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    "name": "Insurance Operations Automation",
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    "sections": [
      {
        "title": "Insurance Operations Automation",
        "body": "Comprehensive insurance operations framework for AI agents. Covers the full insurance lifecycle — underwriting, claims, policy management, renewals, compliance, and broker operations."
      },
      {
        "title": "What This Skill Does",
        "body": "Guides your AI agent through insurance-specific workflows with industry benchmarks, regulatory requirements, and automation priorities."
      },
      {
        "title": "1. Underwriting Assessment",
        "body": "Risk scoring framework (12 factors, weighted by line of business)\nData enrichment checklist (credit, claims history, property data, telematics)\nReferral triggers and authority limits by tier\nCombined ratio targets by line: Auto (95-98%), Home (85-92%), Commercial (88-95%), Life (varies by mortality table)"
      },
      {
        "title": "2. Claims Processing Pipeline",
        "body": "FNOL intake automation (voice + digital, structured extraction)\nSeverity triage: Green (auto-approve <$2K) → Yellow (adjuster review $2K-$25K) → Red (SIU referral >$25K or fraud indicators)\nSubrogation identification triggers\nReserve estimation formulas by claim type\nSettlement authority matrix"
      },
      {
        "title": "3. Policy Administration",
        "body": "Quote-to-bind workflow (target: <15 min for personal lines)\nMid-term adjustment processing\nRenewal scoring: retention probability model (7 factors)\nCancellation/non-renewal compliance by state/jurisdiction"
      },
      {
        "title": "4. Broker Operations (Jointly AI Model)",
        "body": "5-agent pipeline architecture: Intake → Research → Quoting → Analysis → Delivery\nMarket panel management and placement optimization\nQuote comparison normalization across carriers\nFCA/state regulatory compliance verification\nParallel execution: up to 4 simultaneous carrier interactions"
      },
      {
        "title": "5. Compliance & Regulatory",
        "body": "US: State DOI requirements, NAIC model laws, Solvency II (reinsurers)\nUK: FCA handbook (ICOBS, SYSC), Consumer Duty, IDD compliance\nEU: Solvency II, IDD, GDPR for policyholder data\nAnti-fraud indicators (SIU trigger list — 15 red flags)\nSAR/suspicious activity reporting thresholds"
      },
      {
        "title": "6. Insurance Metrics Dashboard",
        "body": "MetricPersonal Lines TargetCommercial TargetCombined Ratio95-98%88-95%Loss Ratio60-70%55-65%Expense Ratio25-32%28-35%Claims Settlement Time<48h (auto)<14 daysPolicy Issuance Time<15 min<24hRenewal Rate>85%>80%Quote-to-Bind Ratio>25%>15%NPS>40>35"
      },
      {
        "title": "7. Automation Priority Matrix",
        "body": "ProcessHours/Month (50-person broker)Agent-Ready?Expected SavingsQuote comparison160hYes — now$140K-$280K/yrFNOL intake120hYes — now$105K-$210K/yrPolicy document generation80hYes — now$70K-$140K/yrRenewal processing100hYes — now$87K-$175K/yrCompliance checks60hYes — now$52K-$105K/yrSubrogation identification40hPartial$35K-$70K/yrComplex claims adjustment200hHuman-in-loop$50K-$100K/yr"
      },
      {
        "title": "8. Insurance-Specific Agent Prompts",
        "body": "Underwriting Agent:\n\nYou are an underwriting assessment agent. For each submission:\n1. Extract all risk factors from the application\n2. Score each factor against the risk matrix (1-10 scale)\n3. Calculate composite risk score (weighted by line of business)\n4. Flag any referral triggers (prior losses >3 in 5yr, credit <600, high-hazard occupation)\n5. Recommend: Auto-approve / Refer to senior / Decline with reason\n6. Generate underwriting memo with supporting data\n\nClaims Triage Agent:\n\nYou are a claims triage agent. For each FNOL:\n1. Extract: date of loss, type, description, estimated amount, policyholder details\n2. Verify active coverage and applicable endorsements\n3. Assign severity: Green (<$2K auto-process) / Yellow ($2K-$25K adjuster) / Red (>$25K or fraud flags)\n4. Check fraud indicators against the 15-point SIU trigger list\n5. Set initial reserve based on claim type benchmarks\n6. Route to appropriate handler with priority score"
      },
      {
        "title": "90-Day Deployment Roadmap",
        "body": "Month 1: Deploy intake + quote comparison agents. Target: 70% of personal lines quotes handled autonomously.\n\nMonth 2: Add claims triage + policy document generation. Target: FNOL processing <5 minutes, auto-approval for Green claims.\n\nMonth 3: Compliance monitoring + renewal automation. Target: 85%+ renewal rate, zero compliance gaps."
