Rules Studio · claim controls
Rules Studio: the claim controls that fired most in the last 30 days, each as a readable sentence
Rules Studio (illustrative): the busiest claim controls in 30 days — a floor gap over 25%, wording not in the policy, a denial over $1M, excess attachment, SLA breaches, a passed notice deadline.

Months after a claim settles, someone will ask why the broker conceded one position and fought another, why the client was told to hold out for a number, why a notice went on the day it did. The decision record is the answer, written as the work happened.

What goes on it

  • Every claim control that fired on an Analyze, with its rule code, version and the evidence it evaluated.
  • Every prepared decision and its answer — accepted, rejected or asked about — by whom, when, with their note.
  • Sign-offs by the practice leader when a control refers to a lead.
  • What was sent, as a dry-run message id today.
flowchart LR A["Analyze"] --> H["Control hits
rule, version, evidence"] A --> PD["Prepared decisions"] PD --> AN["Answers
signed by a person"] H --> DR[("Decision record")] AN --> DR SO["Practice leader
sign-off"] --> DR DR --> AU["Audit and E&O review"] AN --> EV["Agreement evidence
for the autonomy dial"]

The verdict

Controls have outcomes — warn, refer to a lead, block until resolved — and the most severe one sets the claim’s verdict. On the illustrative water-damage claim:

SectionHitOutcome
Claim controlLARGE_DENIAL: a denial on a claim over $1Mrefer
Claim controlSLA_BREACHES: two or more carrier clocks breachedrefer
Claim controlSETTLEMENT_GAP: carrier more than 25% below the floorrefer
Claim controlUNSUPPORTED_POSITION: a position cites wording not in the policywarn

Verdict refer: nothing goes to the client on settlement until the practice leader has signed. A block — a notice deadline passed with notice unsent — shows as a red banner across the workspace.

Claim Workspace · Agents
A claim control blocking because a notice deadline passed unsent, above the notice checker's prepared notices
A kitchen fire at intake (illustrative): the block banner for a passed notice deadline, and the notice checker’s prepared decision — send notice to two carriers, one overdue — with Accept, Reject and Ask.

Signed as the person

When an advocate accepts a prepared decision, it is carried out as them, not as the agent, and the record says both: who decided, and which agent prepared it at which level. The platform’s decision service (insight_decisions) is shared with the other Insight products, so a record from InsightAdvocate reads the same as one from InsightPlacement or InsightCW.

Keep reading