Order the evidence a case needs, summarise the medical record with every finding tied to its page, apply the carrier's accelerated-underwriting rules, and hand the underwriter a file they can decide on and explain.
Assembles the evidence, never the decision to underwrite
In
01
An application arrives, and the agent orders the evidence still missing under the signed authorization on file.
02
An APS, lab panel or Rx report comes back, and the agent reads it into the underwriting file.
Reason
03
Each medical finding in the summary carries the page of the source record it was drawn from.
04
The carrier's own accelerated-underwriting rules are applied to the case, not a generic ruleset.
05
Genetic-information handling follows the state configured for the case, never one assumed rule.
Decide
06
Ambiguous findings, contradictions and low-confidence reads are flagged for the underwriter.
07
The assembled file is routed to the underwriter to decide.
Out
08
The evidence, its source page, the summary and the underwriter's classification stay on the file.
09
Execute write actions only inside the approval boundaries agreed during implementation.
→Product statement
The agent assembles the file; the underwriter classifies the risk and decides, and is the one who can explain why.
Example workflow
One case, application to file
AgentHuman
1Application receivedApplication, medical questions, requested amount and signed authorization
2Evidence orderedAPS, labs, prescription history, MIB and MVR — each against the authorization on file
3File summarisedFindings tied to source pages, flags and accelerated-underwriting eligibility
4Controls appliedAuthorization validity, permissible-purpose checks, AU-rule fit and confidence threshold
No human action required
Stages 1 to 4 run unaided, and nothing is classified at any of them — the agent is assembling, and the underwriter's lane opens at the confidence gate.
5DecisionBranches at the confidence threshold
High confidence
Goes to the underwriter's queue as a completed file.
Low confidence
Routes the case out of the accelerated path for a fluid order.
Underwriter review
The file is held with its evidence, its flagged findings and the confidence.
Decide · Request more evidence · Escalate
Decided — released for issue▼
6Policy admin system updatedOnly where write access and approval policy allow it
7Outcome evaluatedEvidence accuracy, flag outcomes, classification agreement and post-issue corrections
Evidence requests
Every evidence request is counted in the evaluation.
What should not run autonomously
Human approval stays in control
Outside the boundary — human approval required8 items
Classifying a risk or applying a mortality or morbidity rating.
Setting a premium, rider price or annuity rate.
Declining, postponing or issuing a counter-offer.
Sending an adverse-underwriting-decision notice.
Automation boundaryAgent acts unaided
✓Order the evidence a case needs and read it into the file.
✓Summarise medical findings with each one tied to its source page.
✓Apply the carrier's own accelerated-underwriting rules to the case.
✓Flag ambiguous or contradictory findings, and hold.
Any write happens inside the boundaries agreed at implementation, never ahead of the underwriter.
Requesting or using a genetic-test result where the case's state prohibits it.
Pulling APS, Rx, MIB or MVR data without a valid signed authorization on file.
Treating a vendor's proprietary-process claim as sufficient on its own.
Changes to accelerated-underwriting rules or state configuration.
Example output
One finding in the file, annotated
Everything the agent summarises is attached to the source page it came from.
Underwriting-file output · single caseIllustrative example
Case
Summarised finding
Source page
Evidence type
Confidence
Attribution
45-year-old, $1M term case
Treated hypertension, well-controlled per the most recent visit noted
APS p. 4
Attending physician statement
89%
Underwriter of record and licence ID
As receivedTaken from the ordered evidence and the page cited — nothing on this side is written by the agent.
A book-level file-rework rate can look acceptable while a handful of case cohorts absorb most of it. Nestack reports the rate by slice, not only in total Nestack reports it by slice rather than in aggregate..
Slice performance — reported separately, not only in aggregateIllustrative example
Slice
Failure rate
Lift
Lift vs. threshold
Status
Cases routed out of the accelerated path
7.8%
4.0×
Review
Files resting on a summarised medical record
5.2%
2.8×
Review
Applicants with prescription-history hits
3.5%
1.8×
Watch
Clean fluidless cases inside the rules
1.9%
0.7×
Normal
Bar: file-rework-rate lift vs. the clean-fluidless baseline · scale 0–4.0× · tick at 2.0×2 of 4 slices over threshold
Evidence-linked improvement
Every cycle earns its next regression case
A cycle closes when the unexplainable decline is a case the next release has to survive. That suite is what the next file assembled is measured against.
Improvement cycle · five stagesSwitchback — the path turns at Improve and returns at Learn
01Detect
File-rework rate rises in a case slice.
