Insurance Claims Processor
请根据来源仓库和你的 AI 工具说明安装此技能。先阅读技能文件和依赖要求，再添加到工作流。
SkillHub CLI
skillhub install 1kalin/afrexai-insurance-claims打开来源仓库，查看说明和兼容环境后，按来源提供的命令或步骤安装。
将来源链接提供给你的 Agent，让它先读取说明、核对依赖，并向你说明将执行的安装步骤。
Process, analyze, and optimize insurance claims. Covers property, liability, workers' comp, auto, and professional indemnity.
Takes raw claim details and produces:
Provide claim details in any format — adjuster notes, policyholder statement, incident report, photos, or free text. The agent structures everything.
Analyze this claim: [paste details]
Process claim for:
- Policy type: [commercial general liability / property / WC / auto / PI]
- Incident date: [date]
- Reported date: [date]
- Claimant: [name/entity]
- Description: [what happened]
- Claimed amount: [if known]
- Policy limits: [if known]
- Jurisdiction: [state/country]
Score 1-10 on insured liability exposure:
Factors evaluated:
Three-point estimate:
Include:
这些信息来自收录时的来源分析，可能滞后；使用前请核对最新来源文件。
Turn raw claim data into structured analysis with liability scoring, reserve estimates, fraud detection, and settlement strategy.
Covers property, liability, workers' comp, auto, and professional indemnity claims across US and UK jurisdictions.
clawhub install afrexai-insurance-claims
# Insurance Claims Processor Process, analyze, and optimize insurance claims. Covers property, liability, workers' comp, auto, and professional indemnity. ## What This Does Takes raw claim details and produces: - Structured claim summary with policy coverage mapping - Liability assessment with supporting/weakening factors - Reserve estimate with confidence range - Subrogation opportunity analysis - Red flag detection (fraud indicators, coverage gaps) - Settlement recommendation with negotiation range - Regulatory compliance checklist by jurisdiction ## Usage Provide claim details in any format — adjuster notes, policyholder statement, incident report, photos, or free text. The agent structures everything. ### Quick Claim Analysis ``` Analyze this claim: [paste details] ``` ### Full Processing ``` Process claim for: - Policy type: [commercial general liability / property / WC / auto / PI] - Incident date: [date] - Reported date: [date] - Claimant: [name/entity] - Description: [what happened] - Claimed amount: [if known] - Policy limits: [if known] - Jurisdiction: [state/country] ``` ## Claim Analysis Framework ### 1. Coverage Determination - Map incident to policy provisions - Identify applicable endorsements and exclusions - Flag coverage disputes early - Check occurrence vs claims-made triggers ### 2. Liability Assessment Score 1-10 on insured liability exposure: - **1-3**: Strong defense position, deny or minimal settlement - **4-6**: Mixed liability, negotiate - **7-10**: Clear insured liability, reserve and settle Factors evaluated: - Comparative/contributory negligence (jurisdiction-specific) - Statutory obligations - Contractual indemnity provisions - Prior loss history pattern ### 3. Reserve Estimation Three-point estimate: - **Low**: Best case with strong defense - **Mid**: Most likely outcome - **High**: Worst case including litigation costs Include: - Indemnity reserve - Defense costs (inside/outside limits) - Allocated loss adjustment expense...
# Insurance Claims Processor Turn raw claim data into structured analysis with liability scoring, reserve estimates, fraud detection, and settlement strategy. Covers property, liability, workers' comp, auto, and professional indemnity claims across US and UK jurisdictions. ## Install ``` clawhub install afrexai-insurance-claims ``` ## What You Get - **Coverage mapping** — matches incidents to policy provisions, endorsements, exclusions - **Liability scoring** — 1-10 scale with comparative negligence analysis - **Reserve estimates** — three-point (low/mid/high) with ALAE/ULAE breakdown - **Fraud detection** — pattern-based red flag scoring - **Subrogation analysis** — recovery potential and cost-benefit - **Settlement strategy** — opening position, authority range, mediation vs litigation - **Compliance timeline** — jurisdiction-specific deadlines and bad faith triggers ## Who This Is For - Claims adjusters processing high volume - Insurance operations managers automating triage - Risk managers handling self-insured retentions - TPAs standardizing claim handling procedures - InsurTech teams building claims automation ## More From AfrexAI - [AI Agent Context Packs](https://afrexai-cto.github.io/context-packs/) — $47 industry packs covering 10 verticals - [AI Revenue Calculator](https://afrexai-cto.github.io/ai-revenue-calculator/) — see what AI agents save your operation - [Agent Setup Wizard](https://afrexai-cto.github.io/agent-setup/) — configure your AI workforce in 5 minutes
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