Verifies claim processing timelines against state Unfair Claims Settlement Practices Act deadlines and renders a compliance checklist.

How it works 10 steps

Inspect the data fetches, transforms, gates, and output this recipe runs.

Process (10 steps)

■ days_to_acknowledge date_diff

Calculate days between claim date received and claim date acknowledged

■ days_to_investigate date_diff

Calculate days between claim date received and claim date investigated started

■ days_to_decision date_diff

Calculate days between claim date received and claim date decision

■ state_limits switch

Map claim policyholder state to one of: CA, FL, IL, NY, TX

■ ack_ok compare

Check if days to acknowledge is at most state limits acknowledge days

skip: step.days_to_acknowledge is_null

■ inv_ok compare

Check if days to investigate is at most state limits investigate days

skip: step.days_to_investigate is_null

■ dec_ok compare

Check if days to decision is at most state limits decision days

skip: step.days_to_decision is_null

■ form_sent_ok compare

Check if claim claim form sent date exists

■ denial_ok compare

Check if claim denial reason has data

■ compliance_checklist to_checklist

Format results as an actionable checklist

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Output

checklist compliance_checklist