The claims industry is eating its young

Claims was always an apprenticeship trade. You learned it by sitting near people who were good at it, watching how they worked a hard file, and asking questions until the instinct rubbed off. That model still works — it just assumes both people have time. Neither does anymore. The desk that was supposed to teach the next generation is too overloaded to teach anyone, and the industry is quietly eating its young: burning out new adjusters before the judgment ever forms, then wondering where the talent went.

For decades the trade passed down through spare minutes: a veteran with a moment to explain why a reserve moved, why a story did not add up, which question to ask next. When the channel for transfer is a busy person with a free half hour, the shortage of free half hours quietly becomes a shortage of trained adjusters. The load is the thing that closed the channel.

Research on caseloads puts the point where outcomes start to degrade around 110–125 open claims. Plenty of desks run at double that or more. At 300 files, even a sixteen-year veteran is not teaching — they are surviving.

Onboarding a new adjuster costs an estimated $8,000–$10,000, and most of it goes to compliance, systems, and process — how to move a file through the platform. Almost none of it goes to judgment, because judgment is the part no module teaches. New hires arrive roughly 15% less productive and are handed the same inventory as everyone else. What onboarding covers and what the hard file actually needs are two different lists:

When carriers lean on adjusters who have not had time to build judgment, the survey data from chief claims officers is blunt: indemnity payouts run up to 20% higher and operating costs about 12% higher. And the knowledge does not just sit idle — it walks out the door, roughly six years of experience with every exit, onto a bench that was never deep enough to mentor the bench behind it. Nine in ten insurance leaders call building these skills urgent; only about one in four has actually done anything about it.

The thing that helps a first-year adjuster is not more training in a classroom — it is the veteran’s path built into the file, so they work a claim through the same steps a senior would and can see the reasoning behind each one instead of having to catch it from someone in passing. In practice that means:

• Put the veteran’s route to a decision on the file itself, so a new adjuster follows it without needing someone free to walk them through it.
• Surface the reasoning behind each step — the rule, the facts that mattered, the confidence — so the “why” is visible, not folklore.
• Let the process carry what mentorship used to, so learning does not depend on a senior adjuster having a half hour they no longer have.
• Make every decision a teaching example, so the book of past calls becomes the training set for the next hire.

This is where Mysa changes the shape of the problem. It encodes the path a strong adjuster takes through a claim and captures the reasoning behind each decision as part of the decision itself — so the structure and the “why” that used to live in a veteran’s head now live on the file, available to whoever picks it up. You are not asking overloaded people to teach in time they do not have. You are making the judgment already on the floor visible and reusable, so a new adjuster learns from the book instead of from a colleague who has no minutes to give.

The industry is not short on talent because people cannot do the work. It is short on talent because the work leaves no room to learn it. Fix the room to learn — build it into the file — and the pipeline stops leaking at the top.