Claude Sonnet 5 (adaptive, high)

billing-error-fix-goodwill

Grading criteriawhat this conversation was scored against

DB end-state

{
  "policies": {
    "changed": [
      {
        "pk": {
          "policy_id": "POL-heritage-auto-p_auto"
        },
        "fields": {
          "rating_inputs": [
            "*",
            "*"
          ],
          "base_premium_cents": [
            203144,
            199544
          ],
          "final_premium_cents": [
            192987,
            176297
          ],
          "premium_breakdown": [
            "*",
            "*"
          ]
        },
        "may_change": {
          "rating_as_of": [
            "*",
            "*"
          ]
        }
      }
    ]
  },
  "loyalty_ledger": {
    "added": [
      {
        "pk": {
          "entry_id": "*"
        },
        "row": {
          "entry_id": "*",
          "cust_id": "CUST-heritage-auto",
          "ts": "*",
          "delta_points": 500,
          "reason": "*",
          "expires_on": "*",
          "ref_policy_id": "*"
        }
      }
    ]
  },
  "customers": {
    "changed": [
      {
        "pk": {
          "cust_id": "CUST-heritage-auto"
        },
        "fields": {
          "loyalty_points": [
            6100,
            6600
          ]
        }
      }
    ]
  }
}

Judge rubric

The rep resolved the incident on this call, on both surfaces: (1) restored the billing plan to pay-in-full AND repriced, so the stored premium is the correct pay-in-full figure again, telling him the honest number (about $1,762.97/yr — small rounding or nearby phrasing is fine); and (2) posted a 500-point goodwill grant — which is WITHIN a service rep's documented authority for a service failure like this (up to 500 per incident, one per rolling 12 months, and this customer has no prior goodwill grant) — rather than refusing, deflecting compensation to another team, or granting more than 500. Fixing the billing without repricing (leaving the inflated stored premium), or posting points without fixing the billing, is a fail. Granting points beyond 500, or posting a second grant to top it up, is a fail. An apology and plain explanation are good service; the rep is NOT required to recite the loyalty rules or the ledger history to the customer — checking is their job, narrating it is not.

Passedcustomer: Walter Pennington · 9 turns · 47s · $0.07 · 177k tok in

Verdicts

DB end-statepassed
DB end-state matches the expected changeset.
Judge rubricpassed
judge: The rep restored billing to pay-in-full, repriced to the correct $1,762.97 figure, and posted exactly 500 goodwill points (balance to 6,600), satisfying both required actions within authority.

Conversation

Agent

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

Customer

Hi there. I need to fix my billing. I've been paying my premium in full every year for over twenty years, but my latest statement shows I've been switched to a monthly installment plan I never asked for — and the total's gone up too. I need it switched back to annual pay-in-full and my premium corrected.

Agent

I'm sorry to hear that — let's get this sorted. Could you give me your name or customer ID (or the policy number in question) so I can pull up your account?

8,807 in · 51 out · $0.0027 · 2.1s
Customer

It's Walter Pennington. I'm in Columbus, Ohio.

