Use the same assignment cohort for the numerator and denominator, and include work retained by the carrier. Treat this as the desk’s proposed procurement metric rather than an established market benchmark.
Total cost per accepted file = all attributable production-route costs for a defined cohort ÷ unique files accepted from that cohort.
Include:
- Supplier charges or internal production labour.
- Retained preparation and coordination.
- Review, correction and repeat-review labour.
- Exception handling and attributable reinspection.
- Relevant software, integration, supervision and vendor-management costs.
- An explicitly stated allocation of implementation and transition costs.
Do not count the same payroll cost once through allocated departmental expenditure and again through timed activities. Keep one-off evaluation costs visible separately from expected run-rate costs, and identify costs shared with other claims functions.
Which measurements belong beside the headline cost?
| Measure | Proposed definition | Protection against misleading results |
|---|---|---|
| First-pass acceptance | Files accepted at first carrier review ÷ files receiving a first review decision | Include reviewer edits that rescued an otherwise failing delivery as rework |
| Cohort acceptance yield | Unique accepted files ÷ all assigned files | Show rejected, declined, withdrawn and unfinished assignments separately |
| Material-error rate | Audited files containing at least one material error ÷ audited files | Report sample selection, severity and loss mix |
| Carrier effort | All retained handling minutes, including unsuccessful files | Do not time only the files that passed |
| Time to usable file | Initial intake to carrier acceptance | Also report input-complete-to-acceptance time and open-file age |
| Post-acceptance defects | Later-discovered production defects and attributable correction effort | Do not make acceptance an irreversible statistical clean bill of health |
Existing workflow data may support part of this exercise. Verisk documents correction reporting and scorecards covering cycle time, estimate quality, price-list changes and reinspection; buyers should reconcile those system definitions with their own acceptance definition. (xactanalysis.helpdocs.io)
How should you handle unfinished files?
Label an immature cohort’s cost per accepted file provisional. Report costs to date, accepted count, outstanding count and ageing together; do not compare it unqualified with a fully matured cohort. If no files have been accepted, the ratio is undefined.
Keep supplier-declined work and its fallback cost visible. Do not count each revision as another accepted file. Conversely, define genuinely separate production assignments before the pilot rather than changing the unit afterwards.
When is a higher supplier price justified?
Illustrative calculation—not market pricing: If an alternative costs $18 more per file and retained labour is valued at an assumed $72 per hour, it must remove 15 minutes of labour per file merely to offset that premium, with everything else equal. Additional integration, oversight or exception costs increase the requirement.
Report benefits in separate categories:
- Released capacity: Hours available for other work.
- Cash savings: Demonstrable reductions in expenditure, such as avoidable overtime or external support.
- Service improvement: Better turnaround or backlog recovery, valued separately by the sponsor.
Decision gate: Finance and claims operations reconcile the baseline and agree which benefits can legitimately support the business case.
Working document: Accepted-File Cost Calculator.
Sources cited on this page
- xactanalysis.helpdocs.ioxactanalysis.helpdocs.io