Claims handled fast enough to keep pet parents loyal

Client profile

A venture-backed pet insurance startup underwriting policies for dogs and cats across the U.S. Rapid policy growth outpaced their small in-house claims team, causing backlogs during peak vet-visit seasons like holidays and summer travel.

With claim volume tripling year over year and policyholders expecting near-instant reimbursement decisions, the startup needed a partner who could scale claims capacity up and down without the overhead of a permanent, oversized team.

"RCVRY didn't just add claims processors. They helped us build a claims operation that scales with our growth instead of falling behind it every renewal season."
VP of Claims, Pet Insurance Startup

The challenge

The client's leadership identified several operational pain points:

Claims volume tripled year-over-year, but the in-house adjuster team stayed flat, creating multi-day backlogs.
Policyholders expected near-instant reimbursement decisions, especially for emergency vet visits.
New team members needed training on veterinary terminology, itemized invoice review, and breed/condition exclusions.
Customer support inboxes were flooded with “where's my claim” tickets, pulling adjusters off actual claims work.
Fraud and duplicate-claim detection was entirely manual, slowing down legitimate claims in the queue.

What RCVRY delivered

People-Focused Solutions

Built a claims team trained on veterinary language and policy logic, not just generic customer service.

Claims Processing & Adjusting

Trained a dedicated adjuster pod on veterinary invoice review, diagnostic codes, and policy exclusion logic.
Handled first-pass claim triage, itemization, and eligibility checks before escalation to senior adjusters.
Managed direct communication with policyholders on claim status, missing documents, and appeals.
Covered extended hours to match after-hours emergency vet visit patterns.

Policyholder Support

Staffed live chat and phone support for billing questions, coverage explanations, and policy changes.
Reduced “where's my claim” ticket volume by proactively notifying customers at each claim stage.
Supported onboarding for new policyholders, including waiting-period and pre-existing-condition education.

Technology-Focused Solutions

Standardized the claims workflow so speed didn't come at the cost of accuracy.

Claims Workflow & Fraud Flagging

Implemented a claims triage tracker to flag duplicate submissions and inconsistent invoice patterns.
Built standardized checklists for common claim types (accidents, illness, wellness) to speed up decisions.
Integrated with the client's claims platform for real-time status updates instead of manual spreadsheets.

Reporting & Renewal Support

Delivered weekly dashboards on claims turnaround time, approval rates, and backlog trends.
Supported renewal season surges with flexible staffing scaled to seasonal claim spikes.
Assisted underwriting with policy renewal outreach and lapse-prevention follow-ups.

The Outcome

A claims operation that flexes with growth instead of falling behind it.

Average claim turnaround dropped from several days to near same-day for straightforward claims.
“Where's my claim” support tickets dropped significantly once proactive status updates went live.
The startup scaled claims capacity through two renewal-season surges without hiring in-house.
Adjuster team freed up to focus on complex and appealed claims instead of routine processing.