Blog
August 12, 2026
by
Andrej Evtimov
How an adjuster at a top 20 commercial carrier walked defense counsel through a full demand package, live, and found what the file was hiding before it became a problem.
A demand package can run 100 to 500 pages: medical records, bills, legal letters, all building toward one number. The adjuster who opens it usually has 30 days and a full desk of other files sitting behind it.
Most demands get read once, carefully, and answered on the numbers as presented. The ones that hold up in negotiation are the ones where someone actually checked those numbers against the record: the treatment gaps, the prior conditions, the bills that don't match what was documented. That takes time most adjusters don't have.
This is what it looked like when one adjuster, at a top 20 commercial carrier, had that time.
Wednesday to Friday
The demand landed on a Wednesday. The adjuster uploaded it into amaise the same day.
Two days later, on Friday, she got on a call with defense counsel. They leveraged the amaise insights dashboard, with links back to source documents, to walk the full demand together, live. It took 1.5 hours.
What the file was hiding
In that hour and a half, they found a pre-existing lumbar surgery that wasn't mentioned anywhere in the demand.
They also found:
- Missing medical records
- Inconsistent numbers across the billing
The same day as the review, a scratch email went out with the initial findings. A formal request for additional information followed a few days later, with a follow-up shortly after that.
In their words
“I was able to review the entire claim in amaise with Defense Counsel in 1.5 hours. amaise identified pre-existing conditions, critical missing medical records and bills, and identified incorrect amounts in the demand. We were able to send a detailed response to the demand within 3 days and take control of the case. amaise helped us be more efficient and effective on this case.”
- Adjuster, Top 20 commercial carrier
Why it matters
A demand package doesn't announce its own weak points. Someone has to find them, and find them fast enough that the response still lands inside the window that matters.
Contact us to learn more or to set up a conversation about how agentic AI can improve your claims operations.
