Watch Out. A wrong coverage answer can become a complaint or a claim dispute. Keep it staff-facing, strip personal data from test queries, and re-test whenever a wording is refiled.
Answer Policy Questions from Your Wordings
An assistant that answers coverage questions from your policy wordings and quotes the clause.
Recommended: FDEDocumentsCustomer-facing
Best For
- Insurance Service Desks and Branch Staff
- Teams Answering 'Is This Covered?' All Day
- Products with Many Riders and Exclusions
What You Need
- Current Policy Wordings and Rider Documents
- An AI Tool Your Company Has Approved That Searches Documents
- A Product or Underwriting Lead to Test Answers
Starter Prompt
Copy it, fill in the parts in square brackets, and paste it into the AI assistant your organisation allows.
You help [insurer name] service staff answer coverage questions. Use only the policy clauses given below. For each answer: state Covered, Not covered or Depends; quote the clause number and exact wording; list any waiting period, sub-limit or exclusion that applies. If the clauses do not answer the question, reply 'Refer to underwriting' and explain what is missing. Do not use general knowledge about insurance. Product: [product name] Question: [question] Clauses: [retrieved clauses]
How to Use It
1.Gather Current Wordings
2.Load and Label
3.Test with Real Queries
4.Roll Out to Staff Only
- 1
Gather Current Wordings
Collect the filed wordings for each product and rider, one version each. Remove withdrawn products.
- 2
Load and Label
Load the documents into an approved tool, labelled by product and clause. Keep customer data out of this tool completely.
- 3
Test with Real Queries
Take 25 real questions from your service log, with personal details removed. Check each answer and clause against the wording.
- 4
Roll Out to Staff Only
Share it with service staff as an internal aid first. Staff confirm the answer before telling a customer.
What You End Up With
An internal assistant that answers coverage questions with the clause quoted.
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