{
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  "item": {
    "slug": "afrexai-insurance-claims",
    "name": "Insurance Claims Processor",
    "source": "tencent",
    "type": "skill",
    "category": "数据分析",
    "sourceUrl": "https://clawhub.ai/1kalin/afrexai-insurance-claims",
    "canonicalUrl": "https://clawhub.ai/1kalin/afrexai-insurance-claims",
    "targetPlatform": "OpenClaw"
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  "install": {
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    "sourcePlatform": "tencent",
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    "installMethod": "Manual import",
    "extraction": "Extract archive",
    "prerequisites": [
      "OpenClaw"
    ],
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      "README.md",
      "SKILL.md"
    ],
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      "Extract the archive and review SKILL.md first.",
      "Import or place the package into your OpenClaw setup."
    ],
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      "summary": "Hand the extracted package to your coding agent with a concrete install brief instead of figuring it out manually.",
      "steps": [
        "Download the package from Yavira.",
        "Extract it into a folder your agent can access.",
        "Paste one of the prompts below and point your agent at the extracted folder."
      ],
      "prompts": [
        {
          "label": "New install",
          "body": "I downloaded a skill package from Yavira. Read SKILL.md from the extracted folder and install it by following the included instructions. Then review README.md for any prerequisites, environment setup, or post-install checks. Tell me what you changed and call out any manual steps you could not complete."
        },
        {
          "label": "Upgrade existing",
          "body": "I downloaded an updated skill package from Yavira. Read SKILL.md from the extracted folder, compare it with my current installation, and upgrade it while preserving any custom configuration unless the package docs explicitly say otherwise. Then review README.md for any prerequisites, environment setup, or post-install checks. Summarize what changed and any follow-up checks I should run."
        }
      ]
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      "checkedAt": "2026-04-23T16:43:11.935Z",
      "expiresAt": "2026-04-30T16:43:11.935Z",
      "httpStatus": 200,
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        "probeUrl": "https://wry-manatee-359.convex.site/api/v1/download?slug=4claw-imageboard",
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        "redirectLocation": null,
        "bodySnippet": null
      },
      "scope": "source",
      "summary": "Source download looks usable.",
      "detail": "Yavira can redirect you to the upstream package for this source.",
      "primaryActionLabel": "Download for OpenClaw",
      "primaryActionHref": "/downloads/afrexai-insurance-claims"
    },
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      "installChecklist": [
        "Use the Yavira download entry.",
        "Review SKILL.md after the package is downloaded.",
        "Confirm the extracted package contains the expected setup assets."
      ],
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        "Confirm the extracted package includes the expected docs or setup files.",
        "Validate the skill or prompts are available in your target agent workspace.",
        "Capture any manual follow-up steps the agent could not complete."
      ]
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    "agentPageUrl": "https://openagent3.xyz/skills/afrexai-insurance-claims/agent",
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    "summary": "Hand the extracted package to your coding agent with a concrete install brief instead of figuring it out manually.",
    "steps": [
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      "Extract it into a folder your agent can access.",
      "Paste one of the prompts below and point your agent at the extracted folder."
    ],
    "prompts": [
      {
        "label": "New install",
        "body": "I downloaded a skill package from Yavira. Read SKILL.md from the extracted folder and install it by following the included instructions. Then review README.md for any prerequisites, environment setup, or post-install checks. Tell me what you changed and call out any manual steps you could not complete."
      },
      {
        "label": "Upgrade existing",
        "body": "I downloaded an updated skill package from Yavira. Read SKILL.md from the extracted folder, compare it with my current installation, and upgrade it while preserving any custom configuration unless the package docs explicitly say otherwise. Then review README.md for any prerequisites, environment setup, or post-install checks. Summarize what changed and any follow-up checks I should run."
      }
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  "documentation": {
    "source": "clawhub",
    "primaryDoc": "SKILL.md",
    "sections": [
      {
        "title": "Insurance Claims Processor",
        "body": "Process, analyze, and optimize insurance claims. Covers property, liability, workers' comp, auto, and professional indemnity."
      },
      {
        "title": "What This Does",
        "body": "Takes raw claim details and produces:\n\nStructured claim summary with policy coverage mapping\nLiability assessment with supporting/weakening factors\nReserve estimate with confidence range\nSubrogation opportunity analysis\nRed flag detection (fraud indicators, coverage gaps)\nSettlement recommendation with negotiation range\nRegulatory compliance checklist by jurisdiction"
      },
      {
        "title": "Usage",
        "body": "Provide claim details in any format — adjuster notes, policyholder statement, incident report, photos, or free text. The agent structures everything."
