Predictika · Group and executive life insurance underwriting

An AI sales agent's multilife life insurance case, checked before it goes out

An AI sales agent prepares a multilife life insurance case under one of three underwriting programs, with its group size, ages, incomes and face amounts. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of the published underwriting guide and returns a verdict, every reason and the figures it computed.

Scope: Lincoln Executive Multilife cases under Guaranteed Issue, Simplified Issue and Professional Advantage: group size, participation, ages, income, face amounts and in-force limits. See everything this validator covers

This validator models Lincoln Executive Multilife case eligibility as published in its underwriting advisor guide, not just the scenarios shown below.

  • Group size and participation — Guaranteed Issue needs 10 or more enrolled lives and Simplified Issue 5 or more, with 75% of the eligible group participating.
  • Ages, income and who is eligible — issue ages, the average group age of 55 or younger, minimum incomes, U.S. citizens or permanent residents only, and no religious organizations, unions, associations, fraternal organizations, government entities, charities or professional athletes.
  • Face amounts — Guaranteed Issue limits per life by group size and ownership, Simplified Issue maximum death benefits by group size, the 5 million issue limit, the five-times-average rule for the highest face amount, the 20% annual increase cap, and the 20 million Professional Advantage limit with underwriter approval above 65 million of in-force coverage.

Any multilife case that touches these rules is in scope — not only the scenarios pictured here. Not covered: prices or premiums (the guide publishes no rates, so this validator produces no price build-up or line-item quote), medical questions and underwriting requirements, product features, and other Lincoln programs. Assumptions: for employer-owned Guaranteed Issue, where the guide gives a range per life, the model uses the upper end; the Simplified Issue maximums are applied to employer-paid cases; the guide is dated June 2021, so current rules may differ.

The AI sales agentBuilds the multilife case from the conversation and says it is ready.
Predictika validatorChecks every rule at once and returns the verdict, each finding, and the computed figures.

7 scenarios in 3 groups · each group runs from the agent’s first attempt to the outcome · click one to switch

What the agent proposes

The AI sales agent says

Illustrative agent statement. The validator receives the structured request below.

Proposing agent: AI sales agent (scripted)

Before sending, the agent must call Recorded run

Predictika validator


      

        
        
        
      

      
Waiting for the call.

      
    

  

  
  

    
Where rules-based CPQ gets it wrong
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Our assessment of what a typical rules-based CPQ (product rules, price rules and validation rules, as in Salesforce CPQ) does with the same cases. It is a judgment about effort and reliability, not a claim that nothing can be built.

    
What the validator caughtTypical rules-based CPQPredictika
Limits that change with group size and ownershipOnly with care
Each size band and ownership type needs its own limit, so the table becomes many rules to maintain.		The group size, ownership and face amount are in one request and the right limit is computed on every call.
A highest face amount tied to the group averageOnly with care
The rule compares a figure on one line to an average over all the lines, so it needs a roll-up that must stay in step with the rest.		The average and the highest face amount are in one request and compared on every call.
Different programs with different ages, incomes and limitsOnly with workarounds
Each program has its own age range, income floor and caps, so a flat rule set breeds exceptions for every program.		The program is one choice and every rule that depends on it is checked together.
Participation as a share of the eligible groupOnly with workarounds
A percentage between two counts is usually computed in a separate step that runs at save time, not as the case is built.		Enrolled and eligible lives travel in one request and the share is checked on every call.
Every problem returned in one answerOnly with workarounds
Rules tend to fire as the case is saved or a step is completed, so a rep often fixes one error and meets the next.		All findings come back together, whatever order the choices arrived in.

  

  

    
What this validator catches: findings from its test cases
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Every rule is checked on every call, in any order the choices arrive; one problem never hides another. Blocking findings stop the quote; approval findings need a person to sign off; everything else is computed.

