File Claim

---
name: File Claim
description: >
  Take a first report of a new loss on one of the signed-in policyholder's
  HarborCover policies and submit it as a claim. Activate for "a pipe burst",
  "my bike was stolen", "someone hit my car", "I need to make a claim", "the
  storm damaged my fence", for files the customer attaches to a report, and for
  changes to a report they are making.
import_tools:
  - check_claim_submission
  - route_claims_intake
tool_constraints:
  - submit_claim_report:
      requires: session.file_claim.claim_ready_to_submit
      requires_confirmation:
        enabled: true
        utter_for_confirmation: utter_confirm_claim_report
---

Take one first report of a loss and submit it once the customer has confirmed
it. A draft is not a claim: the claim is filed only when the claims system
acknowledges the submission and returns a claim-intake reference. Coverage is
decided later by a claims handler, never here.

1. Work out which policy the loss is on. The customer's policies are
   @memory.project.policy_list. If more than one could fit and they have not
   said, ask. If they give a number that is not on the account, say there is
   no such policy on their account; never say whether it belongs to someone
   else.
2. You need the type of loss, the date of loss and what happened. Ask only
   for what is missing. Then call @tool.start_claim_draft with a one-line
   summary in the customer's words (at most 80 characters) and the rest in
   loss_details. The date is the one the customer gave; never guess one.
3. Call @tool.check_attachments with the draft_id. It reads every file the
   customer attached in this chat from the attachment service. Tell the
   customer what was received and what is still needed, and name any failed
   upload as not received. A file that is still scanning has an unknown state
   and the report cannot be submitted yet: offer to check again after their
   next message, or to leave that file out (exclude) so the item is listed as
   still needed.
4. When the customer wants to submit, call @tool.submit_claim_report with the
   draft_id straight away. Do not ask for confirmation yourself: the engine
   reads the report back and asks the customer.
5. If the customer answers the engine's question with a change (another date
   of loss, another detail, another policy), decline the confirmation and
   record the change with @tool.update_claim_draft, or start a new draft for
   another policy. The engine does not accept a second submit_claim_report in
   the same turn, so tell the customer what changed and ask whether to submit
   it. When they agree, call @tool.submit_claim_report; the engine reads the
   new version back.
6. When submit_claim_report returns succeeded, give the claim-intake
   reference, the material received and what is still needed. Say coverage has
   not been decided.
7. When it returns pending, say the claim is not filed yet and call
   @tool.check_claim_submission with the draft_id. If that returns
   acknowledged, give the reference; it is the same claim, not a new one. If
   it returns unknown, call @tool.route_claims_intake with the draft_id and
   give the desk reference; the draft is kept. Never submit the same draft
   again.

From rasahq/rasa-community-resources at f54ddf4, shown as plain text under its license: Apache-2.0 (permissive). The license text is in LICENSE.

• memory.yml1.1 KB · 29d5e546b12e
• responses.yml515 B · 874c7ae1052f
• skill.md3.2 KB · cab228fc926e
• tools.py6.7 KB · cdab7891bd26

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