Overview

AUTO-INS-011, Determine Claim Intake Priority, ranks new auto-insurance claims by urgency, severity, customer impact, handling risk, and financial exposure.

Decision ID

AUTO-INS-011

Decision Name

Determine Claim Intake Priority

Description

Rank new claims by urgency, severity, customer impact, and handling risk.

Industry

Automotive

Sector

Auto Insurance (AUTO-INS)

Category

Claims Intake & Triage (AUTO-INS-CLAIMS-INTAKE-TRIAGE)

Decision Preparation Model

auto-insurance-determine-claim-intake-priorit-auto-ins-011 version 1.0.0

Default Profile

balanced

Default Scenario

standard

Algorithm

TOPSIS

Weight Strategy

Expert (Manual) (API value Expert)

Catalog

DKR-AUTO-RUNTIME-001, version 13.9.3

Understanding This Decision

Determine Claim Intake Priority helps claims intake teams decide which newly reported claims should be reviewed first by balancing claim severity, customer impact, coverage clarity, fraud risk, and estimated loss exposure.

Criteria

Use exact criterionId keys. Display names can change; canonical IDs drive validation, mapping, weighting, and execution.

Data Preparation Guide

Constraint Processing

This decision currently has no catalog-defined hard constraints. All validated candidates proceed to criteria-based ranking.

{
  "constraintSummary": {
    "definedConstraintCount": 0,
    "activeConstraintCount": 0,
    "eligibleOptionCount": 3,
    "excludedOptionCount": 0,
    "eligibleOptions": [
      "CLAIM-011-01",
      "CLAIM-011-02",
      "CLAIM-011-03"
    ],
    "excludedOptions": []
  }
}

const constraints = decisionDetail.constraints || [];
if (constraints.length === 0) {
  // No catalog-defined hard constraints.
  // Submit all validated candidates for criteria-based ranking.
}

const summary = response.constraintSummary;
const excluded = response.decisionResult?.excludedOptions || [];

Excluded candidates do not participate in ranking because hard constraints are evaluated before scoring. For AUTO-INS-011, no candidates are excluded by catalog-defined constraints because Decision Catalog currently defines none for this decision.

Decision Preparation Model

The published Decision Preparation Model validates and transforms illustrative Business Data into the canonical criteria required by AUTO-INS-011 before Decision Service applies ranking.

Profile ID

auto-insurance-determine-claim-intake-priorit-auto-ins-011

Version

1.0.0

Options Path

$.claims

Option ID Path

$.optionId

Display Name Path

$.name

{
  "requestContext": {
    "sourceSystem": "automotive-profile-factory",
    "correlationId": "factory-auto-ins-011"
  },
  "claims": [
    {
      "optionId": "CLAIM-011-01",
      "name": "Determine Claim Intake Priority Option 1",
      "assessment": {
        "claimSeverityScore": 46.0,
        "customerImpactScore": 50.0,
        "coverageClarityScore": 64.0
      },
      "risk": {
        "fraudRiskScore": 30.0
      },
      "financial": {
        "estimatedLossAmount": 50000.0
      }
    },
    {
      "optionId": "CLAIM-011-02",
      "name": "Determine Claim Intake Priority Option 2",
      "assessment": {
        "claimSeverityScore": 43.0,
        "customerImpactScore": 75.0,
        "coverageClarityScore": 59.0
      },
      "risk": {
        "fraudRiskScore": 51.0
      },
      "financial": {
        "estimatedLossAmount": 42500.0
      }
    }
  ]
}

{
  "optionId": "CLAIM-011-01",
  "name": "Determine Claim Intake Priority Option 1",
  "values": {
    "claim_severity_score": 46.0,
    "customer_impact_score": 50.0,
    "coverage_clarity_score": 64.0,
    "fraud_risk_score": 30.0,
    "estimated_loss_amount": 50000.0
  }
}

Profiles and Scenarios

This example selects a Profile for evaluation emphasis and a Scenario for operating context. Discover both from the selected Decision Catalog definition.

Prepared Input

The active Decision Service Prepared Criteria Mode contract accepts decisionId, profileId, scenarioId, algorithm, weightStrategy, runSensitivity, requestContext, and options.

{
  "decisionId": "AUTO-INS-011",
  "profileId": "balanced",
  "scenarioId": "standard",
  "algorithm": "TOPSIS",
  "weightStrategy": "Expert",
  "runSensitivity": false,
  "requestContext": {
    "correlationId": "auto-ins-011-demo-001"
  },
  "options": [
    {
      "optionId": "CLAIM-011-01",
      "name": "Claim CASE-001",
      "values": {
        "claim_severity_score": 83,
        "customer_impact_score": 83,
        "coverage_clarity_score": 83,
        "fraud_risk_score": 78,
        "estimated_loss_amount": 62500
      }
    },
    {
      "optionId": "CLAIM-011-02",
      "name": "Claim CASE-002",
      "values": {
        "claim_severity_score": 75,
        "customer_impact_score": 75,
        "coverage_clarity_score": 75,
        "fraud_risk_score": 70,
        "estimated_loss_amount": 107500
      }
    }
  ]
}

Execute

curl -X POST "https://dde.vinquery.com/api/v1/decide" \
  -H "Authorization: Bearer ${DECISIOQ_TOKEN}" \
  -H "Content-Type: application/json" \
  -H "X-Correlation-Id: auto-ins-011-demo-001" \
  --data @auto-ins-011-execute.json

Decision Service retrieves authoritative criteria, profiles, scenarios, and validation metadata from Decision Catalog, composes the engine-ready request, and executes the deterministic ranking.

