hours claims now acknowledged the same night they are reported.
- Document collection cycle shortened by 8 days on average. Automated follow-up eliminated the multi-day gaps that occurred when manual re-requests were missed or delayed.
On the revenue side, faster cycle times allowed Midland to take on three new carrier contracts in Q3 2024 without adding headcount. Hensley estimated the operational capacity freed up by ClaimRelay was equivalent to hiring 1.5 full-time coordinators — at a fraction of the cost.
"We're processing more claims than we were a year ago with the same team. The work is just different now — our people are actually adjusting claims instead of chasing paperwork." — Patricia Hensley, Claims Manager, Midland Claims Group
What Other TPAs and Agencies Can Take From This
Midland's experience reflects a pattern common across third party administrators and regional carriers: the bottlenecks are rarely caused by a lack of effort. They're caused by manual processes that were never designed to scale.
If your team is managing claims processing through a mix of phone calls, email threads, and individual adjuster follow-up, the capacity cost is real — even if it's hard to quantify until you measure it directly. Midland started by tracking time spent on logistical tasks for two weeks before implementation. That baseline made the results undeniable.
For practices managing related billing workflows alongside claims, BillingBeam automates medical billing and payment reconciliation in a similar structured way — useful if your TPA handles medical claims with downstream billing touchpoints.
And if your firm works closely with legal counsel on disputed claims or litigation files, BriefFlow brings the same kind of structured workflow automation to law firm office management, which can reduce back-and-forth on shared case files.
The core lesson from Midland is straightforward: when your claims adjuster team spends less time on logistics, they close more claims — and close them correctly.