Coverage determination
Coverage analyzed against the policy, letter drafted
How a run goes
The steps this agent takes, in order, and what each one leaves behind.
Reads the loss facts and the policy documents
Analyzes the loss against the policy form, the endorsements and the exclusions and drafts the coverage position
Maps the facts to the provisions and drafts the position
Cites each policy provision the position relies on and flags the questions that need the examiner's judgment
Drafts the letter for the examiner's review
Drafts the coverage letter, including the reservation of rights where one is called for
Works in
Box, Salesforce, ServiceNow
Box, Salesforce, ServiceNowWhat it does
- Analyzes the loss against the policy form, the endorsements and the exclusions and drafts the coverage position
- Cites each policy provision the position relies on and flags the questions that need the examiner's judgment
- Drafts the coverage letter, including the reservation of rights where one is called for
Connects to
Box
Read, classify, and file documents with retention rules.
Salesforce
Enrich, update, and report on records under your profile.
ServiceNow
Open, correlate, and resolve incidents and requests.
Skills included
- Policy provision mapping
- Coverage letter drafting
Need it to work differently?
Every agent can be changed: the steps it takes, the systems it uses and who approves what.