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: InnovatorDocumentsCustomer-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 Remove withdrawn products.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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