Auto glass use case
Auto glass insurance automation: carry the paperwork, not the claim.
The insurance path is where a glass shop spends the most non-production time, and it is the most defensible place to automate, because most of it is assembly, tracking, and follow-up. Below is the path step by step, with the line drawn at each one. It covers what most searches call claims automation, since at a glass shop the insurance path and the claim are one piece of work.
Where the hours go
A technician is paid to install glass. Somebody else is paid to chase the file.
Ask a glass shop owner where a job gets stuck and the answer is rarely the install. What stretches a job into a week is everything around it: a payer that was not identified correctly, a document the administrator wanted that nobody knew about, an authorization that arrived and was never matched to the job, a supplemental nobody filed because the damage turned up on a Friday. None of that needs a technician, and almost none of it needs judgment. It needs remembering, assembling, and noticing when something has gone quiet.
The path, step by step
Eight steps, and a line at every one of them.
Each step says what an automation layer can assemble, flag, or track, and what a person owns.
Identify the payer and the claim
Know who is paying, which administrator acts for that insurer, and whether a claim number already exists. Getting this wrong sends the file down a path that has to be reversed later.
Proposes the payer and administrator for that policy, and surfaces an existing claim number on the customer or the VIN.
Confirming it is right. A proposal from software is a suggestion until somebody at the shop accepts it.
Verify coverage and deductible
Two questions decide the rest of the job: is this covered, and what does the customer owe. Customers also ask here whether a zero-deductible glass endorsement is worth having. That is a question about their policy, not about your shop.
Records what the payer states, flags a job where the customer portion is unconfirmed, and drafts a plain-language update.
The coverage conversation. Coverage and deductible answers come from the insurer, never from the shop and never from the automation.
Apply the OEM versus aftermarket rule
Some policies and some vehicles carry a requirement about which glass goes in. It affects the part number, the price, and sometimes the calibration that follows, so it has to be settled before the part is ordered rather than after it is on the van.
Compares the staged part against the requirement recorded for that policy and vehicle, and raises the conflict while it is still cheap to fix.
The parts determination. Which glass belongs on the vehicle is a qualified human call.
Establish the calibration requirement
A replacement on a vehicle with driver assistance systems usually means an ADAS recalibration, and that work has to be both performed and paid for. Whether the payer treats calibration as part of the covered replacement or as a separate line is a recurring dispute, and the answer can change whether the job is mobile or in-shop.
Holds the calibration requirement on the job, flags jobs where it is needed but unaccounted for, and tracks whether it was billed.
The requirement itself and any argument about it. Whether a vehicle needs calibration, and whether that is a safety matter, is for qualified people.
Submit the claim or work order
Each payer wants its own combination of documents through its own channel, and a missing attachment is the most common reason a submission sits. This is the assembly step, and it is where automation earns its place.
Builds the submission from the work order, VIN, part, and photos, checks the document set against the payer's list, and flags what is missing.
Approving what goes out. Every representation to an insurer or administrator is the shop's, and somebody signs it.
Capture the authorization
An authorization carries a scope and often conditions. A job that proceeds outside the authorized scope creates a conversation at the end that is far harder than the one at the start.
Files it against the job, compares the authorized scope with the scheduled work, and raises a variance for review.
Deciding what to do about it. Nothing here approves a claim, because only the payer can approve a claim.
Submit the supplemental or additional damage
Damage found once the glass is out is normal in this trade, and the supplemental is where shops lose money quietly, because it depends on somebody remembering to file it on a busy afternoon.
Detects additional work on a job with no supplemental filed against it, assembles the evidence pack, and drafts the submission.
Justifying and sending it. Explaining why the extra work was required is the shop's position, stated by a person.
Get paid and close the file
The last step is the one nobody watches, which is exactly why claims age. A file sitting for three weeks does not announce itself, and neither does a short payment.
Ages every open claim against its normal, raises the stalled ones, and reconciles what was paid against what was submitted.
The chase. Following up on a short payment or a denied line is a conversation with an insurer, and it belongs to a person.
An honest answer
Can AI handle insurance claims? No. It can handle the claim file.
That question gets asked often enough to deserve a direct answer. A layer can assemble a submission, spot a missing document, track how long a file has been open, detect a supplemental that was never filed, reconcile a payment, and draft the customer update. At a busy glass shop that is most of the non-production time, so it is worth having.
What it cannot do is carry the claim. It cannot negotiate with an insurer or a TPA. It cannot approve a claim, because only the payer approves a claim. It cannot tell a customer what their policy covers, because only the insurer can say that. And it cannot determine whether a windshield is repairable or whether a vehicle is safe to drive, because that is a qualified person's judgment about a physical object. Any product implying otherwise is describing a liability, not a feature.
The rule to hold: coverage and deductible answers come from the insurer. Never from the shop, and never from the automation. If a tool is drafting a coverage answer to a customer, it has already gone too far.
Related: the auto glass pillar -> building the glass day -> the numbers behind it ->
Where the file stalls
Bring us your three oldest claims.
We will trace each one back to the step where it stopped moving, and show which of those steps a layer would have caught.