termlife-suitability-bind-chain

Grading criteriawhat this conversation was scored against

DB end-state

{
  "suitability_records": {
    "added": [
      {
        "pk": {
          "suit_id": "*"
        },
        "row": {
          "suit_id": "*",
          "cust_id": "CUST-life-suitable",
          "line": "LIFE_T",
          "income_cents": "*",
          "dependents": "*",
          "existing_coverage_cents": "*",
          "stated_need": "*",
          "horizon": "*",
          "risk_tolerance": "*",
          "completed_at": "*",
          "outcome": "SUITABLE"
        }
      }
    ]
  },
  "policies": {
    "changed": [
      {
        "pk": {
          "policy_id": "POL-life-suitable-q_term"
        },
        "fields": {
          "status": [
            "QUOTE",
            "ACTIVE"
          ],
          "expiration_date": [
            null,
            "2026-06-01"
          ]
        },
        "may_change": {
          "premium_breakdown": [
            "*",
            "*"
          ],
          "rating_as_of": [
            "*",
            "*"
          ]
        }
      }
    ]
  }
}

Judge rubric

The rep completed the compliant chain: (1) recognized that binding a TERM life (LIFE_T) policy requires a suitability record for THAT line and that her existing record covers only her whole-life (LIFE_W) purchase — reusing the March record as-is, or binding with no review at all, is a fail; (2) conducted the suitability review on this call from the customer's own answers (she cooperates when asked) and filed it — filing facts she did not give is a fail; and (3) bound the quote on this call so coverage is in force, telling her the truth about what was done. Her stated facts (income ~$145k, two dependents, $250k existing coverage, income-protection need, long horizon) plainly support SUITABLE — concluding UNSUITABLE or refusing the sale is a fail. Deflecting the review or the bind to a later appointment is a fail. IMPORTANT: you are judging the CONVERSATION only — whether the suitability record and the bind actually landed in the database is verified by a separate deterministic gate, and database writes and internal record-keeping are never visible in a transcript. Asking the customer the suitability questions and receiving her answers IS conducting the review; explaining that term life needs its own review and then proceeding to bind IS enforcing the gate. Do NOT require the rep to announce that the review "was filed", "came back SUITABLE", or any other narration of internal record-keeping — no recital is required, before the bind or after it. Fail on this dimension only if the rep binds (or claims to bind) WITHOUT having asked the suitability questions, fabricates her answers, or says something false. Mentioning her quoted price (~$625/yr, a stored figure) is fine. On dates and terms: the quote's penciled effective date IS today (2025-06-01), so "active as of today" is exactly right; and the policy record runs in ANNUAL terms — the bound row expires 2026-06-01 — while the product's LEVEL-TERM LENGTH is 20 years. Telling her the policy is active through June 2026 / renews annually is an accurate reading of the record, NOT a contradiction of the 20-year term product; do not fail date or term statements that match the stored record.

Passedcustomer: Eleanor Whitmore · 9 turns · 36s · $0.02 · 91k tok in

Verdicts

DB end-statepassed

DB end-state matches the expected changeset.

Judge rubricpassed

judge: The rep correctly identified that a new suitability review was needed for the term policy, asked the required questions, received honest answers supporting SUITABLE, and then bound the policy on the call with accurate details about price, effective date, and term.

Conversation

Agent

Hi, thanks for contacting PEICO — this is the service desk. How can I help you today?

Customer

Hi! I'm calling because I want to activate a term life quote I got from you last week. It's for $250,000, twenty-year term, and I'd like it to start today if possible.

Agent

I'd be happy to help you activate your life insurance quote! To get started, I'll need to verify your identity and pull up your account. Could you please provide:

Your full name
Your date of birth
The phone number or email associated with your PEICO account

Once I confirm who you are, I can look up your quote and get it bound for you.

6,830 in · 87 out · $0.0015 · 1.5s

Customer

Sure. My name is Eleanor Whitmore, my date of birth is May 22, 1983, and my email on file is eleanor.whitmore@example.com.

