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Sam Ellis

Health application · disclosed condition

ChatAdverse decision

Conversation

I have moderate asthma, well managed for years. Will that change my health cover price?

Customer·11:12am

Thanks for telling me, Sam. Bob here, Northwind's AI. A disclosed condition can affect the price, and that is a decision a licensed adviser makes, not me. I have put the details together and flagged it for your adviser.

Bob · AI·11:13am

Bob drafted a replyAdverse decisionIndicative until you send

Hi Sam, thanks for being upfront about your asthma. Based on that disclosure, a small health loading may apply to your cover. Because that is an adverse decision, it is not something I finalise: your licensed adviser reviews the underwriting and signs it off, and they will talk you through the options. I have everything ready for them.

Why Bob drafted this

A disclosed condition (managed asthma) affects rating. Proposing a loading is an ADVERSE_DECISION under the compliance rules: it must be reviewed and signed by a currently-authorised adviser, and Bob never actions it on its own.

66% · Medium confidence

Based on: Health application HA-3391, underwriting guide 3.4, Fair Insurance Code (utmost good faith)

Adverse decision, adviser-only. Bob cannot send this, it is your call. Review the underwriting and sign it off, or decline.

Details

Channel: Chat
Decision: Adverse decision
Queue: Needs you
Bob confidence: 66%

Nothing goes out until you approve it. Bob logs every reply with its reasoning and sources.