Afrexai Insurance Automation

# Insurance Operations Automation

Comprehensive insurance operations framework for AI agents. Covers the full insurance lifecycle — underwriting, claims, policy management, renewals, compliance, and broker operations.

## What This Skill Does

Guides your AI agent through insurance-specific workflows with industry benchmarks, regulatory requirements, and automation priorities.

## Capabilities

### 1. Underwriting Assessment
- Risk scoring framework (12 factors, weighted by line of business)
- Data enrichment checklist (credit, claims history, property data, telematics)
- Referral triggers and authority limits by tier
- Combined ratio targets by line: Auto (95-98%), Home (85-92%), Commercial (88-95%), Life (varies by mortality table)

### 2. Claims Processing Pipeline
- FNOL intake automation (voice + digital, structured extraction)
- Severity triage: Green (auto-approve <$2K) → Yellow (adjuster review $2K-$25K) → Red (SIU referral >$25K or fraud indicators)
- Subrogation identification triggers
- Reserve estimation formulas by claim type
- Settlement authority matrix

### 3. Policy Administration
- Quote-to-bind workflow (target: <15 min for personal lines)
- Mid-term adjustment processing
- Renewal scoring: retention probability model (7 factors)
- Cancellation/non-renewal compliance by state/jurisdiction

### 4. Broker Operations (Jointly AI Model)
- 5-agent pipeline architecture: Intake → Research → Quoting → Analysis → Delivery
- Market panel management and placement optimization
- Quote comparison normalization across carriers
- FCA/state regulatory compliance verification
- Parallel execution: up to 4 simultaneous carrier interactions

### 5. Compliance & Regulatory
- **US:** State DOI requirements, NAIC model laws, Solvency II (reinsurers)
- **UK:** FCA handbook (ICOBS, SYSC), Consumer Duty, IDD compliance
- **EU:** Solvency II, IDD, GDPR for policyholder data
- Anti-fraud indicators (SIU trigger list — 15 red flags)
- SAR/suspicious activity reporting thre...

# Insurance Operations Automation

AI agent skill for insurance brokers, MGAs, and carriers. Covers underwriting, claims, policy admin, broker operations, and compliance.

Built on the 5-agent pipeline architecture (inspired by Jointly AI's autonomous broker model): Intake → Research → Execution → Analysis → Delivery.

## Install
```
clawhub install afrexai-insurance-automation
```

## What's Inside
- Underwriting risk scoring (12 factors, weighted by line)
- Claims triage pipeline (Green/Yellow/Red + fraud detection)
- Quote comparison automation (4 parallel carrier interactions)
- Compliance frameworks (FCA, state DOI, NAIC, Solvency II, IDD)
- Insurance metrics dashboard with targets
- 90-day deployment roadmap
- Cost framework by organization size

## Who This Is For
- Insurance brokers automating quote-to-bind
- MGAs building underwriting automation
- Carriers modernizing claims processing
- Insurtechs building agent-first platforms

## Resources
- [AI Revenue Leak Calculator](https://afrexai-cto.github.io/ai-revenue-calculator/)
- [Industry Context Packs](https://afrexai-cto.github.io/context-packs/) ($47/pack)
- [Agent Setup Wizard](https://afrexai-cto.github.io/agent-setup/)

*AfrexAI — turning AI agent intelligence into revenue.*