Claims Fnol Triagev0.1.2

A policyholder calls in a single-vehicle accident with no injuries. The agent collects masked PII, loss details, and confirms facts before generating a draft triage record with express severity and coverage verification questions for the adjuster.

A fleet manager reports a collision involving a company truck with minor injuries. The system gathers line of business, driver info, and telematics data, runs fraud red-flag checks, and produces a standard-severity record with coverage hooks for the adjuster.

An insured submits an online FNOL for roof damage from a hailstorm. The tool collects loss details, confirms the event is CAT-coded, assigns catastrophe severity, and generates questions about policy period, deductible, and named-storm exclusions.

An employee reports a fall at a warehouse via agent email. The intake captures injury details, flags fatality/none, and screens for course-and-scope issues. The output includes state-specific reporting deadlines and compensability investigation prompts.

A third party reports a slip-and-fall at a retail store. The tool handles PII-safe intake of claimant info, determines complex severity due to hospitalization, and generates a list of coverage questions regarding occurrence vs. claims-made and exclusions.

MGAs and program administrators embed this triage skill into their claims portal to standardize FNOL intake, reduce data entry errors, and accelerate assignment to adjusters. Revenue is based on per-claim processing fees or monthly SaaS subscription.

Insurtech companies integrate the skill via API to automate FNOL processing for auto, property, and workers' comp lines. Revenue comes from API call volume tiers with a free threshold plus premium features like fraud scoring.

Large insurance carriers license the skill for internal use by claims intake associates. Revenue is an annual license fee determined by number of claims users and supported lines of business, with optional premium support.