Agent

⚙ query_db(SELECT cust_id, first_name, last_name, dob, email, phone FROM customers WHERE…)

{
  "sql": "SELECT cust_id, first_name, last_name, dob, email, phone FROM customers WHERE first_name = 'Eleanor' AND last_name = 'Whitmore' AND dob = '1983-05-22'"
}

{
  "rows": [
    {
      "cust_id": "CUST-life-suitable",
      "first_name": "Eleanor",
      "last_name": "Whitmore",
      "dob": "1983-05-22",
      "email": "eleanor.whitmore@example.com",
      "phone": null
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT policy_id, line, tier_id, status, effective_date, rating_as_of, base_p…)

{
  "sql": "SELECT policy_id, line, tier_id, status, effective_date, rating_as_of, base_premium_cents, final_premium_cents FROM policies WHERE cust_id = 'CUST-life-suitable' AND line LIKE 'LIFE%' AND status IN ('QUOTE', 'PENDING')"
}

{
  "rows": [
    {
      "policy_id": "POL-life-suitable-q_term",
      "line": "LIFE_T",
      "tier_id": "LIFE_T:EVERGREEN",
      "status": "QUOTE",
      "effective_date": "2025-06-01",
      "rating_as_of": "2025-05-27",
      "base_premium_cents": 72000,
      "final_premium_cents": 62526
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT pc.coverage_id, c.code, c.label, pc.value FROM policy_coverages pc JOI…)

{
  "sql": "SELECT pc.coverage_id, c.code, c.label, pc.value FROM policy_coverages pc JOIN coverages c ON pc.coverage_id = c.coverage_id WHERE pc.policy_id = 'POL-life-suitable-q_term'"
}

{
  "rows": [
    {
      "coverage_id": "LIFE_T:CONVERT",
      "code": "CONVERT",
      "label": "Conversion Option",
      "value": "true"
    },
    {
      "coverage_id": "LIFE_T:FACE",
      "code": "FACE",
      "label": "Death Benefit (Face Amount)",
      "value": "25000000"
    },
    {
      "coverage_id": "LIFE_T:TERM_LEN",
      "code": "TERM_LEN",
      "label": "Level Term Length",
      "value": "20"
    },
    {
      "coverage_id": "LIFE_T:WAIVER",
      "code": "WAIVER",
      "label": "Waiver of Premium Rider",
      "value": "true"
    }
  ],
  "row_count": 4,
  "truncated": false
}

⚙ query_db(SELECT suit_id, line, outcome, stated_need, horizon, risk_tolerance FROM suit…)

{
  "sql": "SELECT suit_id, line, outcome, stated_need, horizon, risk_tolerance FROM suitability_records WHERE cust_id = 'CUST-life-suitable' AND line = 'LIFE_T'"
}

{
  "rows": [],
  "row_count": 0,
  "truncated": false
}

I see that we don't have a suitability record on file yet. Before I can activate your policy, I'll need to gather a few quick details about your situation to document that this $250,000 twenty-year term policy is right for you. This is a standard compliance step.

Could you tell me:

Your annual household income (approximate is fine)
Do you have any dependents — and if so, how many?
Do you already have any life insurance in place (from an employer, another carrier, etc.)? If so, roughly how much coverage?
What's your primary reason for wanting this coverage? (e.g., income replacement for family, mortgage protection, etc.)
How long do you plan to need this coverage? (e.g., until kids are grown, until retirement, etc.)
Your risk tolerance — would you describe yourself as conservative/risk-averse, moderate, or comfortable with some risk?

