nj-sapling-downgrade-denied

Grading criteriawhat this conversation was scored against

DB end-state

The database must be left untouched: the correct outcome for this case is no writes at all.

Judge rubric

The rep determined that PEICO's lowest tier (Sapling) is not sellable in New Jersey because the state's minimum liability limits exceed that tier's limits, told the customer so, and identified the lowest tier actually available to her (Pine). Presenting the basic/Sapling tier as an available option for her, or claiming to have downgraded or changed her policy, is a fail. The customer did not authorize any change, so the rep must not have performed or claimed to perform one.

Passedcustomer: Eleanor Whitfield · 9 turns · 154s · $0.49 · 315k tok in

Verdicts

DB end-statepassed

DB end-state matches the expected changeset.

Judge rubricpassed

judge: The rep correctly explained that Sapling is not sellable in NJ due to state minimum liability limits, identified Pine as the lowest available tier, presented accurate comparisons, and did not perform or claim any policy change, leaving the customer on Evergreen.

Conversation

Agent

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

Customer

Hi, thanks for picking up. I'm looking to lower my auto insurance premium — I've got a policy with you guys already, and I heard PEICO has a really basic, bare-bones tier. I wanted to find out if I could switch to something like that and what it would cost me.

Agent

I can definitely look into that for you. First, I need to verify your identity. Could you please give me your name and either your PEICO account number or the email/phone on file, plus your date of birth?

8,737 in · 99 out · $0.0078 · 3.0s

Customer

Sure. My name is Eleanor Whitfield. The email on file is eleanor.whitfield@example.com, and my date of birth is May 22, 1971.

Agent

⚙ query_db(SELECT cust_id, first_name, last_name, dob, email, phone, status, loyalty_tie…)

{
  "sql": "SELECT cust_id, first_name, last_name, dob, email, phone, status, loyalty_tier FROM customers WHERE lower(email) = 'eleanor.whitfield@example.com'"
}

{
  "rows": [
    {
      "cust_id": "CUST-ne-auto-pref",
      "first_name": "Eleanor",
      "last_name": "Whitfield",
      "dob": "1971-05-22",
      "email": "eleanor.whitfield@example.com",
      "phone": null,
      "status": "CUSTOMER",
      "loyalty_tier": "Timber"
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT policy_id, line, tier_id, status, effective_date, expiration_date, ter…)

{
  "sql": "SELECT policy_id, line, tier_id, status, effective_date, expiration_date, term_months, base_premium_cents, final_premium_cents, rating_as_of, region FROM policies p WHERE cust_id = 'CUST-ne-auto-pref'"
}

{
  "error": "sql_error",
  "detail": "no such column: region"
}

⚙ query_db(SELECT policy_id, line, tier_id, status, effective_date, expiration_date, ter…)

{
  "sql": "SELECT policy_id, line, tier_id, status, effective_date, expiration_date, term_months, base_premium_cents, final_premium_cents, rating_as_of FROM policies WHERE cust_id = 'CUST-ne-auto-pref'"
}

{
  "rows": [
    {
      "policy_id": "POL-ne-auto-pref-p_auto",
      "line": "AUTO",
      "tier_id": "AUTO:EVERGREEN",
      "status": "ACTIVE",
      "effective_date": "2025-01-10",
      "expiration_date": "2026-01-10",
      "term_months": 12,
      "base_premium_cents": 144108,
      "final_premium_cents": 114557,
      "rating_as_of": "2025-01-10"
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT tier_id, code, label, position, sellable, retired_on, notes FROM tiers…)

{
  "sql": "SELECT tier_id, code, label, position, sellable, retired_on, notes FROM tiers WHERE line = 'AUTO' ORDER BY position"
}

{
  "rows": [
    {
      "tier_id": "AUTO:HERITAGE",
      "code": "HERITAGE",
      "label": "Heritage",
      "position": 0,
      "sellable": 0,
      "retired_on": "2009-07-01",
      "notes": "Retired 2009. Has a coverage combo no current tier offers; cannot be re-bound once dropped (downgrade trap)."
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "SAPLING",
      "label": "Sapling",
      "position": 1,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "PINE",
      "label": "Pine",
      "position": 2,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "EVERGREEN",
      "label": "Evergreen",
      "position": 3,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    },
    {
      "tier_id": "AUTO:SEQUOIA",
      "code": "SEQUOIA",
      "label": "Sequoia",
      "position": 4,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    }
  ],
  "row_count": 5,
  "truncated": false
}

