Claims adjudication for insurance carriers.¶
A carrier sends what it knows about a claim. Adjust360 returns a determination: which theory applies, which facts carried it, what could defeat it, what is still missing. No language model on the decision path. This site documents the process, the product, and the engineering reference.
Documentation¶
Fact status vocabulary¶
Every fact a carrier sends arrives with a status. The engine acts on the difference between them and never swaps two of them.
The carrier said it, with a value. A rule may act on it.
The carrier looked and found nothing. A verified absence; a defense that needs the fact does not fire.
The carrier said nothing about it. Nobody looked. Whatever needs it stays open and the brief asks for it.
A document was read and the fact could not be read from it. Only on the document path.
Subrogation module¶
Property and Auto, six theories each. Situations that change the answer, a quick reference, and a self-test. Coverage, liability, reserve, and authority are documented in their respective modules.
Property subrogation
Contractor, product, utility, tenant, municipal and neighbouring-property theories. Waivers, act of God, spoliation and the two clocks.
Auto subrogation
At-fault driver, respondeat superior, negligent entrustment, fleet negligence, product liability. Fault rules, no-fault heads and channels.
The shape of every subrogation question
Three questions, in order, and the status vocabulary that decides how each is answered.
The subrogation module
Input, output, corpus, jurisdiction content, what a carrier receives and what never leaves.