Policy Coverage Checker
Finds the clause, the exclusion and the condition — and lets a person decide
- 9hard rules
- Things it must never do, enforced in every run
- 6handover rules
- Conditions where it stops and gives the work to a person
- 12output fields
- A structured result, not a paragraph you have to re-read
- ≤6steps per run
- Bounded work: at most 5 tool calls, enforced by the runtime
Read-only by design. This agent has no path to sending, spending, publishing or committing anything. Where that limit is the product, removing it would remove the reason to trust the output.
Overview
Coverage questions get answered from memory, because the wording is forty pages long, the endorsements amend it in three places, and the caller is on hold. That is how a claim gets wrongly discouraged and how a policy gets mis-described at the point of sale.
This agent reads the wording instead. Ask whether a situation falls within cover and it returns the operative clause, the exclusions that touch it, the conditions the insured must have satisfied, and any endorsement that changes the position — each quoted, each with the document and section it came from.
What it will not do is tell you the answer. It does not decide coverage, does not accept or decline a claim, and does not advise a customer. It puts the relevant wording in front of a handler or broker in ten seconds instead of twenty minutes, and the decision stays with the person who is authorised to make it.
Benefits
Twenty minutes down to ten seconds
The wording found and quoted while the caller is still on the line.
Consistent answers
Two handlers asked the same question get the same clauses, not two recollections.
An auditable trail
Every answer records which wording and which version it came from — which is what a complaint file needs.
What it does
Quotes the wording
The operative clause as written, with the document and section, never a paraphrase of what it probably says.
Surfaces exclusions with the cover
An answer that shows the grant of cover and omits the exclusion is the answer that causes complaints.
Applies endorsements
Checks whether an endorsement amends the clause, because the base wording alone is often the wrong answer.
Lists the conditions
Notification periods, warranties and duties the insured must have met for the clause to respond.
Says when the wording is silent
An unaddressed situation is reported as unaddressed and referred, not resolved by inference.
Decides nothing
No coverage determination, no claim accepted or declined, no advice to a policyholder. By design and in every output.
What this changes
What this changes about your week
- It takes over
- Finding the clause, the exclusions and the conditions that bear on a coverage question.
- Done today by
- Claims handlers and brokers, usually while someone waits on the phone.
- How often
- Dozens of times a day in any claims operation.
- Typical manual effort
- Reading a forty-page wording and its endorsements properly takes twenty minutes.
Why Insurance in particular. The alternative is answering from memory, which is how a claim gets wrongly discouraged and a complaint gets upheld.
Runs unattended
Started by you or by an event, and it finishes on its own. Nothing waits for someone to be at a desk.
The same standard every time
The two-hundredth item is held to the bar the first one was. Consistency is the part people cannot sustain.
It cannot act on its own
Policy Coverage Checker has no path to sending, spending or committing. That limit is why its output is safe to act on.
How it runs
This agent runs server-side through the PROMIVO runtime. Each run is logged step by step and every tool call is permission-checked before it executes.
- 1InputValidated against the agent input schema
- 2Modelclaude-opus-5 with automatic fallback
- 3Toolssearch_knowledge
- 4PermissionsRuns READ actions automatically; anything higher waits for approval
- 5OutputStructured result matching the output schema
- 6LoggingTokens, duration and every step recorded
Demo
Demo dataIllustrative sample output, abridged.
Input
{
"question": "Is damage from a burst pipe covered while the property was unoccupied?",
"policyReference": "HH-2024-Standard"
}Output
{
"escalate": false,
"conditions": [
{
"section": "General Condition 6",
"quotedText": "Where the home is unoccupied during the period 1 November to 31 March, the water supply must be turned off at the mains and the system drained, unless heating is maintained at a minimum of 12°C.",
"sourceDocument": "Household Wording HH-2024-Standard v3"
}
],
"disclaimer": "This is the wording that bears on the question, not a coverage decision. Whether this claim responds is for an authorised handler to determine.",
"exclusions": [
{
"section": "Section 1, Exclusion 4b",
"relevance": "Directly engages the unoccupancy element of the question.",
"quotedText": "We will not cover loss or damage occurring while the home is unoccupied for more than 45 consecutive days.",
"sourceDocument": "Household Wording HH-2024-Standard v3"
}
],
"wordingFound": true,
"policyDocument": "Household Wording HH-2024-Standard v3",
"operativeClauses": [
{
"section": "Section 1, Peril 4 — Escape of water",
"quotedText": "We will cover loss or damage caused by water escaping from any fixed water or heating installation.",
"sourceDocument": "Household Wording HH-2024-Standard v3"
}
],
"forHandlerToDetermine": [
"The number of consecutive days the property was unoccupied.",
"Whether General Condition 6 was satisfied on the date of loss."
]
}Requirements
Integrations
No integrations required.
Before you start
- The coverage question and the circumstances
- A knowledge base holding the policy wordings, schedules and endorsements
- Requires the All-Access plan or higher
Use cases
First notification of loss
Find the clauses and conditions that bear on the circumstance, before the file is opened.
Broker coverage queries
Answer a client's 'would this be covered?' with the wording rather than a recollection.
Comparing wordings
See how two policies treat the same peril, clause against clause.
Complaint review
Reconstruct exactly what the wording said when the decision was made.
Pricing
All-Access
Billed monthly through your PROMIVO subscription. Cancel at any time.
Runs consume your plan allowance for agent executions and tokens. See plan limits
FAQ
Will it tell me if a claim is covered?
No, and that is deliberate. It surfaces the operative clause, the exclusions, the conditions and any endorsement, then refers the determination to an authorised person. Coverage decisions carry regulatory consequences and are not the agent's to make.
Can policyholders use it directly?
It is built for handlers and brokers. Putting it in front of a policyholder would mean an automated system appearing to advise on a claim, which is regulated activity in most markets.
How does it handle endorsements?
It looks for them explicitly and reports where one amends the clause it just quoted. Answering from a base wording that an endorsement has changed is the most common way these questions go wrong.
What if the wording is ambiguous?
It reports the ambiguity and both readings, and refers it. Ambiguity in an insurance contract has legal consequences that the agent does not attempt to resolve.
Reviews
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