Back to the discharge queue
Imran Shaikh, claim C-103
What this demo claim shows: Clause C7.1. The agent maps the surgery code to the insurer package, then asks the desk before removing a Rs 6,200 consumables kit.
Not run yet
1. Claim file
Synthetic patient and documentsInsurer and policy
Sahyog General Insurance (fictional), Arogya Shield Plus, sum insured Rs 5,00,000
Policy since
2021-01-15
Room
General ward, Rs 3,500 a day for 2 days
Desk note
Bill raised with hospital surgery code
Documents in the file
2. Bill lines and evidence
Not checked yet| Line | Description and code | Amount | Evidence |
|---|---|---|---|
| L1 | Lap cholecystectomy (hospital surgery code) SURG-LAPCHOL-02 | Rs 53,000 | Not checked |
| L2 | Surgical consumables kit CONS-SURGKIT-07 | Rs 6,200 | Not checked |
| L3 | Pharmacy, post-operative medicines PHA-OP-198 | Rs 3,100 | Not checked |
| L4 | USG abdomen RAD-USG-ABD | Rs 1,900 | Not checked |
3. Policy checks
Deterministic rules engine, not the language modelThe rules run when the agent calls the policy tool. Each result cites the clause it comes from.
4. Agent trace
0 tool callsLLM planner, gpt-4.1-miniThis deployment has a model configured. The language model will choose each tool call; you will see its reasoning notes.
Press Run the agent. Every card is a real tool call with its input and output; nothing is pre-recorded.
7. Messages with the insurer
Hospital and insurer go back and forth here until the claim is approved or rejectedLoading the conversation.