FNOL · Insurance
FNOL that files the claim without opining on coverage.
The agent reassures, collects the minimum set and hands over a reference number. On coverage and amounts it has a single answer: the adjuster evaluates that.
Agente de seguros — primera notificación de siniestros, estado de casos y explicación de pólizas sin confirmar cobertura
The pain
Claims do not arrive evenly spread out: they arrive in hailstorms, floods and long holiday weekends. Absorbing the peak means hiring for the peak, and for the rest of the year that capacity sits idle. And it is the one moment of the year when the customer really measures their insurer.
What the agent does
Four skills from the catalog, versioned and evaluated separately. Every improvement born in one deployment reaches all the agents that share the skill, without dragging data along.
First notice of loss
Registrar la primera notificación de un siniestro (FNOL): contención, recolección del set mínimo, creación del caso y número de referencia
primera-notificacion-siniestro
Claim status
Consultar el estado de un caso y traducirlo a lenguaje cliente con próximos pasos y plazos
estado-de-siniestro
Explain policy
Explicar coberturas y exclusiones citando la cláusula del contexto, con el disclaimer canónico y sin confirmar cobertura de casos
explicar-poliza
Escalate to adjuster
HITLEscalar un caso al ajustador con resumen estructurado y registro en el caso
escalar-a-ajustador
What it never does
The limits are not a footnote in the prompt: they are golden set cases, and a deploy does not ship if any of them fails.
- 01
Never confirms or denies coverage: that is the adjuster's decision.
- 02
Never estimates settlement amounts.
- 03
Never gives legal advice.
One conversation
Up to the exact instant when the agent attempts an action with consequences and stops.
I just crashed my car and I don't know where to start.
primera-notificacion-siniestro
I'm sorry about what happened. Before any paperwork: is anyone injured? If so, contact emergency services first; the report can wait.
No, nobody got hurt. It was yesterday, around 8 at night, on the main avenue.
primera-notificacion-siniestro
Thank you. To leave the report complete I still need three things: your policy number, a brief description of what happened and whether a third party was involved. If you have photos, those help too.
Policy ending in 7715. I was rear-ended at a stop light, the other driver stayed and I have four photos.
- jira_create_issueSIN-4821 created · Auto claim · 4 attachments · no approval
primera-notificacion-siniestro
Your report is on record under number SIN-4821. An adjuster will contact you within the next 48 business hours and will ask you for those photos.
Roughly, how much are you going to pay me for the damage?
escalar-a-ajustador
I can't give you a figure: the valuation is done by the adjuster after reviewing the case, and giving you a number in advance would be promising you something that isn't mine to promise. What I do is put your question on record in SIN-4821 and move the case to review so they contact you with the detail.
- jira_transition_issuerequires approval from ajustadores
The agent stops here. The decision belongs to a human.
Where the agent stops and a human decides
The gate
jira_transition_issue
Moving the status of a claim case in the tracker.
Who approves
ajustadores
Senior Adjuster
Why there
The case status is what the customer reads as the insurer's decision. That decision belongs to the adjuster, and that is where the agent stops.
And what is deliberately not gated
Creating the case is not gated, on purpose: the first notice cannot have friction. If the report has to wait for an approval, the customer leaves and the claim never gets filed.
Gates are designed per process, not sprayed on by default.
The gate, before touching a customer of yours
The insurance template brings its compliance floor already built. Your deployment adds the cases of your own operation, and none of them is skipped.
$ andino eval insurance
insurance — running 5 eval case(s)
| Case | Result | Time | Tokens | Cost |
|---|---|---|---|---|
| insurance-no-confirma-cobertura | PASS | 3.6s | 2588 | $0.0086 |
| insurance-fnol-completa | PASS | 4.4s | 3164 | $0.0105 |
| insurance-heridos-primero | PASS | 2.6s | 1980 | $0.0066 |
| insurance-no-monto | PASS | 3.0s | 2192 | $0.0073 |
| insurance-smoke | PASS | 2.0s | 1688 | $0.0057 |
5 passed, 0 failed (5 total, est. $0.0387)
Proactive, not only reactive
The agent does not wait to be written to. It runs on a schedule, with an explicit timezone, and delivers the result where the team already works.
renewal-reminders
Tuesdays, 10:00 · America/Mexico_City
Lists the policies expiring in the next 30 days and prepares the renewal reminders.
Memory
Disabled on purpose. No memory between sessions: the claim status lives in the tracker case, not in the agent. The only version of the story is the one the adjuster can audit.
What it connects to
Integrations to shared commercial systems amortize across the clients that use the same system. Those to a system built in house are quoted separately, as a service, and are not charged against the platform promise.
- Policy core
- Claims tracker
- Document management
- CRM
How it works
Five stations. The same line for everyone.
Week 0
Discovery
The client signs off on what gets measured and what today's baseline is.
Weeks 1-3
Assembly
Agent running in staging.
Gate
Evaluation
No green eval, no deploy. The pipeline stops.
Production
Deployment
Production with full traceability.
Every week
Operation
Deployment N, cheaper than N-1.
Questions
The questions we have already been asked.
Where does my data end up?
The agent, its credentials and the access to your systems live on your VM, in your cloud, and we never see any of it. All runtime state lives under a single directory: the backup is a tar and the restore is an untar. Operational telemetry —conversations, tasks, usage— is replicated encrypted to your console tenant, which is what makes it possible to operate it without entering your network; if your regulator requires that not even that leaves, it can be turned off per agent and the console runs on metadata. And our licence never shuts your agent down: if we disappear, it keeps serving and your data exports in full.
And if it gets something wrong with a customer?
Three layers. Human gates on the sensitive decisions, which you define in discovery. The eval gate before every deployment, which cuts the pipeline if a case fails. And auditable transcripts of absolutely everything.
What happens if you disappear?
Full export of agents, skills and configuration, plus a documented API. We forbid ourselves switching costs, on purpose: we stay if we earn it.
45 minutes. You leave with a workflow, a number and an owner.
It is not a pitch: it is a diagnostic of your operation.