Underwriting Query Handler Agent
Automates responses to underwriting queries across channels
Description
Challenge:
Underwriting teams often face high query volumes from customers, agents, and internal staff seeking clarification on eligibility, document requirements, and policy rules. Many of these queries are repetitive and reference standard rulebooks, but still consume valuable underwriter time. Delayed or inconsistent responses can lead to confusion, prolonged policy issuance, and poor agent or customer experience. The Underwriting Query Handler Agent addresses this by acting as a digital knowledge assistant, automating query resolution with accurate, policy-aligned responses—available 24/7 across channels.
How It Works:
The agent listens for underwriting-related queries across chat, email, or portal submissions. It interprets questions using NLP models and matches them with underwriting rulebooks, document libraries, product eligibility criteria, and historical case logs. For standard queries—like age-based medical triggers, financial limits, or document requirements—it provides instant answers. For edge cases or uncommon queries, the agent escalates to underwriters with full context, including user history, relevant product details, and the query path taken. This dual approach ensures both speed and accuracy, while continuously learning from resolved cases to expand its coverage.
Benefits:
Resolves 70–85% of UW queries instantly without human input.
Cuts UW-related email/phone workload by 40–50%.
Maintains underwriter focus by filtering non-critical clarifications.
Ensures 95%+ consistent answers across products and regions.
Delivers query responses in under 10 seconds for standard scenarios.
Builds a centralized knowledge base with evolving rule alignment.
Doubles agent productivity with faster, more reliable information.
Features
The Underwriting Query Handler Agent brings underwriting intelligence to the frontlines by interpreting questions and instantly responding using embedded rules and data sources. It eliminates ambiguity in underwriting communication and ensures standardized, guideline-compliant responses through every channel—agent portals, chatbots, email helpdesks, or mobile apps.
Features & Capabilities
Rule-Based Query Mapping: Matches natural language queries to specific underwriting rules and guidelines
Age & Medical Trigger Detection: Flags if medical tests are required based on age and sum assured
Financial Eligibility Validation: Assesses whether income supports requested coverage
Document Suggestion Engine: Recommends accurate forms/checklists based on query and product
Escalation with Context: Routes unresolved queries to relevant underwriters with all supporting data
Learning from Exceptions: Captures manually resolved queries to expand future coverage
CRM & Case Log Integration: References historical interactions to personalize and speed up responses
Consistency Monitor: Tracks and ensures alignment with updated regulatory guidelines
Region/Product-Specific Handling: Adapts query responses as per jurisdictional or plan-specific rules
Response Analytics: Monitors query types, resolution speed, and accuracy to improve service
Eligibility Logic
Decision Logic Flow:
This agent operates on structured logic pathways to evaluate and respond to underwriting queries in real-time. It applies underwriting decision matrices, document matching rules, and product-specific eligibility thresholds to determine whether the question can be resolved instantly or requires escalation.
Key Logic Pathways Followed:
Age-Medical Trigger Rule: → If proposer age > 45 and sum assured > ₹50L, medical tests like ECG/TMT are advised.
Financial Eligibility Rule: → If declared income doesn’t support requested coverage, suggest income proof or downgrade recommendation.
Document Validation Rule: → Based on product and proposer role, suggest necessary forms and ID proofs.
Query Threshold Rule: → If query is too specific, new, or ambiguous, mark for human review.
Escalation Rule: → Route unresolved queries to product-specific or regional underwriter teams with all attached context.
