The api.insure blog
Notes from the reserved line
How agents call insurance work: where the state draws its line, the typed states that hold it, and the clocks that run on every claim.
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Why every reserved act has a flat fee
A fee that grows with the claim pays someone to move the number. A flat fee, fixed before the work starts, does not.
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The Texas claim clocks, as code
Texas gives an insurer 15 days to acknowledge a claim, 15 business days to decide it and 5 business days to pay. Here is how those clocks run on one claim.
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PENDING_ADJUSTER is a promise, not a queue
When a claim reaches an act only a licensed adjuster may perform, the API says so in a type your code can branch on.
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The state reserves a few acts. Everything else is software.
Most of a claim is information work. The decision is reserved to a licensed adjuster. An API should treat that line as a contract, not a dead end.