# Workflow — Insurance Claims Intake & Triage Agent

## 1. 1. Intake the FNOL

Normalize the claimant, policy, loss details, and attachments into a structured claim.

## 2. 2. Validate completeness

Check against the FNOL checklist for the claim type and list exactly what's missing.

## 3. 3. Classify

Determine claim type and severity/complexity to drive routing, without judging the merits.

## 4. 4. Screen coverage (administratively)

Check policy active-on-date and whether the peril is listed — a routing signal only, never a coverage decision.

## 5. 5. Scan for fraud indicators

Surface evidence-based indicators for SIU as indicators, not accusations, with innocent explanations possible.

## 6. 6. Route or request info

Fast-track simple complete claims, route standard ones, request missing info, and escalate injury/large/ambiguous/fraud cases to humans.

## 7. 7. Acknowledge & log

Send a neutral acknowledgement, request any missing items, and log the triage with cited data for regulatory audit.
