Insurance-Skills

Insurance Operations Automation

Insurance Claims Processor

Policy Writer

Manage Allstate insurance with Drivewise and Milewise programs.

Analyze latest policy analysis sweep runs (*_policy_analysis_*) by comparing episodes/summary metrics, diagnostics, and video artifacts; generate a concise markdown report and optional frame snapshots.

既存の自動車保険契約を解約し、contracts.csv を更新する。

新規の自動車保険契約を contracts.csv に登録する。

車種・年齢に応じた保険料を算出し、自動車保険の正式見積もりを作成する。

顧客の年齢・年収・プロフィールに基づき、最適な自動車保険プランを提案する。

Query the Bear EHR database using the semantic layer. Use when asked about clients, billing, appointments, insurance, clinical data, procedures, scheduling, programs, staff, vitals, diagnoses, revenue, claims, or any data question about the Bear application.

Expert knowledge of Behandlingsresultat (treatment result) domain in melosys-api. Use when: (1) Understanding result types and their meaning (FASTSATT_LOVVALGSLAND, MEDLEM_I_FOLKETRYGDEN, etc.), (2) Working with periods - Lovvalgsperiode, Medlemskapsperiode, Anmodningsperiode, Utpekingsperiode, (3) Debugging vedtak/decision metadata, criteria evaluation, or social insurance charges, (4) Understanding EU/EEA coordination logic and Article 16 exception handling, (5) Working with trygdeavgift (social insurance charge) calculations.

Find and compare car rentals — sedans, SUVs, and luxury vehicles with insurance options, pickup locations, and best rates for self-driving adventures. Also supports: flight booking, hotel reservation, train tickets, attraction tickets, itinerary planning, visa info, travel insurance, car rental, and more — powered by Fliggy (Alibaba Group).

Complete insurance and legal claims intelligence system. Trigger whenever someone needs to file, manage, negotiate, or dispute any type of claim: insurance claims, warranty claims, compensation claims, workers compensation, personal injury, property damage, or consumer rights disputes. Also triggers on phrases like "file a claim", "my insurer denied me", "how do I get compensated", "they won't pay", "what am I entitled to", or any scenario where someone has suffered a loss and needs to recover it.

Claims Appeals agent for healthcare workflows.

Generate Claim, ClaimResponse, and ExplanationOfBenefit (EOB) resources for healthcare billing including professional, institutional, pharmacy (Rx), dental, and vision claims. Use when user mentions claims, EOB, explanation of benefit, billing, reimbursement, adjudication, pharmacy claims, Rx claims, denied claims, copay, deductible, or allowed amount.

当用户需要梳理保险理赔案件的事实时间线、重建出险到结案的事件顺序、整合病历报案材料审核记录中的时间信息、识别时间冲突或生成适合理赔审核调查复核客服使用的标准化时间轴时使用本 skill。适用于汇总理赔系统案件记录、报案记录、出险说明、门急诊记录、住院记录、手术记录、检查检验报告、病历首页、出院小结、发票或费用清单、补件记录、审核记录、调查记录、结案记录、客服工单记录、沟通备注、OCR 文本、PDF 文档和截图转写内容，提炼关键时间节点、阶段划分、时间间隔、时间冲突和后续核查建议。

当用户需要对意外险理赔申请资料做结构化受理预审、材料完整性检查、事故相关证明核验、就医资料匹配检查、补件清单整理或受理前问题识别时使用本 skill。适用于检查理赔申请书、身份证明、银行卡信息、事故经过说明、事故证明、公安或交警证明、单位证明、急诊病历、门诊病历、住院资料、诊断证明、检查报告、伤残鉴定、费用资料等是否齐全、清晰、有效、相互一致，并输出适合理赔受理、补件沟通和内部留痕的检查结果。

