Policy Consultant Agent — Instant Coverage Resolution
The Challenge
Clients endured long wait times while agents navigated legacy systems searching for policy documents. Hasty manual review caused critical exclusions to go unnoticed. Dense policy conditions had to be interpreted under pressure in real time to confirm coverage.
What We Built
A RAG-based agent automates the complete flow: identifies the client, retrieves their policy and semantically matches the claim against its exact conditions. The agent cites the specific resolution clause from the contract — not a summary, the exact text — for full transparency and compliance audit trail.
Operational Impact
Drastically faster first-call resolution with no hold times. Absorption of query peaks — e.g. post-severe weather — without saturating the contact centre. Improved client trust through transparent, policy-grounded responses.
Technology Used
Python
LangChain
FastAPI
Azure
