MoraeSpend Intelligence
Insurance Claims edition

Defense spend, this week

Reconciled to claims payments through 30 Sep · 2,412 open litigated claims · 11 panel firms
$41.2M
Defense spend YTD
6.8% under plan
$8.9K
Cost per closed claim, severity-adjusted
Panel median $9.6K
$2.46M
Net realized savings, reconciled to payment
5.9% of reviewed · 91% retained after appeals
140
Claims past settle-vs-defend threshold
$1.5M cost-to-go at risk
6
Matters needing a phase-gate decision
p(overrun) above 0.6
$0.80M
Unresolved FY28 budget gap after modeled actions
Decision due 31 Oct
$6.4M
Proposed month-end accrual
Firm WIP $4.1M + predicted $2.3M
212
Invoices pending review
14 need your decision
Proactive insights
5 new1 action required2 decisionsRanked by expected dollar impact · filtered to your role
Action requiredSettle vs defend. 38 soft-tissue claims (QLD, reserve $60–120K) have defense spend above 30% of reserve. Comparable claims settled at 0.8× reserve at this stage. Expected avoided cost-to-go $0.9M.
Review 38
Decision neededStaffing drift. Firm D partner share is 2.4× the panel median on the same severity band since Q2; $610K annualized. A staffing covenant letter is drafted.
Open draft
ProposalAssignment rule candidate. Routing NSW property claims under $50K to Firms B and G saves $1.1M/yr at an equal indemnity ratio and 31 days faster cycle time.
Simulate
ProposalFixed-fee candidate. Early-resolution motor claims (no suit filed) show a coefficient of variation of 0.19 across 1,240 units. Quote a $2,850 fixed fee (p60) to the panel.
Build quote
Due 5 OctAccrual. Proposed month-end accrual $6.4M (firm WIP $4.1M + predicted unbilled $2.3M). Last quarter's firm-only accrual under-stated by 31%.
Review accrual
Decision neededFY28 budget. Volume explains $2.4M of a $3.1M variance; modeled actions recover $320K; $800K remains to fund or accept.
Open scenarios
ProposalRule retune. LMG-6.1 block billing realized savings fell 22% Q/Q as firms split entries; LMG-9.1 time-reasonableness is carrying more weight. Draft v2026.3 ready.
Open draft pack
Panel value curve
Cost per closed claim, severity-adjusted, last 24 months
$6.1K
Firm B
$6.8K
Firm G
$7.4K
Firm C
$8.3K
Firm A
$8.7K
Firm E
$9.4K
Firm F
$11.8K
Firm D
Same indemnity-to-reserve band (0.78–0.84) across all seven firms. Firm D is flagged for staffing drift.
Ask Spend · "Which firms would you move Firm D's QLD motor volume to?" → Firms B and G have capacity for 180 more claims each. Expected saving $1.4M at equal outcome. Open the simulation.
The write-down is the wrong trophy
Invoice adjustment rate ranks Firm D first; combined defense plus indemnity on the same 186-claim cohort ranks it last.
Adjustment rate · ignore for panel choice
Firm D
4%
Firm C
5%
Firm B
6%
Firm G
7%
Combined defense + indemnity vs cohort · the sort
Firm G
−8%
Firm B
median
Firm C
+4%
Firm D
+30%
Cheapest on the bill, most expensive on the claim. Firm D tries claims the cohort settles at L160; partner on production; rate explains about a third of the gap. A rate negotiation does not fix this firm. Open panel review.
Executive decisions this week
Each has an owner, a deadline, a baseline and a follow-up date
DecisionOwnerDueEvidenceFollow-up
Authorize settlement on 38 QLD soft-tissue claims
Reserve $60–120K; defense spend above 30% of reserve
Head of claims litigation9 OctCohort n=186 · 0.80× reserve p50Outcome vs reserve at close
Approve routing rule: NSW property under $50K to Firms B and G
Capacity and conflicts to confirm
Panel owner15 OctCohort n=212/301 · p20–p80 shownCost per closed claim, 2 quarters
Fund or accept the $800K FY28 gap
After $320K of modeled actions
General counsel · CFO31 OctVariance decompositionQuarterly reforecast
Where the money is decided
FY27 YTD
Assignment and panel mix$3.1MPhase gates and settle/defend$1.9MInvoice review, realized$2.46MRate and fixed-fee negotiation$0.7M
A recommendation shows its trigger, cohort definition and exclusions, sample size, freshness, uncertainty, the status-quo option, who can approve, what is reversible, and the follow-up measure. A forecast is useful when it changes a decision.
Open Claim QLD-88213Panel reviewPhone approvals