Claims File Prep & Triage

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Insurance — Claims

P&C carriers, MGAs, TPAs

FNOLOCRpolicyclaims routing

First Notice of Loss (FNOL) arrives by email, fax-scan, or carrier portal — every channel different.
Junior adjuster manually creates the claims file, indexes documents, looks up policy by name + DOL.
Coverage check is done eyeball-on-PDF — easy to miss exclusions, sublimit triggers, named perils.
Routing to specialty adjusters is by gut feel; mis-routes cost days.

Detect new FNOL emails, group attachments by claim. search_emails · read_emails

claims-file-prep skill normalises filenames, OCRs scans, builds the standard folder structure. claims-file-prep skill

policy-comparison skill cross-checks the loss against the bound policy — coverage, sublimits, exclusions. policy-comparison skill

Route to the right adjuster queue based on line-of-business + severity flags. send_email · custom routing rules

Draft a coverage-position letter with placeholders for adjuster review. create_docx · email-draft-reply

"New FNOL from broker XYZ for policyholder ABC — prep the claims file and check coverage."

Deliverables: claim_<id>/ folder · coverage_position_draft.docx · routing_decision.md · evidence_index.md

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