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.
In short
PENDING_ADJUSTER is the state a claim takes when its next act is reserved to a licensed adjuster and no attestation exists yet. It names the act, the license it requires and the authority it runs under. It clears only on a fact: the adjuster attests, sends the file back or declines, so your code waits on a fact instead of polling an untyped queue.
Most claims systems have a status called something like "in review." It means a person will look at the file eventually. It does not say who, under what license, or what the file is waiting for.
That ambiguity is expensive. A product can't tell the policyholder anything true, and a statutory clock keeps running while the file sits.
A state with a meaning
PENDING_ADJUSTER is narrower. A claim enters it only when the next act is reserved to a licensed adjuster and no attestation exists yet. The response says exactly what is being waited on:
{ "claim": "clm_8f3ka92", "stage": "evaluate", "status": "PENDING_ADJUSTER", "reservedAct": { "verb": "adjust", "license": "TX all-lines adjuster", "verified": "at_call_time", "authority": "delegated_by_carrier", "fee": { "shape": "flat", "fixed": "at_post" } }}
Your code can branch on it. Show the policyholder that a licensed adjuster is reviewing the file. Keep the decide clock visible. Stop retrying.
How it clears
The state clears on a fact, never on a timer:
- The adjuster attests. Their decision, approve or deny with reasons, and their signed attestation arrive on
decision.issued. - The adjuster sends it back. The file returns to preparation with the gaps noted, and the claim leaves the pending state until it is ready again.
- The adjuster declines. A declination is a refusal to sign, carried by a reasoned memo. The file is rerouted to another licensed adjuster, and no process can commit past the refusal.
Why a type beats a queue
A queue tells you where a file is. A type tells you what it is waiting for, and what will move it. The license in reservedAct is checked at call time against the state registry, per state and line of authority, so the promise in the response is one the system can keep.
Producer-reserved acts work the same way. A bind answers PENDING_PRODUCER until a licensed producer binds, and policy.bound closes it.
Questions
What does PENDING_ADJUSTER mean?
The claim's next act is reserved to a licensed adjuster and no attestation exists yet. The response names the act, the license it requires and the authority it runs under.
How does a claim leave PENDING_ADJUSTER?
Only on a fact: the adjuster attests to a decision, sends the file back with the gaps noted, or declines, which reroutes the file to another licensed adjuster.
Is a send-back the same as a denial?
No. A denial is a signed decision on coverage. A send-back returns the file to preparation with defects noted, so it can be completed and reviewed again.
How is the adjuster's license checked?
At call time, against the state registry, for the state and line of authority the act requires.