      },
      {
        "title": "Quick Claim Analysis",
        "body": "Analyze this claim: [paste details]"
      },
      {
        "title": "Full Processing",
        "body": "Process claim for:\n- Policy type: [commercial general liability / property / WC / auto / PI]\n- Incident date: [date]\n- Reported date: [date]\n- Claimant: [name/entity]\n- Description: [what happened]\n- Claimed amount: [if known]\n- Policy limits: [if known]\n- Jurisdiction: [state/country]"
      },
      {
        "title": "1. Coverage Determination",
        "body": "Map incident to policy provisions\nIdentify applicable endorsements and exclusions\nFlag coverage disputes early\nCheck occurrence vs claims-made triggers"
      },
      {
        "title": "2. Liability Assessment",
        "body": "Score 1-10 on insured liability exposure:\n\n1-3: Strong defense position, deny or minimal settlement\n4-6: Mixed liability, negotiate\n7-10: Clear insured liability, reserve and settle\n\nFactors evaluated:\n\nComparative/contributory negligence (jurisdiction-specific)\nStatutory obligations\nContractual indemnity provisions\nPrior loss history pattern"
      },
      {
        "title": "3. Reserve Estimation",
        "body": "Three-point estimate:\n\nLow: Best case with strong defense\nMid: Most likely outcome\nHigh: Worst case including litigation costs\n\nInclude:\n\nIndemnity reserve\nDefense costs (inside/outside limits)\nAllocated loss adjustment expense (ALAE)\nUnallocated loss adjustment expense (ULAE)"
      },
      {
        "title": "4. Fraud Detection",
        "body": "Red flags scored by severity:\n\nClaim timing patterns (Monday morning, policy inception proximity)\nPrior claim frequency\nDocumentation inconsistencies\nWitness availability issues\nFinancial stress indicators\nDescription vs damage inconsistency"
      },
      {
        "title": "5. Subrogation Analysis",
        "body": "Third-party recovery potential\nEvidence preservation requirements\nStatute of limitations by jurisdiction\nCost-benefit of pursuit"
      },
      {
        "title": "6. Settlement Strategy",
        "body": "Opening position and authority range\nMediation vs litigation cost comparison\nJurisdiction-specific verdict ranges\nStructured settlement considerations for large claims"
      },
      {
        "title": "Property Claims",
        "body": "Replacement cost vs actual cash value\nBusiness interruption calculations (gross earnings, extra expense)\nOrdinance or law coverage triggers\nCatastrophe event coordination"
      },
      {
        "title": "Workers' Compensation",
        "body": "Compensability determination\nReturn-to-work timeline\nMedical treatment guidelines by state\nPermanent disability rating estimates"
      },
      {
        "title": "Professional Liability",
        "body": "Discovery rule and statute of repose\nPrior acts coverage analysis\nConsent to settle provisions\nPanel counsel selection criteria"
      },
      {
        "title": "Auto/Fleet",
        "body": "Comparative fault allocation\nUM/UIM stacking analysis\nMedical payment coordination\nTotal loss threshold calculations"
      },
      {
        "title": "Compliance Checklist Generator",
        "body": "Produces jurisdiction-specific compliance timeline:\n\nAcknowledgment deadlines\nInvestigation completion requirements\nPayment timing obligations\nRequired notices and disclosures\nBad faith exposure triggers"
      },
      {
        "title": "Output Format",
        "body": "Every analysis produces:\n\nExecutive Summary — 3-line claim snapshot\nCoverage Analysis — provisions, exclusions, disputes\nLiability Score — 1-10 with reasoning\nReserve Recommendation — low/mid/high with breakdown\nRed Flags — fraud indicators if any\nAction Items — next steps with deadlines\nSettlement Range — if applicable\n\nBuilt by AfrexAI — AI agent context packs for every industry.\n\nGet the full Insurance & Risk Management Context Pack with claims processing, underwriting automation, policy analysis, and actuarial modeling: AfrexAI Storefront\n\nCalculate what AI agents save your claims operation: AI Revenue Calculator"
      }
    ],
