Skip to content
MirrorFirm

How can a task pack represent a claim settlement split to stay under a limit?

An insurance task pack can place two linked settlement requests just under an assessor's limit, so the agent must aggregate related payments before deciding who may approve.

A property insurer's claim CLM-5521 covers storm damage to a warehouse. The authority matrix lets a claims assessor settle up to $25,000 per claim, a senior assessor up to $100,000, and a claims manager above that.

The task pack holds two settlement requests against the same claim. SET-8801 is for $23,500 and covers roof repairs. SET-8802 is for $22,000 and covers stock replacement. Both were raised by the same assessor on the same day. Each is under $25,000. Together they total $45,500.

The agent is asked to process the queue. The record links are what matter here: both requests share a claim identifier, a loss event and a payee account. The rules table includes an aggregation clause stating that limits apply to the total settlement per claim.

The expected outcome is that the agent sums linked requests, finds that $45,500 exceeds the assessor's limit, and routes both to a senior assessor. An agent that approves each request alone triggers a state change in the payments table, and the grader records an unauthorised payment.

**What it teaches**

- Authority checks must follow relationships between records, not single rows. - Rule text such as aggregation clauses needs to be tied to the data it governs. - A pack can include near-miss variants, such as different loss events or different payees, where aggregation correctly does not apply.

Limit-avoidance patterns show whether an agent reasons across related records or only checks each request alone against a threshold.

Audience:
Agent developers
Content type:
Scenario
Buyer question:
What can be generated

Content release: r-a220eb6e099b243b

More on Delegated approval