      },
      {
        "title": "Cost Framework",
        "body": "Solo broker/MGA: $2K-$5K/month (2-3 agents)\nMid-size broker (20-50 staff): $5K-$15K/month (5-8 agents)\nCarrier/large broker (100+ staff): $15K-$50K/month (10-20 agents)"
      },
      {
        "title": "Resources",
        "body": "Calculate your insurance automation ROI → AI Revenue Leak Calculator\nFull Insurance & Fintech Context Pack → AfrexAI Context Packs — $47, includes fintech agent configurations, compliance frameworks, and industry benchmarks\nConfigure your insurance agent stack → Agent Setup Wizard\nBundle: Pick 3 packs for $97 | All 10 for $197 | Everything $247"
      }
    ],
    "body": "Insurance Operations Automation\n\nComprehensive insurance operations framework for AI agents. Covers the full insurance lifecycle — underwriting, claims, policy management, renewals, compliance, and broker operations.\n\nWhat This Skill Does\n\nGuides your AI agent through insurance-specific workflows with industry benchmarks, regulatory requirements, and automation priorities.\n\nCapabilities\n1. Underwriting Assessment\nRisk scoring framework (12 factors, weighted by line of business)\nData enrichment checklist (credit, claims history, property data, telematics)\nReferral triggers and authority limits by tier\nCombined ratio targets by line: Auto (95-98%), Home (85-92%), Commercial (88-95%), Life (varies by mortality table)\n2. Claims Processing Pipeline\nFNOL intake automation (voice + digital, structured extraction)\nSeverity triage: Green (auto-approve <$2K) → Yellow (adjuster review $2K-$25K) → Red (SIU referral >$25K or fraud indicators)\nSubrogation identification triggers\nReserve estimation formulas by claim type\nSettlement authority matrix\n3. Policy Administration\nQuote-to-bind workflow (target: <15 min for personal lines)\nMid-term adjustment processing\nRenewal scoring: retention probability model (7 factors)\nCancellation/non-renewal compliance by state/jurisdiction\n4. Broker Operations (Jointly AI Model)\n5-agent pipeline architecture: Intake → Research → Quoting → Analysis → Delivery\nMarket panel management and placement optimization\nQuote comparison normalization across carriers\nFCA/state regulatory compliance verification\nParallel execution: up to 4 simultaneous carrier interactions\n5. Compliance & Regulatory\nUS: State DOI requirements, NAIC model laws, Solvency II (reinsurers)\nUK: FCA handbook (ICOBS, SYSC), Consumer Duty, IDD compliance\nEU: Solvency II, IDD, GDPR for policyholder data\nAnti-fraud indicators (SIU trigger list — 15 red flags)\nSAR/suspicious activity reporting thresholds\n6. Insurance Metrics Dashboard\nMetric\tPersonal Lines Target\tCommercial Target\nCombined Ratio\t95-98%\t88-95%\nLoss Ratio\t60-70%\t55-65%\nExpense Ratio\t25-32%\t28-35%\nClaims Settlement Time\t<48h (auto)\t<14 days\nPolicy Issuance Time\t<15 min\t<24h\nRenewal Rate\t>85%\t>80%\nQuote-to-Bind Ratio\t>25%\t>15%\nNPS\t>40\t>35\n7. Automation Priority Matrix\nProcess\tHours/Month (50-person broker)\tAgent-Ready?\tExpected Savings\nQuote comparison\t160h\tYes — now\t$140K-$280K/yr\nFNOL intake\t120h\tYes — now\t$105K-$210K/yr\nPolicy document generation\t80h\tYes — now\t$70K-$140K/yr\nRenewal processing\t100h\tYes — now\t$87K-$175K/yr\nCompliance checks\t60h\tYes — now\t$52K-$105K/yr\nSubrogation identification\t40h\tPartial\t$35K-$70K/yr\nComplex claims adjustment\t200h\tHuman-in-loop\t$50K-$100K/yr\n8. Insurance-Specific Agent Prompts\n\nUnderwriting Agent:\n\nYou are an underwriting assessment agent. For each submission:\n1. Extract all risk factors from the application\n2. Score each factor against the risk matrix (1-10 scale)\n3. Calculate composite risk score (weighted by line of business)\n4. Flag any referral triggers (prior losses >3 in 5yr, credit <600, high-hazard occupation)\n5. Recommend: Auto-approve / Refer to senior / Decline with reason\n6. Generate underwriting memo with supporting data\n\n\nClaims Triage Agent:\n\nYou are a claims triage agent. For each FNOL:\n1. Extract: date of loss, type, description, estimated amount, policyholder details\n2. Verify active coverage and applicable endorsements\n3. Assign severity: Green (<$2K auto-process) / Yellow ($2K-$25K adjuster) / Red (>$25K or fraud flags)\n4. Check fraud indicators against the 15-point SIU trigger list\n5. Set initial reserve based on claim type benchmarks\n6. Route to appropriate handler with priority score\n\n90-Day Deployment Roadmap\n\nMonth 1: Deploy intake + quote comparison agents. Target: 70% of personal lines quotes handled autonomously.\n\nMonth 2: Add claims triage + policy document generation. Target: FNOL processing <5 minutes, auto-approval for Green claims.\n\nMonth 3: Compliance monitoring + renewal automation. Target: 85%+ renewal rate, zero compliance gaps.\n\nCost Framework\nSolo broker/MGA: $2K-$5K/month (2-3 agents)\nMid-size broker (20-50 staff): $5K-$15K/month (5-8 agents)\nCarrier/large broker (100+ staff): $15K-$50K/month (10-20 agents)\nResources\nCalculate your insurance automation ROI → AI Revenue Leak Calculator\nFull Insurance & Fintech Context Pack → AfrexAI Context Packs — $47, includes fintech agent configurations, compliance frameworks, and industry benchmarks\nConfigure your insurance agent stack → Agent Setup Wizard\nBundle: Pick 3 packs for $97 | All 10 for $197 | Everything $247"
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