insurance-claim-adjustment

What problem does it solve?

It prevents incorrect claim settlement calculations by verifying eligibility, checking input completeness and consistency, orchestrating a calculation-engine call, and producing a standardized settlement memo after receiving computed results.

Core Features & Use Cases

• Admission & readiness checks: Confirms the case is in the right state and that required prior steps (liability, medical review, expense review, policy parameters) are completed.
• Input integrity validation: Verifies required fields and consistency rules such as amount equations (price × quantity), deduction references, policy parameter alignment, and date constraints.
• Settlement orchestration via MCP: Calls calculation-engine.calculate_settlement with validated inputs, then performs a reasonableness review on returned results.
• Standardized output: Generates an audit-friendly settlement memo (amounts in cents, dates in ISO 8601) and clearly labels the computation source.

Quick Start

Ask the AI to run the insurance claim adjustment settlement memo for case X with the provided expense items, deduction items, and policy parameters.