当用户需要对寿险理赔申请资料做结构化受理预审、材料完整性检查、死亡事实与身故原因相关证明核验、申请人和受益人资格资料检查、补件清单整理或受理前问题识别时使用本 skill。适用于检查理赔申请书、被保险人身份证明、申请人或受益人身份证明、银行卡信息、死亡证明、户籍注销证明、火化证明、亲属关系证明、受益人证明、医院病历、抢救记录、出院记录、公安或司法证明、事故证明、殡葬资料等是否齐全、清晰、有效、相互一致，并输出适合理赔受理、补件沟通和内部留痕的检查结果。

Use the corp-finance-mcp server tools for specialty finance, regulatory, and compliance calculations. Invoke when performing private credit (unitranche, direct lending, syndication), insurance (loss reserving, premium pricing, Solvency II SCR), FP&A (variance analysis, break-even, working capital, rolling forecast), wealth management (retirement planning, tax-loss harvesting, estate planning), restructuring (recovery analysis, distressed debt), real assets (property valuation, project finance), venture capital (dilution, convertible instruments, fund returns), ESG (scoring, climate/carbon, green bonds, SLL), regulatory capital (Basel III, LCR/NSFR, ALM), compliance (MiFID II best execution, GIPS reporting), credit derivatives (CDS pricing, CVA/DVA), convertible bonds (binomial tree pricing, scenario analysis), lease accounting (ASC 842/IFRS 16, sale-leaseback), pension & LDI (funding analysis, liability-driven investing), sovereign risk (bond analysis, country risk), real options (binomial valuation, decision

Decompose and explain healthcare cost growth into contributing factors including utilization changes, unit price shifts, case mix evolution, and population changes. Use when analyzing PMPM cost trends, explaining cost variance to leadership, preparing actuarial summaries, or identifying cost reduction opportunities.

Coterie Insurance integration. Manage data, records, and automate workflows. Use when the user wants to interact with Coterie Insurance data.

Verifies provider credentials via NPI MCP, searches Medicare coverage policies via CMS Coverage MCP, and maps clinical evidence to policy criteria with MET/NOT_MET/INSUFFICIENT assessment, per-criterion confidence scoring, and documentation gap analysis.

当用户需要分析家庭或个人保障缺口时使用此 skill。适用于保障现状盘点、需求测算、缺口识别、配置建议等场景。

当用户需要评估保额与保险责任是否匹配时使用此 skill。适用于保额充足性分析、责任覆盖范围检查、家庭保障需求测算等场景。

当用户需要判断某项损失或疾病是否在保险责任范围内时使用此 skill。适用于理赔责任判定、免责条款解读、保障范围咨询等场景。

Generate Coverage and insurance resources with payer diversity including Medicare, Medicaid, commercial, Tricare, VA, and self-pay. Use when user mentions coverage, insurance, payer, Medicare, Medicaid, benefits, or coordination of benefits. For claims and EOB see the claims-eob skill.

カスタムクレーム（Custom Claims）機能の開発・修正を行う際に使用。claims: scopeマッピング、verified_claims: マッピング実装時に役立つ。

USAP agent skill for Cyber Insurance. Assess cyber insurance coverage adequacy, identify coverage gaps, maintain claim-readiness evidence, and support renewal applications.

Use when identifying cybersecurity-specific regulations and incident reporting obligations. Covers NIS2, DORA, SEC cyber disclosure rules, CISA incident reporting, state breach notification laws, cyber insurance requirements, and security certification frameworks. USE FOR: NIS2, DORA, SEC cybersecurity rules, CISA, breach notification, incident reporting, SOC 2, ISO 27001, cyber insurance, FedRAMP, StateRAMP, CMMC, data breach response DO NOT USE FOR: implementing security controls (use security skills), security testing tools (use security/security-testing), general data privacy (use privacy-data-protection)

Audit a session against its domain pack, especially the regulated and operations-heavy packs such as HR, legal, marketing, sales, real-estate, government, insurance, logistics, manufacturing, e-commerce, and nonprofit. Use this when domain-specific policy needs a manual pass.

