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insurance-domain

insurance-domain

Use when modifying domain/models/, domain/services/, adaptor/llm/, or any business logic involving insurance terms, coverages, or risk rules. Also use when adding new fields, endorsements, or coverage types.

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name: insurance-domain description: "Use when modifying domain/models/, domain/services/, adaptor/llm/, or any business logic involving insurance terms, coverages, or risk rules. Also use when adding new fields, endorsements, or coverage types."

Insurance Domain Knowledge (ACORD-Based)

ACORD (Association for Cooperation in Operations Research and Development) defines the insurance industry's data standards. This project covers Personal Lines — Auto (ACORD 90) and Homeowners (ACORD 80).

Core Terminology

TermDefinitionACORD Context
RenewalPolicy renewal. Comparing Prior vs Renewal is the core workflowACORD 80/90 Status: Renew
EndorsementMid-term policy change or rider. Expands/restricts coverage scopeACORD 70 (HO), 71 (Auto): change type A/C/D
PremiumInsurance premium. Rate of change at renewal is the primary risk indicatorACORD WrittenAmt
DeductibleAmount the insured pays first before a claim is coveredACORD DeductibleAmt
Liability LimitLiability cap. A protected field that must never be auto-reducedACORD BI, PD, Coverage E
Coverage DroppedCoverage item removed. Flagged when True→False or amount decreasesDiffFlag.COVERAGE_DROPPED
Material ChangeA change with substantial impact on coverage scopeLLM endorsement_comparison target
Risk SignalRisk factors extracted from renewal notes (claims history, property condition, etc.)LLM risk_signal_extractor output
BundleAuto + Home package for the same customer. Discount eligible; risk when unbundledCore concept in Portfolio analysis
SR-22High-risk driver certificate. Minimum insurance proof required by the stateACORD Driver field

Coverage Types (ACORD Code Mapping)

Auto Coverages

ACORD CodeNameCurrent Model FieldNotes
BIBodily Injurybodily_injury_limitsplit limit "100/300"
PDProperty Damageproperty_damage_limit
COLLCollisioncollision_deductible
COMPComprehensivecomprehensive_deductible
UMUninsured Motoristuninsured_motorist
MEDPMMedical Paymentsmedical_payments
TLTowing/Roadsideroadside_assistancebool only — ACORD uses amount
RENTALRental Reimbursementrental_reimbursementbool only — ACORD uses daily/max limit
UNDUMUnderinsured Motoristnot implementedseparate from UM, required in many states
PIPPersonal Injury Protectionnot implementedrequired in no-fault states
UMPDUM Property Damagenot implementedseparate coverage in some states

Home Coverages

ACORD CodeNameCurrent Model FieldNotes
DWELLCoverage A (Dwelling)coverage_a_dwellingprotected field
OTSTRCoverage B (Other Structures)coverage_b_other_structurestypically 10% of A
PPCoverage C (Personal Property)coverage_c_personal_property
ALECoverage D (Loss of Use)coverage_d_loss_of_use
PLCoverage E (Liability)coverage_e_liabilityprotected field
MEDPMCoverage F (Medical)coverage_f_medical
WINDWind/Hailwind_hail_deductibledeductible only
—Water Backupwater_backupbool only — ACORD uses limit amount
EQEarthquakenot implementednear-mandatory in CA/WA/OR
FLOODFloodnot implementedseparate NFIP policy

ACORD Gap Analysis — Known Limitations of Current Models

High Priority (Directly impacts renewal review)

  1. UIM/PIP/UMPD not implemented — Cannot compare state-required coverages
  2. No amounts on boolean coverages — Cannot compare limits for rental($30/day), roadside($75/occ), water_backup($5K), etc.
  3. No Loss History — ACORD 80/90 Prior Loss section. Key factor in renewal premium determination
  4. No HO Form Type — HO-3(broad), HO-5(open), HO-6(condo), etc. Fundamentally different coverage scopes
  5. No Territory Code — Basic variable in premium calculation

Medium Priority (Improves analysis precision)

  1. Driver DOB — ACORD standard uses DOB instead of age. Enables exact age calculation
  2. Vehicle annual mileage — EstimatedAnnualDistance. Major premium factor
  3. Driver relationship/marital status — RelationshipToInsured, MaritalStatus. Discount factors
  4. Endorsement limit/deductible — Cannot compare endorsement coverage limits
  5. Prior Carrier — ACORD 80 Prior Coverage section. Renewal context

Protected Fields — Never auto-modify

Per ACORD standards, reducing these fields carries legal/contractual risk:

  • bodily_injury_limit — Bodily injury liability limit
  • property_damage_limit — Property damage liability limit
  • uninsured_motorist — Uninsured motorist coverage
  • coverage_a_dwelling — Dwelling reconstruction cost
  • coverage_e_liability — Personal liability

Endorsement Form System

ACORD uses a Form Number system rather than a single code list:

  • Auto: PP series (PP 03 06, PP 03 22, PP 03 23, etc.)
  • Home: HO series (HO 04 10, HO 04 61, HO 04 90, HO 04 95, etc.)
  • Change Request: ACORD 70 (HO), ACORD 71 (Auto) — type A(Add)/C(Change)/D(Delete)

Currently Endorsement.code is free text. Validation can be added when ISO/AAIS form number mapping is implemented.

Application Rules

  1. When adding new coverage fields: Reference the ACORD code mapping tables above for naming
  2. When adding DiffFlags: Consider the industry importance of the coverage (liability types → URGENT)
  3. When modifying LLM prompts: Verify the exact meaning of insurance terms before use
  4. When adding Quote strategies: Re-verify the protected fields list. Protected fields cannot be changed in any strategy
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