Classification factors
Dollar reserve estimate
- Initial reserve sets tier
- Small: < $25K
- Medium: $25K-$100K
- Large: $100K-$500K
- Complex: $500K-$5M
- Catastrophic: $5M+
Complexity factors
- Coverage-dispute potential
- Multiple policies involved
- Litigation history
- Commercial BI involvement
Peril-specific triggers
- Fire: often medium+ regardless of size
- Storm: severity-based
- Water: most are small/medium
Property type
- Commercial always higher tier
- HOA/condo association often elevated
- Specialty property (historic, art-storage) elevated
Staffing by classification
Small
- Junior adjuster
- Field + desk review
- Fast cycle time targets
Medium
- Mid-level adjuster
- Desk supervisor review
- Standard cycle targets
Large
- Senior or specialty adjuster
- Supervisor + manager review
- Extended cycle
Complex
- Large-loss specialist
- Legal review
- Reinsurance notification
Catastrophic
- Senior claims executive
- External counsel often retained
- Reinsurance actively involved
Documentation standards by classification
Higher-tier claims demand:
- Forensic expert reports
- Multiple inspections
- Detailed financial analysis (commercial)
- Long-form documentation
- Multiple approval signatures
Strategic implications
Know which tier your claim is
- Affects expectations (timing, staffing)
- Affects communication approach (more senior audience at higher tiers)
- Affects negotiation dynamics
Match documentation quality to tier
- Small: standard documentation sufficient
- Medium+: professional representation helps
- Large+: forensic experts often warranted
- Complex/catastrophic: attorney coordination essential
Tier-specific escalation
- Escalation paths differ by tier
- Legal review automatic at higher tiers
- Reinsurance involvement changes dynamics