⚙ query_db(SELECT policy_id, rating_inputs, premium_breakdown FROM policies WHERE policy…)

{
  "sql": "SELECT policy_id, rating_inputs, premium_breakdown FROM policies WHERE policy_id = 'POL-ne-auto-pref-p_auto'"
}

{
  "rows": [
    {
      "policy_id": "POL-ne-auto-pref-p_auto",
      "rating_inputs": "{\"billing\": {\"plan\": \"AUTOPAY_MONTHLY\", \"autopay\": true, \"paperless\": true}, \"incidents_5yr\": 0, \"smoker\": false, \"promo_code\": null}",
      "premium_breakdown": "[{\"step\": \"BASE\", \"code\": \"base\", \"detail\": \"base_rate $900\", \"factor\": null, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"BASE\", \"code\": \"tier:EVERGREEN\", \"detail\": \"tier factor \\u00d71.28\", \"factor\": 1.28, \"amount_cents\": null, \"running_cents\": 115200}, {\"step\": \"BASE\", \"code\": \"region:R-NE\", \"detail\": \"region factor \\u00d71.3\", \"factor\": 1.3, \"amount_cents\": null, \"running_cents\": 149760}, {\"step\": \"RISK\", \"code\": \"factor:driver_age\", \"detail\": \"driver_age=53 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 149760}, {\"step\": \"RISK\", \"code\": \"factor:risk_score\", \"detail\": \"risk_score=784 \\u00d70.84\", \"factor\": 0.84, \"amount_cents\": null, \"running_cents\": 125798}, {\"step\": \"RISK\", \"code\": \"factor:annual_miles\", \"detail\": \"annual_miles=11000 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 125798}, {\"step\": \"RISK\", \"code\": \"factor:vehicle_age\", \"detail\": \"vehicle_age=4 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 125798}, {\"step\": \"RISK\", \"code\": \"factor:incidents_5yr\", \"detail\": \"incidents_5yr=0 \\u00d70.95\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 119508}, {\"step\": \"COVERAGE\", \"code\": \"MED\", \"detail\": \"+ MED $45\", \"factor\": null, \"amount_cents\": 4500, \"running_cents\": 124008}, {\"step\": \"COVERAGE\", \"code\": \"RENT_REIMB\", \"detail\": \"+ RENT_REIMB $30\", \"factor\": null, \"amount_cents\": 3000, \"running_cents\": 127008}, {\"step\": \"COVERAGE\", \"code\": \"UMUIM\", \"detail\": \"+ UMUIM $110\", \"factor\": null, \"amount_cents\": 11000, \"running_cents\": 138008}, {\"step\": \"FEES\", \"code\": \"policy_fee\", \"detail\": \"+ policy fee\", \"factor\": null, \"amount_cents\": 2500, \"running_cents\": 140508}, {\"step\": \"FEES\", \"code\": \"installment\", \"detail\": \"+ fractional-pay surcharge\", \"factor\": null, \"amount_cents\": 3600, \"running_cents\": 144108}, {\"step\": \"DISCOUNT\", \"code\": \"SAFE_DRIVER\", \"detail\": \"\\u221212%\", \"factor\": 0.88, \"amount_cents\": null, \"running_cents\": 126815}, {\"step\": \"DISCOUNT\", \"code\": \"PAPERLESS\", \"detail\": \"\\u2212$25\", \"factor\": null, \"amount_cents\": -2500, \"running_cents\": 124315}, {\"step\": \"DISCOUNT\", \"code\": \"AUTOPAY\", \"detail\": \"\\u22123%\", \"factor\": 0.97, \"amount_cents\": null, \"running_cents\": 120586}, {\"step\": \"DISCOUNT\", \"code\": \"LOYALTY\", \"detail\": \"\\u22125%\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 114557}]"
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT tcd.tier_id, c.code, c.label, tcd.included, tcd.default_value, tcd.edi…)