    
1The program needs at least 10 enrolled lives; the case has 9.
2The program needs at least 5 enrolled lives; the case has 4.
374 of 100 eligible employees are enrolled; at least 75% of the eligible group must participate.
4Issue ages must be from 20 to 70; the case has insured ages from 19 to 60.
5Issue ages must be from 20 to 70; the case has insured ages from 25 to 71.
6The average age of the group is 56; it must be 55 or younger.
7The lowest participant income is 74,999 dollars; the program requires at least 75,000 dollars.
8Religious organizations, unions, associations, fraternal organizations, government entities and charities taking out policies on members or donors are not eligible for Guaranteed Issue or Simplified Issue.
9Professional athletes are not eligible for this program.
10Participants must be U.S. citizens or permanent residents.
11The average face amount per life is 40,001; Guaranteed Issue allows at most 40,000 per life for this group size and ownership.
12The average face amount per life is 60,001; Guaranteed Issue allows at most 60,000 per life for this group size and ownership.
13The average face amount per life is 30,001; Guaranteed Issue allows at most 30,000 per life for this group size and ownership.
14The largest face amount is 1,000,001; Simplified Issue on an employer-paid case allows at most 1,000,000 for this group size.
15The largest face amount is 500,001; Simplified Issue on an employer-paid case allows at most 500,000 for this group size.
16The largest face amount, including all increases, is 5,000,001; the maximum issue limit on a participant is 5,000,000.
17The highest insured face amount is 200,001; it cannot exceed five times the average face amount of the group, which is 40,000.
18The planned annual increase is 21 percent; the maximum is 20 percent per year.
19The case states a total face amount of 1,500,000, but 40 lives at an average of 40,000 comes to 1,600,000.
20The face amount is 20,000,001; Professional Advantage allows at most 20,000,000.
21The lowest participant income is 99,999 dollars; the program requires at least 100,000 dollars.
22Issue ages must be from 25 to 65; the case has insured ages from 66 to 66.
23Issue ages must be from 25 to 65; the case has insured ages from 24 to 24.
24Total in-force coverage of 65,000,001 is above the 65,000,000 Jumbo limit; the underwriter must approve.

  

  

    
Scenarios and results
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The recorded result of the validator for each scenario on this page: the request the AI agent sent, the verdict, and every finding, in the order they appear above.

    
1. Face amounts and increases: A Simplified Issue case with a 1.8 million face amount and 25 percent increases

    
The agent's request. Please quote Simplified Issue for a business with 16 of 18 eligible employees enrolled, employee-owned policies, insured ages 30 to 62 with a group average of 47, a lowest income of 120,000 dollars, an average face amount of 300,000 and a highest face amount of 1,800,000, paid for by the employer, with planned annual increases of 25 percent, for a total face amount of 4,800,000. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Simplified Issue death benefit over the group limit. The largest face amount is 1,800,000; Simplified Issue on an employer-paid case allows at most 1,500,000 for this group size.
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  • Highest face over five times the group average. The highest insured face amount is 1,800,000; it cannot exceed five times the average face amount of the group, which is 300,000.
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  • Annual increase above 20%. The planned annual increase is 25 percent; the maximum is 20 percent per year.
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2. Face amounts and increases: The agent resubmits after fixing the errors

    
The agent's request. Please quote Simplified Issue for a business with 16 of 18 eligible employees enrolled, employee-owned policies, insured ages 30 to 62 with a group average of 47, a lowest income of 120,000 dollars, an average face amount of 300,000 and a highest face amount of 1,500,000, paid for by the employer, with planned annual increases of 20 percent, for a total face amount of 4,800,000. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Case summary. 16 enrolled lives, total face amount 4,800,000.
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3. Participation and group age: A Guaranteed Issue case with 80 of 120 employees enrolled and an older group