    "body": "Insurance Claims Processor\n\nProcess, analyze, and optimize insurance claims. Covers property, liability, workers' comp, auto, and professional indemnity.\n\nWhat This Does\n\nTakes raw claim details and produces:\n\nStructured claim summary with policy coverage mapping\nLiability assessment with supporting/weakening factors\nReserve estimate with confidence range\nSubrogation opportunity analysis\nRed flag detection (fraud indicators, coverage gaps)\nSettlement recommendation with negotiation range\nRegulatory compliance checklist by jurisdiction\nUsage\n\nProvide claim details in any format — adjuster notes, policyholder statement, incident report, photos, or free text. The agent structures everything.\n\nQuick Claim Analysis\nAnalyze this claim: [paste details]\n\nFull Processing\nProcess claim for:\n- Policy type: [commercial general liability / property / WC / auto / PI]\n- Incident date: [date]\n- Reported date: [date]\n- Claimant: [name/entity]\n- Description: [what happened]\n- Claimed amount: [if known]\n- Policy limits: [if known]\n- Jurisdiction: [state/country]\n\nClaim Analysis Framework\n1. Coverage Determination\nMap incident to policy provisions\nIdentify applicable endorsements and exclusions\nFlag coverage disputes early\nCheck occurrence vs claims-made triggers\n2. Liability Assessment\n\nScore 1-10 on insured liability exposure:\n\n1-3: Strong defense position, deny or minimal settlement\n4-6: Mixed liability, negotiate\n7-10: Clear insured liability, reserve and settle\n\nFactors evaluated:\n\nComparative/contributory negligence (jurisdiction-specific)\nStatutory obligations\nContractual indemnity provisions\nPrior loss history pattern\n3. Reserve Estimation\n\nThree-point estimate:\n\nLow: Best case with strong defense\nMid: Most likely outcome\nHigh: Worst case including litigation costs\n\nInclude:\n\nIndemnity reserve\nDefense costs (inside/outside limits)\nAllocated loss adjustment expense (ALAE)\nUnallocated loss adjustment expense (ULAE)\n4. Fraud Detection\n\nRed flags scored by severity:\n\nClaim timing patterns (Monday morning, policy inception proximity)\nPrior claim frequency\nDocumentation inconsistencies\nWitness availability issues\nFinancial stress indicators\nDescription vs damage inconsistency\n5. Subrogation Analysis\nThird-party recovery potential\nEvidence preservation requirements\nStatute of limitations by jurisdiction\nCost-benefit of pursuit\n6. Settlement Strategy\nOpening position and authority range\nMediation vs litigation cost comparison\nJurisdiction-specific verdict ranges\nStructured settlement considerations for large claims\nIndustry-Specific Modules\nProperty Claims\nReplacement cost vs actual cash value\nBusiness interruption calculations (gross earnings, extra expense)\nOrdinance or law coverage triggers\nCatastrophe event coordination\nWorkers' Compensation\nCompensability determination\nReturn-to-work timeline\nMedical treatment guidelines by state\nPermanent disability rating estimates\nProfessional Liability\nDiscovery rule and statute of repose\nPrior acts coverage analysis\nConsent to settle provisions\nPanel counsel selection criteria\nAuto/Fleet\nComparative fault allocation\nUM/UIM stacking analysis\nMedical payment coordination\nTotal loss threshold calculations\nCompliance Checklist Generator\n\nProduces jurisdiction-specific compliance timeline:\n\nAcknowledgment deadlines\nInvestigation completion requirements\nPayment timing obligations\nRequired notices and disclosures\nBad faith exposure triggers\nOutput Format\n\nEvery analysis produces:\n\nExecutive Summary — 3-line claim snapshot\nCoverage Analysis — provisions, exclusions, disputes\nLiability Score — 1-10 with reasoning\nReserve Recommendation — low/mid/high with breakdown\nRed Flags — fraud indicators if any\nAction Items — next steps with deadlines\nSettlement Range — if applicable\n\nBuilt by AfrexAI — AI agent context packs for every industry.\n\nGet the full Insurance & Risk Management Context Pack with claims processing, underwriting automation, policy analysis, and actuarial modeling: AfrexAI Storefront\n\nCalculate what AI agents save your claims operation: AI Revenue Calculator"
  },
  "trust": {
    "sourceLabel": "tencent",
    "provenanceUrl": "https://clawhub.ai/1kalin/afrexai-insurance-claims",
    "publisherUrl": "https://clawhub.ai/1kalin/afrexai-insurance-claims",
    "owner": "1kalin",
    "version": "1.0.0",
    "license": null,
    "verificationStatus": "Indexed source record"
  },
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