Motor, health, property, commercial - whatever the line, a claim file asks the same four questions. Valinexis reads the whole file as one case and answers them deterministically. Rule packs ship ready to run, and every document, check, severity and threshold in them is yours to change on a screen.
The document lists, the checks, the severities, the thresholds: all configuration, edited on a screen. Add a document your carriers demand and ours do not. Drop a check that does not apply in your jurisdiction. Build a case type nobody here has thought of. None of that is a release, a professional-services engagement, or a conversation with us.
Six shipped packs across motor, health, property and commercial auto - running on day one, no rule writing required.
Change a threshold, re-rank a severity, rewrite a comparison. Every rule reads as a sentence, so the people who own the policy can review it.
The checks particular to how you underwrite - written against canonical concepts, not against one carrier's labels.
A line of business we have never configured is a screen, not a roadmap item. Content packs deploy as data, not releases.
Whatever the line, a claim file asks the same four questions. The engine is built around those questions rather than around any particular kind of claim - which is why a new line of business is content rather than code. The questions do not change; only the documents they are asked of.
| The question | Motor asks it as | Health asks it as | Property asks it as |
|---|---|---|---|
| 1. Is this payable at all? | Policy in force on the date of loss | Treatment covered when it happened | Loss covered when it happened |
| 2. Is this the right subject? | Right vehicle, right driver | Patient must be the insured | Loss at the insured premises |
| 3. Does the paperwork belong together? | One claim number across the file | Claim quotes the right policy | Claimant is the insured |
| 4. Does the money hold up? | Invoice against approved appraisal | Line amounts add up, nothing billed twice | Reinstatement within cover limit |
A claim file arrives. Somebody has to confirm the policy was in force on the date of loss, that the file is even complete, that the documents in it agree with each other - and that nobody has been billed for something that was never approved. What that looks like depends entirely on the line.
Is the VIN on the repair invoice the VIN on the policy? Is the driver on the loss notice the driver on the crash report? Did the shop bill an aftermarket part at OEM prices, or a suspension line the appraiser never approved?
Is the patient actually the insured? Do the charge dates fall inside the admission? Is the same item billed twice on a hospital bill running to ninety lines? Has this bill already been claimed?
Did the loss happen at the insured premises? Is the claimant the named insured? Does the reinstatement estimate exceed the cover limit?
Six rule packs across four lines of business, ready to run on day one. Nine lines of business come configured - health, motor, commercial auto, homeowner, commercial property, liability, travel, life and procurement - and a line that is not on that list is added on a screen, not by us.
| Pack | Line of business | Roles | Rules |
|---|---|---|---|
| US Auto Physical Damage Audit | Motor | 7 | 12 |
| Motor Own Damage Claim Audit | Motor | 9 | 12 |
| Motor Own Damage Claim | Motor | 7 | 9 |
| Health Cashless Claim | Health & Medical | 6 | 10 |
| Property Loss Claim | Homeowner & Property | 4 | 5 |
| Commercial Auto Claim | Commercial Auto & Fleet | 5 | 4 |
Every shipped pack is a starting point rather than a ceiling.
Most carriers keep perhaps three-quarters of one, change some thresholds, and add the two or three checks particular to how they underwrite. That is the expected way to use them, not a sign something was missing.Two packs are worked through below - one motor, one health. They are examples of what a pack looks like, not the boundary of what the product covers.
A full collision file, seven document roles and twelve rules. Those numbers describe this pack, not the product.
| Role | Document | What it settles |
|---|---|---|
POLICY_COPY |
Policy Declarations | Cover, in-force dates, deductible, named insured |
CLAIM_FORM |
Loss Notice | Date of loss, driver, vehicle, reported circumstances |
POLICE_REPORT |
Traffic Crash Report | Independent record of driver, date and vehicle |
GARAGE_ESTIMATE |
Repair Estimate | The shop's pre-teardown assessment |
SUPPLEMENT |
Estimate Supplement | What was added once the vehicle was apart |
SURVEY_REPORT |
Independent Appraisal | The approved schedule - the authority for the money |
GARAGE_INVOICE |
Final Repair Invoice | What is actually being billed, line by line |
The same assertion - crossCollection - reconciles a hospital
bill against a pre-authorisation, or an invoice against a purchase order. Only the
vocabulary changes.
Rule 11 is the one that pays for the product.
It is where an OEM part billed against an aftermarket approval shows up, where 4.5 labour hours billed against 2.0 approved shows up, and where a line the appraiser never approved at all shows up - each as its own finding, on its own row, with its own figure.A different line, a different shape of problem, the same engine. Six document roles, ten rules - and the same four questions underneath.
The rule types are identical. Only the vocabulary changes.
Checks 7 to 10 are the same kinds of check as the motor pack's line reconciliation - per-row arithmetic, duplicate detection, cross-document comparison - expressed against hospital bills instead of repair invoices. That is what it means for a new line of business to be content rather than code.The product does not decide whether a claim is payable. It establishes that the file is complete, internally consistent and arithmetically sound - so that the person who does decide is not spending their day on that.
This is a deliberately defensible place to automate: it sits ahead of the regulated decision rather than inside it.
Nothing here guesses, and nothing here adjudicates. Every finding names the rule that raised it, and every rule states what it checks in plain words.A model may help draft a rule or propose a mapping. No model evaluates a rule.
A missing value on one side reports "could not be compared" - never "matched".
A case validated against zero rules reports Incomplete, not Passed.
A delivery processed with one document quietly skipped produces a clean result that is a lie.
A policy does not exist as a PDF inside a policy administration system - it exists as data. A data contract template takes that payload directly, so in-force dates, sum insured, sub-limits and named insureds arrive exact rather than being read off a policy schedule and guessed at again.
Onboarded from a sample PDF. Values come from OCR and layout analysis, confidence varies, and low-confidence values go to a review queue - which is exactly what review queues are for.
Onboarded from a sample JSON payload. Values are read from declared paths, exactly, and never go to review because they were never degraded.
Priced per claim file validated, per line of business. One claim file - however many documents it contains, and however long they take to arrive - is one case.
One line of business, running a shipped pack as it comes.
Several lines, your own rules and case types, decisions and measurement.
All nine lines of business, multi-entity, deployed in your tenancy.
Indicative plans shown for illustration. Final pricing is confirmed after a scoping call.
Send us one settled file from whichever line you actually run. We will show you the findings, and where your rules would differ from the ones we ship.
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