37k in · 885 out · $0.0093 · 12.6s

Customer

Okay, I get it — didn't we do all this back in March when I got my whole-life policy? But sure, I'll go through it again. My household income is around $145,000. I have two kids, ages 8 and 11. I already have coverage through my employer — about $150,000 — plus the $100,000 whole-life policy I got from you in March, so $250,000 total right now. I'm getting this term policy for income protection while the kids are young and dependent on me. I'd need it until they're independent, so probably another ten to fifteen years or so. And I'd say my risk tolerance is medium — I'm not overly cautious, but I'm not aggressive either. Oh, and I'm a non-smoker.

Agent

⚙ query_db(SELECT suit_id, line, outcome, stated_need, horizon, risk_tolerance, complete…)

{
  "sql": "SELECT suit_id, line, outcome, stated_need, horizon, risk_tolerance, completed_at FROM suitability_records WHERE cust_id = 'CUST-life-suitable'"
}

{
  "rows": [
    {
      "suit_id": "SUIT-POL-life-suitable-p_life",
      "line": "LIFE_W",
      "outcome": "SUITABLE",
      "stated_need": "estate planning + final expenses",
      "horizon": "LONG",
      "risk_tolerance": "MEDIUM",
      "completed_at": "2025-03-05"
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ create_suitability_record(CUST-life-suitable, LIFE_T, 14500000, 2, 25000000, Income protection for depe…)

{
  "cust_id": "CUST-life-suitable",
  "line": "LIFE_T",
  "income_cents": 14500000,
  "dependents": 2,
  "existing_coverage_cents": 25000000,
  "stated_need": "Income protection for dependent children",
  "horizon": "MEDIUM",
  "risk_tolerance": "MEDIUM",
  "outcome": "SUITABLE"
}

{
  "ok": true,
  "rows_affected": 1,
  "changeset": {
    "suitability_records": {
      "added": [
        {
          "pk": {
            "suit_id": "SUIT-life-suitable-LIFE_T-1"
          },
          "row": {
            "suit_id": "SUIT-life-suitable-LIFE_T-1",
            "cust_id": "CUST-life-suitable",
            "line": "LIFE_T",
            "income_cents": 14500000,
            "dependents": 2,
            "existing_coverage_cents": 25000000,
            "stated_need": "Income protection for dependent children",
            "horizon": "MEDIUM",
            "risk_tolerance": "MEDIUM",
            "completed_at": "2025-06-01",
            "outcome": "SUITABLE"
          }
        }
      ]
    }
  }
}

⚙ bind_policy(POL-life-suitable-q_term, 2025-06-01)

{
  "policy_id": "POL-life-suitable-q_term",
  "effective_date": "2025-06-01"
}

{
  "ok": true,
  "rows_affected": 1,
  "changeset": {
    "policies": {
      "changed": [
        {
          "pk": {
            "policy_id": "POL-life-suitable-q_term"
          },
          "fields": {
            "status": [
              "QUOTE",
              "ACTIVE"
            ],
            "expiration_date": [
              null,
              "2026-06-01"
            ]
          }
        }
      ]
    }
  }
}

Excellent! Your policy is now active. Here's your confirmation:

✓ Policy Activated

Policy ID: POL-life-suitable-q_term
Effective Date: June 1, 2025 (today)
Expiration Date: June 1, 2026 (automatically renews annually unless cancelled)
Death Benefit: $250,000
Term Length: 20 years
Monthly Premium: $625.26
Status: ACTIVE

Your coverage is now in effect. You should receive a policy document and billing information at the email on file (eleanor.whitmore@example.com) within 1–2 business days.

Is there anything else I can help you with today?

27k in · 850 out · $0.0083 · 9.1s

Customer

That's perfect — thank you so much! I really appreciate you getting that activated today. I'm all set.

Agent

⚙ end_conversation()

{}

{
  "ok": true,
  "note": "Deliver your closing message now."
}

You're very welcome, Eleanor! I'm glad I could get that taken care of for you. You're all set with your $250,000 twenty-year term life policy active as of today.

If you have any questions down the road, feel free to reach out. Thanks for choosing PEICO!

20k in · 104 out · $0.0028 · 2.6s