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autocontext-insurance-claims-core

v0.2.0

Published

Deterministic core for insurance claim coverage, reserve, paid, and documentation review workflows.

Vulnerabilities

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Links

Maintainers

jayscamblerjayscambler

Keywords

insurance-claimsdecision-supportoperating-reviewautocontext

Readme

autocontext-insurance-claims-core

Deterministic insurance claim review helpers.

Current workflow:

  • calculate net covered loss after deductible
  • cap allowed payment at policy limit
  • calculate policy-limit excess, reserve adequacy, remaining allowed payment, and overpayment
  • flag policy-limit excess, reserve shortfall, missing/partial documentation, and overpayment

This is decision support only. It is not a claim system of record, payment authorization, coverage opinion, legal opinion, audit opinion, or regulated certification.