    
The agent's request. Please quote Guaranteed Issue for a business with 80 of 120 eligible employees enrolled, employee-owned policies, insured ages 22 to 64 with a group average of 58, a lowest income of 82,000 dollars, an average face amount of 40,000 and a highest face amount of 180,000, for a total face amount of 3,800,000. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Participation below 75%. 80 of 120 eligible employees are enrolled; at least 75% of the eligible group must participate.
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  • Average group age above 55. The average age of the group is 58; it must be 55 or younger.
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  • Stated total face differs from lives times average. The case states a total face amount of 3,800,000, but 80 lives at an average of 40,000 comes to 3,200,000.
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4. Participation and group age: The agent resubmits after fixing the errors

    
The agent's request. Please quote Guaranteed Issue for a business with 95 of 120 eligible employees enrolled, employee-owned policies, insured ages 22 to 64 with a group average of 52, a lowest income of 82,000 dollars, an average face amount of 40,000 and a highest face amount of 180,000, for a total face amount of 3,800,000. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Case summary. 95 enrolled lives, total face amount 3,800,000.
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5. Professional Advantage: A Professional Advantage case for a 66-year-old with a 22 million face amount

    
The agent's request. Please quote Professional Advantage for a business for one executive aged 66 with an income of 400,000 dollars, a face amount of 22,000,000 and 40,000,000 of coverage in force in total, for a total face amount of 22,000,000. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Issue age outside the program range. Issue ages must be from 25 to 65; the case has insured ages from 66 to 66.
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  • Professional Advantage face amount over 20 million. The face amount is 22,000,000; Professional Advantage allows at most 20,000,000.
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6. Professional Advantage: The agent resubmits after fixing the errors

    
The agent's request. Please quote Professional Advantage for a business for one executive aged 62 with an income of 400,000 dollars, a face amount of 20,000,000 and 70,000,000 of coverage in force in total, for a total face amount of 20,000,000. It is ready to send.

    
Verdict: Needs approval.

    
    
      
  • In-force coverage above the Jumbo limit. Total in-force coverage of 70,000,000 is above the 65,000,000 Jumbo limit; the underwriter must approve.
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  • Case summary. 1 enrolled life, total face amount 20,000,000.
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7. Professional Advantage: The agent resubmits after fixing the errors

    
The agent's request. Please quote Professional Advantage for a business for one executive aged 62 with an income of 400,000 dollars, a face amount of 20,000,000 and 60,000,000 of coverage in force in total, for a total face amount of 20,000,000. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Case summary. 1 enrolled life, total face amount 20,000,000.
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Narration transcript
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The text of the narrated walkthrough, step by step.

    
    
      
  1. Welcome to a demo of Predictika's Validator. An AI sales agent prepares a multilife life insurance case under one of three underwriting programs, with its group size, ages, incomes and face amounts. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of the published underwriting guide and returns a verdict, every reason and the figures it computed.
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  2. I will start with the first request by the agent.
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  3. The agent says. Please quote Simplified Issue for a business with 16 of 18 eligible employees enrolled, employee-owned policies, insured ages 30 to 62 with a group average of 47. It is ready to send. The rest of the request is on screen.
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  4. Before it goes out, the agent calls the validator.
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  5. Blocked, with three findings, all in one answer. The largest face amount is 1,800,000; Simplified Issue on an employer-paid case allows at most 1,500,000 for this group size. The highest insured face amount is 1,800,000; it cannot exceed five times the average face amount of the group, which is 300,000. The planned annual increase is 25 percent; the maximum is 20 percent per year.
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  6. The validator returned three blocking findings in one answer. A check that reads one field at a time would pass most of this; it shows only when the choices in the quote are checked against each other.
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  7. What this shows: for a highest face amount tied to the group average, a rules-based CPQ is error-prone for this.
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  8. Now the agent resubmits.
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  9. The corrected request. It changes the highest face amount to 1,500,000 dollars and the planned annual increase to 20 percent.
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  10. It calls the validator again.
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  11. This time the validator clears it.
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  12. All three earlier findings are cleared, and the validator's figure matches the quote.
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  13. Three problems caught in one call, fixed in one pass, and a clean quote. That is the value of Predictika's validator: catching mistakes before they reach the customer.
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