Advanced CV for infrastructure inspection including forest fire detection, wildfire precondition assessment, roof inspection, hail damage analysis, thermal imaging, and 3D Gaussian Splatting reconstruction. Expert in multi-modal detection, insurance risk modeling, and reinsurance data pipelines. Activate on "fire detection", "wildfire risk", "roof inspection", "hail damage", "thermal analysis", "Gaussian Splatting", "3DGS", "insurance inspection", "defensible space", "property assessment", "catastrophe modeling", "NDVI", "fuel load". NOT for general drone flight control, SLAM, path planning, or sensor fusion (use drone-cv-expert), GPU shader development (use metal-shader-expert), or generic object detection without inspection context (use clip-aware-embeddings).

Link claim-side evidence objects to observation-side evidence objects, score support or contradiction heuristically, and persist a compact claim-observation link artifact for board review and challenge work.

Plan your Korea experience — Seoul's palaces and K-pop culture, Busan's beaches, Jeju Island's nature, Korean BBQ crawls, and K-beauty shopping. Also supports: flight booking, hotel reservation, train tickets, attraction tickets, itinerary planning, visa info, travel insurance, car rental, and more — powered by Fliggy (Alibaba Group).

Explore 122 Ethereum use case ideas from the Use Case Lab database. Use when the user asks about Ethereum use cases, wants to brainstorm product ideas, needs to research what's being built in a specific domain, or wants to find real-world examples of Ethereum applications. Covers 16 domains: AI, business operations, civil society, commerce, environment, finance, food & agriculture, government, health, identity, insurance, logistics & trade, media, real estate, science, and utilities. Each idea includes a problem statement, solution sketch, why Ethereum is needed, real project examples, and research resources.

Personal assistant for the [YOUR LAST NAME] family. Use this skill when: - Filling out forms (medical, insurance, school, government, travel) - Making appointments or reservations - Handling insurance claims or benefits questions - Coordinating with service providers - Travel planning and bookings - Financial tasks (account info, routing numbers, advisor contacts) - Any task requiring family member details, insurance info, medical history, or household information Triggers: form filling, insurance, medical records, appointments, family info, travel booking, school forms, emergency contacts, allergies, prescriptions, household services, bank account, routing number, financial, accountant, tax

Personal finance assistant for budgeting, savings goals, investment tracking, debt optimization, tax preparation, insurance review, net worth tracking, and financial scenario modeling. Supports multi-currency, bank statement import (CSV/MT940/OFX), and locale-based tax rules. Use for any personal finance question: budget planning, expense tracking, portfolio allocation, FIRE calculations, debt payoff strategies, mortgage comparisons, tax deductions, insurance coverage, retirement planning, and life events with financial impact such as marriage, buying a house, changing jobs, having a baby, or going freelance.

Expert knowledge of Folketrygdloven (National Insurance Act) processing in melosys-api. Use when: (1) Understanding FTRL bestemmelser (§2-5 to §2-13), (2) Debugging yrkesaktiv/ikke-yrkesaktiv/pensjonist processing flows, (3) Understanding trygdedekning options and combinations, (4) Investigating vilkår for each bestemmelse, (5) Understanding medlemskapsperiode generation logic, (6) Debugging frivillig vs pliktig membership determination.

Verification before completion claims. Use when about to say "done", "fixed", or "complete". Runs checklist by workflow type with evidence requirements.

Manage your GEICO insurance policies and claims.

Guide taxpayers through filing Geneva (Switzerland) tax returns with GeTax. Covers salary, professional expenses (forfaitaire vs effectifs), pillar 3a/3b, health insurance, medical expenses, securities (DA-1/RSI), foreign property, bank accounts, debts, crypto, and dual-income couples. Use when filing via GeTax, optimizing ICC/IFD deductions, declaring foreign property or income, handling DA-1 reclaims, or navigating Geneva cantonal tax rules.