Interpret the Result

Every successful response includes the deterministic decisionResult and a top-level explanation object. Use decisionResult.winner and decisionResult.ranking as the ranking; the explanation adds context but does not change it. Scores are useful within the same run, not across unrelated decisions or catalog versions.

{
  "service": "decisioq",
  "version": "7.6.3",
  "requestId": "0HNE...",
  "operation": "Decide",
  "success": true,
  "timestampUtc": "2026-07-19T00:00:00Z",
  "requestContext": {
    "correlationId": "auto-ins-011-demo-001",
    "decision": {
      "id": "AUTO-INS-011",
      "name": "Prioritize Insurance Claims",
      "catalogVersion": "13.9.3"
    }
  },
  "configurationUsed": {
    "weightStrategy": { "value": "Expert", "source": "ExplicitRequest" },
    "rankingAlgorithm": { "value": "TOPSIS", "source": "ExplicitRequest" },
    "profile": { "value": "balanced", "source": "ExplicitRequest" },
    "scenario": { "value": "standard", "source": "ExplicitRequest" },
    "sensitivity": { "value": false, "source": "PlatformDefault" }
  },
  "decisionResult": {
    "winner": "CLAIM-011-01",
    "confidence": 72.4,
    "ranking": [
      {
        "optionId": "CLAIM-011-01",
        "score": 0.8421,
        "breakdown": {
          "claim_severity_score": 0.15,
          "customer_impact_score": 0.20
        },
        "normalizationBreakdown": {}
      }
    ],
    "excludedOptions": []
  },
  "explanation": {
      "summary": "The selected claim has the strongest overall priority.",
      "whyRecommended": "It combined high customer impact and clear coverage with manageable loss exposure.",
      "keyDrivers": [],
      "tradeoffs": [],
      "competitors": [],
      "sensitivitySummary": "Sensitivity analysis was not included in this response.",
      "scenarioSummary": "The standard claim-handling scenario was selected.",
      "risks": [],
      "nextSteps": [],
      "assumptions": []
  },
  "constraintSummary": {
    "definedConstraintCount": 0,
    "activeConstraintCount": 0,
    "eligibleOptionCount": 3,
    "excludedOptionCount": 0,
    "eligibleOptions": [
    "CLAIM-011-01",
    "CLAIM-011-02",
    "CLAIM-011-03"
    ],
    "excludedOptions": []
  },
  "warnings": []
}

Sensitivity Analysis

Use "runSensitivity": true when the client needs evidence about recommendation stability. DecisioQ varies criterion weights by controlled factors while keeping submitted options and values fixed.

{
  "runSensitivity": true,
  "sensitivityResult": {
    "stableWinner": true,
    "winner": "CLAIM-011-01",
    "mostSensitiveCriterion": "claim_severity_score",
    "confidence": 95,
    "criterionImpacts": {
      "claim_severity_score": 0.1842
    },
    "winnerChangeCounts": {
      "claim_severity_score": 0
    }
  }
}

Explanation of Decision Result

Every successful response includes a provider-neutral top-level explanation object. The Explanation Service receives the finalized deterministic result and a controlled evidence package; the object adds context but does not change the ranking.

{
  "explanation": {
      "summary": "The selected claim has the strongest overall priority.",
      "whyRecommended": "It combined high customer impact and clear coverage with manageable loss exposure.",
      "keyDrivers": [],
      "tradeoffs": [],
      "competitors": [],
      "sensitivitySummary": "Sensitivity analysis was not included in this response.",
      "scenarioSummary": "The standard claim-handling scenario was selected.",
      "risks": [],
      "nextSteps": [],
      "assumptions": []
  }
}

The Explanation of Decision Result must not receive raw private claim files or unrestricted notes. It explains the already-finalized result; it does not select, rerank, recalculate, or override it.

Tracing and Logs

Use request identifiers to connect client, Identity, Decision Catalog, and Decision Service activity. Authentication and identity-security activity belongs in IdentityAuditEvents. Catalog, mapping, decision execution, sensitivity, and explanation operations belong in decisioq_log.

X-Request-Id

Optional client-supplied request ID. If omitted, Decision Service or Decision Catalog generates one.

X-Correlation-Id

Optional client workflow ID propagated from Decision Service to Decision Catalog.

requestContext.correlationId

Payload value echoed by Decision Service and used for execution logging.

DecisionId

Recorded for decision-specific operations. General catalog and identity operations may not have a decision ID.

Code Examples

These examples authenticate, retrieve AUTO-INS-011 metadata, validate profile and scenario selections, execute the decision, pass a correlation ID, and print the deterministic result.

DECISIOQ_CLIENT_ID
DECISIOQ_CLIENT_SECRET

Optional:
DECISIOQ_IDENTITY_URL=https://identity.vinquery.com/connect/token
DECISIOQ_DKS_URL=https://dks.vinquery.com
DECISIOQ_DDE_URL=https://dde.vinquery.com

Troubleshooting

Production Checklist