{
  "sql": "SELECT tcd.tier_id, c.code, c.label, tcd.included, tcd.default_value, tcd.editable FROM tier_coverage_defaults tcd JOIN coverages c ON c.coverage_id = tcd.coverage_id WHERE tcd.tier_id IN ('AUTO:SAPLING','AUTO:EVERGREEN') ORDER BY tcd.tier_id, c.code"
}

{
  "rows": [
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "BI",
      "label": "Bodily Injury Liability",
      "included": 1,
      "default_value": "10000000/30000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "COLL",
      "label": "Collision",
      "included": 1,
      "default_value": "50000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "COMP",
      "label": "Comprehensive",
      "included": 1,
      "default_value": "50000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "GAP",
      "label": "Loan/Lease Gap",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "MED",
      "label": "Medical Payments",
      "included": 1,
      "default_value": "500000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "OEM",
      "label": "OEM Parts Guarantee",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "PD",
      "label": "Property Damage Liability",
      "included": 1,
      "default_value": "10000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "RENT_REIMB",
      "label": "Rental Reimbursement",
      "included": 1,
      "default_value": "90000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "ROAD",
      "label": "Roadside Assistance",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "UMUIM",
      "label": "Uninsured/Underinsured Motorist",
      "included": 1,
      "default_value": "10000000/30000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "BI",
      "label": "Bodily Injury Liability",
      "included": 1,
      "default_value": "2500000/5000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "COLL",
      "label": "Collision",
      "included": 1,
      "default_value": "100000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "COMP",
      "label": "Comprehensive",
      "included": 1,
      "default_value": "100000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "GAP",
      "label": "Loan/Lease Gap",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "MED",
      "label": "Medical Payments",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "OEM",
      "label": "OEM Parts Guarantee",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "PD",
      "label": "Property Damage Liability",
      "included": 1,
      "default_value": "2500000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "RENT_REIMB",
      "label": "Rental Reimbursement",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "ROAD",
      "label": "Roadside Assistance",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "UMUIM",
      "label": "Uninsured/Underinsured Motorist",
      "included": 0,
      "default_value": "2500000/5000000",
      "editable": 1
    }
  ],
  "row_count": 20,
  "truncated": false
}

⚙ query_db(SELECT pc.coverage_id, c.code, c.label, pc.value, pc.premium_contribution_cen…)

{
  "sql": "SELECT pc.coverage_id, c.code, c.label, pc.value, pc.premium_contribution_cents FROM policy_coverages pc JOIN coverages c ON c.coverage_id = pc.coverage_id WHERE pc.policy_id = 'POL-ne-auto-pref-p_auto'"
}

{
  "rows": [
    {
      "coverage_id": "AUTO:BI",
      "code": "BI",
      "label": "Bodily Injury Liability",
      "value": "10000000/30000000",
      "premium_contribution_cents": null
    },
    {
      "coverage_id": "AUTO:COLL",
      "code": "COLL",
      "label": "Collision",
      "value": "50000",
      "premium_contribution_cents": null
    },
    {
      "coverage_id": "AUTO:COMP",
      "code": "COMP",
      "label": "Comprehensive",
      "value": "50000",
      "premium_contribution_cents": null
    },
    {
      "coverage_id": "AUTO:MED",
      "code": "MED",
      "label": "Medical Payments",
      "value": "500000",
      "premium_contribution_cents": 4500
    },
    {
      "coverage_id": "AUTO:PD",
      "code": "PD",
      "label": "Property Damage Liability",
      "value": "10000000",
      "premium_contribution_cents": null
    },
    {
      "coverage_id": "AUTO:RENT_REIMB",
      "code": "RENT_REIMB",
      "label": "Rental Reimbursement",
      "value": "90000",
      "premium_contribution_cents": 3000
    },
    {
      "coverage_id": "AUTO:UMUIM",
      "code": "UMUIM",
      "label": "Uninsured/Underinsured Motorist",
      "value": "10000000/30000000",
      "premium_contribution_cents": 11000
    }
  ],
  "row_count": 7,
  "truncated": false
}

⚙ query_db(SELECT c.cust_id, a.state, a.region, c.peico_risk FROM customers c JOIN addre…)

