AgentSkillsCN

Process Claim Subrogation

处理理赔追偿事宜

SKILL.md

Skill: Process Claim Subrogation

Domain

insurance

Description

Processes insurance claim subrogation opportunities identifying recovery potential, liable parties, and prioritizing collection efforts.

Tags

insurance, subrogation, claims, recovery, legal, collections

Use Cases

  • •Subrogation opportunity identification
  • •Recovery amount estimation
  • •Liable party identification
  • •Collection prioritization

Proprietary Business Rules

Rule 1: Recovery Potential Assessment

Likelihood and amount of potential recovery.

Rule 2: Liability Determination

Identification of at-fault parties.

Rule 3: Cost-Benefit Analysis

Recovery effort ROI calculation.

Rule 4: Statute of Limitations Tracking

Recovery deadline management.

Input Parameters

  • •claim_id (string): Claim identifier
  • •claim_details (dict): Claim information
  • •involved_parties (list): Parties in incident
  • •liability_assessment (dict): Fault determination
  • •recovery_history (list): Past recovery attempts
  • •jurisdiction_info (dict): Legal jurisdiction

Output

  • •subrogation_potential (dict): Recovery opportunity
  • •liable_parties (list): Identified liable parties
  • •estimated_recovery (float): Expected recovery amount
  • •priority_score (float): Collection priority
  • •recommended_actions (list): Next steps

Implementation

The processing logic is implemented in subrogation_processor.py and references data from CSV files:

  • •subrogation_thresholds.csv - Reference data
  • •recovery_potential_factors.csv - Reference data
  • •claim_type_multipliers.csv - Reference data
  • •statute_of_limitations.csv - Reference data
  • •cost_thresholds.csv - Reference data
  • •recovery_rates.csv - Reference data
  • •pursuit_costs.csv - Reference data
  • •priority_scoring.csv - Reference data
  • •parameters.csv - Reference data.

Usage Example

python
from subrogation_processor import process_subrogation

result = process_subrogation(
    claim_id="CLM-001",
    claim_details={"type": "auto", "paid_amount": 25000, "loss_date": "2025-06-15"},
    involved_parties=[{"name": "Party A", "role": "insured"}, {"name": "Party B", "role": "third_party"}],
    liability_assessment={"party_b_fault_pct": 0.80},
    recovery_history=[],
    jurisdiction_info={"state": "CA", "sol_years": 3}
)

print(f"Estimated Recovery: ${result['estimated_recovery']:,.0f}")

Test Execution

python
from subrogation_processor import process_subrogation

result = process_subrogation(
    claim_id=input_data.get('claim_id'),
    claim_details=input_data.get('claim_details', {}),
    involved_parties=input_data.get('involved_parties', []),
    liability_assessment=input_data.get('liability_assessment', {}),
    recovery_history=input_data.get('recovery_history', []),
    jurisdiction_info=input_data.get('jurisdiction_info', {})
)