Recued
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UCSPA Compliance Verifier

by recued-core v1 action

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

How it works

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
Output
checklist compliance_checklist

Tags

claims-system claimscomplianceucspainsurance

Details

10 steps recipe_id: verify-ucspa-compliance-claims runs on Device + server

Install

Install in Recued View publisher Open Kitchen

If the webclient is not paired yet, copy verify-ucspa-compliance-claims and paste it after pairing.