# Setup guide — Insurance Claims Intake & Triage Agent

## 1. Install and connect claims systems

Install the agent and connect it to your claims/policy systems under appropriate access.

```
pipx install claims-triage-agent
claims-triage-agent connect --claims guidewire --policy core
claims-triage-agent doctor   # checks PII handling + audit logging
```

## 2. Configure boundaries and routing

Lock the agent to administrative triage. Adjudication is impossible by config.

```
cp .env.example .env
ANTHROPIC_API_KEY=sk-ant-...
ADJUDICATION=false        # never approves/denies or decides coverage
ESCALATE: ["bodily_injury", "fatality", "large_loss", "litigation", "fraud_indicator"]
SIU_QUEUE=special_investigations
```

## 3. Define FNOL checklists & routing rules

Provide the required-items checklist per claim type and the queue routing rules.

```
# claims.yml
auto_glass: { required: [date, location, photos, policy_number], severity: low }
theft: { required: [date, location, police_report, item_list], severity: moderate }
bodily_injury: { always_escalate: true }
```

## 4. Dry-run on past FNOLs

Replay historical claims to check classification and routing before going live.

```
claims-triage-agent backtest --range 60d --explain
# reports completeness/classification/routing accuracy and any mis-routes
```

## 5. Wire into intake

Route new FNOLs to the agent for triage; injury/large/fraud cases auto-route to humans/SIU.

```
# FNOL channel -> POST https://your-host/claims/intake (HMAC)
# decision=ESCALATE auto-assigns to senior adjuster / SIU
```
