Vehicle Claims Resolution
Automated decision system for determining optimal insurance claim resolution based on damage severity, vehicle age, and parts availability.
This template can be edited in GoRules BRMS
Solution
This decision engine streamlines the vehicle insurance claims process by determining whether to repair, replace, or offer cash settlement for damaged vehicles. The system evaluates the extent of vehicle damage through a percentage assessment, categorizing cases as minor, moderate, severe, or total loss. For vehicles with significant damage but not qualifying as total loss, the solution factors in the vehicle's age and parts availability status.
When dealing with older vehicles that have severe damage and limited parts availability, the system typically recommends cash settlements to avoid lengthy repairs with uncertain outcomes. For newer vehicles with similar damage profiles, it might recommend replacement when parts cannot be sourced. In cases where damage is repairable and necessary parts are available or can be obtained with reasonable delay, the system recommends repair. Each recommendation comes with a clear explanation of the decision factors, helping adjusters communicate effectively with policyholders while ensuring consistent claim handling.
How it works
The decision graph processes vehicle claims through three sequential evaluation steps:
- Damage Assessment: Analyzes the damage percentage to classify severity as minor (under 30%), moderate (30-59%), severe (60-79%), or total loss (80%+).
- Parts Availability Check: Evaluates the availability of replacement parts based on the vehicle's age and reported parts status (available, limited, discontinued).
- Resolution Determination: Combines damage level, parts availability, and vehicle age to recommend the optimal resolution:
- Total loss claims automatically receive cash settlement recommendations
- Severe damage with unavailable parts triggers cash settlement for older vehicles (>8 years) or replacement for newer ones
- Moderate damage with unavailable parts leads to cash settlement for vehicles older than 6 years
- All minor damage and repairable moderate/severe damage with obtainable parts defaults to repair recommendations
Each recommendation includes a detailed explanation of the decision factors.
Other Insurance Templates
View all templatesPolicy Eligibility Analyzer
Automated rule-based system that evaluates customer eligibility for insurance policies based on age, location, and specific risk factors.
Explore InsuranceAuto Insurance Premium Calculator
Dynamic pricing system that determines accurate premiums based on driver profile, vehicle specifications, and coverage options for personalized insurance rates.
Explore InsuranceInsurance Claim Validation System
Automated verification system that validates insurance claims against policy status, timeframe requirements, and claim details before advancing to investigation.
Explore