Adjudicates low-complexity, low-severity claims within configured authority limits (coverage confirmed, no fraud signals, estimate within tolerance) and triggers payment, escalating everything else to an adjuster with a prepared analysis.
Not yet specifiedSemi-autonomousComplexity: High
This agent is in the backlog. Registered interest decides which agents are specified and prototyped next.
What it does
Validate coverage, estimate and documentation against STP rules
Run fraud and duplicate-claim checks
Calculate settlement net of deductible/depreciation
Issue payment and settlement communication
Log decision rationale and route out-of-tolerance claims with a summary