02Diagnose
The applicant who was told nothing useful is traced back through the file until the cause narrows to one page.
03Improve
The fix ships against a version, with the files that exposed it attached.
04Verify
Release is held until the affected explanation cases pass again.
05Learn
The case joins the permanent suite and the evidence rules move with it.
Learn → DetectThe return edge. Detection next time runs against a suite one file longer.
Typical build scope
Twelve workstreams across six weeks
The build scope read against the delivery timeline. Week structure follows the six-week plan — discovery, evidence sources, underwriting workflow, evaluation, integration, then production validation and handover.
WorkstreamWeek 1Week 2Week 3Week 4Week 5Week 6
01Underwriting workflow discovery and scope and boundary definition.
02Evidence-vendor and source assessment.
03AU-rule and state-configuration mapping and rule mapping.
04Application ingestion and normalisation.
05Evidence-ordering logic and summarisation.
06Confidence scoring and flag routing.
07Underwriter review workflow.
08Evidence-vendor system integration.
09Explanation regression cases.
10Guardrails and classification controls.
11File-trail instrumentation.
12Deployment, documentation and Agent Care handover.
12 workstreams · 6 weeks · bar shows the weeks a workstream is active — several run in parallelFinal scope and sequence confirmed in discovery
Engagement tiers
What each tier includes
Rows are the capabilities named in each tier's scope. Higher tiers include everything below them.
Capability✓ in scope · — not at this tierPilotOne product lineProductionProduction new-business systemsAdvancedMultiple products / states
Introduced at Pilot
Evidence assembly to your file and rules✓✓✓
Underwriter review✓✓✓
Evidence-accuracy baseline✓✓✓
Introduced at Production
Reporting by product—✓✓
Underwriter workflow in your systems—✓✓
Approved evidence write-back—✓✓
Evidence-source integration—✓✓
Introduced at Advanced
Multi-state AU rule complexity——✓
Multi-stage underwriter review——✓
High application volume——✓
Multi-state underwriting controls——✓
Build priceFrom $5,000From $8,000Custom quote
Final build priceConfirmed after discovery based on integrations, workflow complexity, case volume, review controls and deployment requirements.
Separate from buildBuild pricing is separate from recurring Agent Care, which covers managed monitoring, evaluations, incidents and verified improvements after launch.
What we need from you
What you bring, and what we build with it
Each input maps to a piece of build scope and a week in the delivery timeline.
You bringWe build with it
01Your case-file structure and evidence-vendor list→Case-file ingestion and evidence-source mappingWeek 1
02Representative past cases, including declines→Evidence-ordering baseline and summarisation baselineWeek 2
03Your accelerated-underwriting rules and state list→AU-rule and state-configuration mappingWeek 1
04Access to relevant APIs, feeds or exports→Evidence-vendor and case-system assessment, then integration setupWeek 2
05Decisions you would not want explained→Adverse-action cases and failure-mode testingWeek 4
06What no decision may rest on→Confidence scoring, flag routing, guardrails and classification controlsWeek 3
07Named underwriters to review files→Underwriter review workflow, then pilot and production validationWeeks 5–6
Nothing else is requiredDeployment, documentation and Agent Care handover are ours.
Delivery timeline
Four phases across six weeks
Each band covers the weeks the work really takes, which is why week 5 carries evaluation and pilot together.
PhaseW1W2W3W4W5W6
DiscoveryW1
BuildW2 – W3
EvaluateW4 – W5
Pilot & LaunchW5 – W6
Week focusW1Underwriting workflow discovery, AU-rule mapping and the automation boundaryW2Evidence-source integration and the assembly baselineW3Assembly workflow, confidence logic and underwriter-review controlsW4Evaluation suite, adverse-action checks and failure-mode testingW5Evidence-vendor integration, pilot cases and targeted correctionsW6One new-business cycle run under the chief underwriter, then Agent Care handover
Reading the bandA bar covers the weeks its work is named in, and nothing else. The week 5 overlap is real, not padding.
At the end of W6Validation closes on live files, and Agent Care picks up monitoring.
DurationSix-week plan shown · typical delivery 4–6 weeks depending on scope confirmed in discovery.
Next step · Insurance AI agent
Build a life underwriting agent around your accelerated-underwriting rules.
Show us your accelerated-underwriting rules and your evidence vendors. If your book already routes cases by evidence, we'll map the assembly workflow, set the automation boundary and name what stays with the underwriter.
