WorkflowLife & Annuities

Contestable Review

Contestable Claim Investigation

Every contestable claim gets a cited review of what was disclosed and what the records show.

Film coming soonSee it working, liveWe’ll walk you through Contestable Review on your own documents.
WorkflowDocuments in; a checked, signed result out.
5specialist agents
5kinds of input
Soonfilm in production
The problem

Why it matters

Contestable reviews mean reading the application against years of medical records; the work is slow, and families wait while it happens.

What it does

How the solution handles it

Five agents read the application, build a dated medical history, find answers the records contradict, check whether the underwriting manual would have changed the decision and write a cited findings memo. The claims examiner decides with counsel.

How it works

How a claim moves

Five specialist agents read the application, build the history, find misstatements, check materiality and write the memo; a claims examiner decides.

What comes in
Records in5 kinds of record · application, medical, Rx, notes
Agents at work
Application readerevery answer, cited
Then
Medical history builderbefore + after app
Then
Misstatement finderanswer vs record
Materiality checkerwould rating change?
Then
Findings memo writerfor examiner + counsel
A person decides
Claims examinerdecides with counsel
What comes out
Findings memo
Decision letter
Audit trail
In and out

What it reads, and what it hands back.

What goes in

  • Original application
  • Medical records and APS
  • Prescription history
  • Death certificate and autopsy report
  • Agent and interview notes

What comes out

  • Cited misstatement review
  • Medical history timeline
  • Materiality check
  • Findings memo

Who uses it

CEClaims examinersCCClaims counselMDMedical directorsUUnderwriters
What it changes

The difference, in numbers.

Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.

target
2hrs
from records received to a cited findings memo
By hand3–5 days
With agents≈ 2 hrs
target
100%
of application answers checked against the records
every answer checked
target
2–3yrs
contestable window applied per market (US 2 years, India 3)

Sources: US incontestability clauses (2 years) · Insurance Act 1938 §45 (India, 3 years) · “Target” = design goal, measured in the live solution · “typical” = published figures · “estimated” = our estimate

Built on the engine

5 specialist agents. One person decides.

Application readerevery answer on the application
Medical history builderdated history around the app date
Misstatement finderanswers the records contradict
Materiality checkertests against the manual
Findings memo writermemo with every finding cited
Claims examinerdecides with counsel

Build this
for your team.

We’ll show Contestable Review running on your own documents.