The Standard — Society for Claims Excellence

A common measure of competent claims handling.

The Standard is the Society’s statement of what disciplined claims work looks like. Every member — carrier, adjuster, TPA, or vendor — attests to it on admission and at each renewal.

The Standard is written to be auditable. Each expectation carries a timeline and a documentation requirement, because an action that is not documented cannot be verified, and an undocumented file cannot be defended. Where a statute, regulation, or policy provision imposes a shorter deadline than the Standard, the shorter deadline controls.

Acknowledgment & Contact

First contact sets the tone for the entire claim. The insured's confidence or their attorney involvement — is often decided in the first day.

Timelines

Initial contact with the insured (or their representative) is attempted within 4 hours of receipt of assignment.
If the first attempt does not reach the insured, a minimum of three attempts across at least two channels (phone, email, text where permitted) are made within the first 24 hours.
Written acknowledgment of the claim — identifying the assigned handler, direct contact information, the claim number, and what happens next — is sent within 1 business day of assignment.
The coverage position, or the status of the coverage review if a position cannot yet be stated, is communicated in plain language at first substantive contact.

Documentation

Making contact isn't enough — the file must show it. Every attempt, successful or not, is logged in the claim file with date, time, method, number or address used, and outcome. A successful first contact is documented with a summary of what was discussed: the loss facts as reported, expectations set, next steps, and any immediate needs (emergency mitigation, temporary housing, vehicle rental). An entry reading “called insured” does not meet the Standard; an entry a reviewer can reconstruct the conversation from does.