{
  "sql": "SELECT c.cust_id, a.state, a.region, c.peico_risk FROM customers c JOIN addresses a ON a.address_id = c.address_id WHERE c.cust_id = 'CUST-ne-auto-pref'"
}

{
  "rows": [
    {
      "cust_id": "CUST-ne-auto-pref",
      "state": "NJ",
      "region": "R-NE",
      "peico_risk": 784
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT rule_id, tier_id, coverage_id, state, effect, condition, effective_sta…)

{
  "sql": "SELECT rule_id, tier_id, coverage_id, state, effect, condition, effective_start, effective_end, reason_doc, notes FROM eligibility_rules WHERE line='AUTO' AND (tier_id='AUTO:SAPLING' OR tier_id IS NULL)"
}

{
  "rows": [
    {
      "rule_id": "ELIG-AUTO-GAP-FINANCED",
      "tier_id": null,
      "coverage_id": "AUTO:GAP",
      "state": null,
      "effect": "GATE",
      "condition": "vehicle_financed",
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-AUTO-GAP",
      "notes": "GAP eligible only when the vehicle is financed/leased."
    },
    {
      "rule_id": "ELIG-AUTO-MED-EVERGREEN",
      "tier_id": null,
      "coverage_id": "AUTO:MED",
      "state": null,
      "effect": "GATE",
      "condition": "tier_position_gte_evergreen",
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-AUTO-TIERS",
      "notes": "Medical Payments available Evergreen and above."
    },
    {
      "rule_id": "ELIG-NY-AUTO-SAPLING",
      "tier_id": "AUTO:SAPLING",
      "coverage_id": null,
      "state": "NY",
      "effect": "DENY",
      "condition": null,
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-NE-MIN-LIMITS",
      "notes": "NY minimum BI/PD exceeds Sapling limits -> Sapling auto ineligible."
    },
    {
      "rule_id": "ELIG-NJ-AUTO-SAPLING",
      "tier_id": "AUTO:SAPLING",
      "coverage_id": null,
      "state": "NJ",
      "effect": "DENY",
      "condition": null,
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-NE-MIN-LIMITS",
      "notes": "NJ minimum BI/PD exceeds Sapling limits -> Sapling auto ineligible."
    },
    {
      "rule_id": "ELIG-CA-AUTO-FACTORS",
      "tier_id": null,
      "coverage_id": null,
      "state": "CA",
      "effect": "PROHIBIT_FACTOR",
      "condition": "factors: [credit_insurance_score, gender]",
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-CA-RATING",
      "notes": "CA auto rating may not use credit-based insurance score or gender; risk_components credit term is zeroed."
    }
  ],
  "row_count": 5,
  "truncated": false
}

⚙ query_db(SELECT tcd.tier_id, c.code, c.label, tcd.included, tcd.default_value, tcd.edi…)

{
  "sql": "SELECT tcd.tier_id, c.code, c.label, tcd.included, tcd.default_value, tcd.editable FROM tier_coverage_defaults tcd JOIN coverages c ON c.coverage_id = tcd.coverage_id WHERE tcd.tier_id = 'AUTO:PINE' ORDER BY c.code"
}

{
  "rows": [
    {
      "tier_id": "AUTO:PINE",
      "code": "BI",
      "label": "Bodily Injury Liability",
      "included": 1,
      "default_value": "5000000/10000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "COLL",
      "label": "Collision",
      "included": 1,
      "default_value": "100000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "COMP",
      "label": "Comprehensive",
      "included": 1,
      "default_value": "50000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "GAP",
      "label": "Loan/Lease Gap",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "MED",
      "label": "Medical Payments",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "OEM",
      "label": "OEM Parts Guarantee",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "PD",
      "label": "Property Damage Liability",
      "included": 1,
      "default_value": "5000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "RENT_REIMB",
      "label": "Rental Reimbursement",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "ROAD",
      "label": "Roadside Assistance",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "UMUIM",
      "label": "Uninsured/Underinsured Motorist",
      "included": 0,
      "default_value": "5000000/10000000",
      "editable": 1
    }
  ],
  "row_count": 10,
  "truncated": false
}