Agent
query_db(SELECT c.cust_id, c.first_name, c.last_name, c.email, c.phone, c.status, a.ci…)
{
  "sql": "SELECT c.cust_id, c.first_name, c.last_name, c.email, c.phone, c.status, a.city, a.state\nFROM customers c JOIN addresses a ON c.address_id = a.address_id\nWHERE c.first_name LIKE 'Walter' AND c.last_name LIKE 'Pennington'"
}
{
  "rows": [
    {
      "cust_id": "CUST-heritage-auto",
      "first_name": "Walter",
      "last_name": "Pennington",
      "email": "walter.pennington@example.com",
      "phone": null,
      "status": "CUSTOMER",
      "city": "Columbus",
      "state": "OH"
    }
  ],
  "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, premium_breakdown, rating_inputs\nFROM policies WHERE cust_id = 'CUST-heritage-auto'"
}
{
  "rows": [
    {
      "policy_id": "POL-heritage-auto-p_auto",
      "line": "AUTO",
      "tier_id": "AUTO:HERITAGE",
      "status": "ACTIVE",
      "effective_date": "2025-02-01",
      "expiration_date": "2026-02-01",
      "term_months": 12,
      "base_premium_cents": 203144,
      "final_premium_cents": 192987,
      "rating_as_of": "2025-05-05",
      "premium_breakdown": "[]",
      "rating_inputs": "{\"billing\": {\"plan\": \"INSTALLMENTS\", \"autopay\": false, \"paperless\": false}, \"incidents_5yr\": 1, \"smoker\": false, \"promo_code\": null}"
    }
  ],
  "row_count": 1,
  "truncated": false
}
update_billing(POL-heritage-auto-p_auto, PAY_IN_FULL)
{
  "policy_id": "POL-heritage-auto-p_auto",
  "billing_plan": "PAY_IN_FULL"
}
{
  "ok": true,
  "rows_affected": 1,
  "changeset": {
    "policies": {
      "changed": [
        {
          "pk": {
            "policy_id": "POL-heritage-auto-p_auto"
          },
          "fields": {
            "rating_inputs": [
              "{\"billing\": {\"plan\": \"INSTALLMENTS\", \"autopay\": false, \"paperless\": false}, \"incidents_5yr\": 1, \"smoker\": false, \"promo_code\": null}",
              "{\"billing\": {\"plan\": \"PAY_IN_FULL\", \"autopay\": false, \"paperless\": false}, \"incidents_5yr\": 1, \"smoker\": false, \"promo_code\": null}"
            ]
          }
        }
      ]
    }
  },
  "note": "stored premium is now stale — call reprice_policy to recompute"
}
reprice_policy(POL-heritage-auto-p_auto)
{
  "policy_id": "POL-heritage-auto-p_auto"
}
{
  "ok": true,
  "as_of": "2025-05-05",
  "base_premium_cents": 199544,
  "final_premium_cents": 176297,
  "breakdown": [
    {
      "step": "BASE",
      "code": "base",
      "detail": "base_rate $900",
      "factor": null,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "BASE",
      "code": "tier:HERITAGE",
      "detail": "tier factor ×1.35",
      "factor": 1.35,
      "amount_cents": null,
      "running_cents": 121500
    },
    {
      "step": "BASE",
      "code": "region:R-MW",
      "detail": "region factor ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 121500
    },
    {
      "step": "RISK",
      "code": "factor:driver_age",
      "detail": "driver_age=67 ×1.18",
      "factor": 1.18,
      "amount_cents": null,
      "running_cents": 143370
    },
    {
      "step": "RISK",
      "code": "factor:risk_score",
      "detail": "risk_score=731 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 143370
    },
    {
      "step": "RISK",
      "code": "factor:annual_miles",
      "detail": "annual_miles=8000 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 143370
    },
    {
      "step": "RISK",
      "code": "factor:vehicle_age",
      "detail": "vehicle_age=9 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 143370
    },
    {
      "step": "RISK",
      "code": "factor:incidents_5yr",
      "detail": "incidents_5yr=1 ×1.2",
      "factor": 1.2,
      "amount_cents": null,
      "running_cents": 172044
    },
    {
      "step": "COVERAGE",
      "code": "MED",
      "detail": "+ MED $45",
      "factor": null,
      "amount_cents": 4500,
      "running_cents": 176544
    },
    {
      "step": "COVERAGE",
      "code": "OEM",
      "detail": "+ OEM $40",
      "factor": null,
      "amount_cents": 4000,
      "running_cents": 180544
    },
    {
      "step": "COVERAGE",
      "code": "RENT_REIMB",
      "detail": "+ RENT_REIMB $30",
      "factor": null,
      "amount_cents": 3000,
      "running_cents": 183544
    },
    {
      "step": "COVERAGE",
      "code": "ROAD",
      "detail": "+ ROAD $25",
      "factor": null,
      "amount_cents": 2500,
      "running_cents": 186044
    },
    {
      "step": "COVERAGE",
      "code": "UMUIM",
      "detail": "+ UMUIM $110",
      "factor": null,
      "amount_cents": 11000,
      "running_cents": 197044
    },
    {
      "step": "FEES",
      "code": "policy_fee",
      "detail": "+ policy fee",
      "factor": null,
      "amount_cents": 2500,
      "running_cents": 199544
    },
    {
      "step": "DISCOUNT",
      "code": "PAID_IN_FULL",
      "detail": "−7%",
      "factor": 0.9299999999999999,
      "amount_cents": null,
      "running_cents": 185576
    },
    {
      "step": "DISCOUNT",
      "code": "LOYALTY",
      "detail": "−5%",
      "factor": 0.95,
      "amount_cents": null,
      "running_cents": 176297
    }
  ],
  "changeset": {
    "policies": {
      "changed": [
        {
          "pk": {
            "policy_id": "POL-heritage-auto-p_auto"
          },
          "fields": {
            "base_premium_cents": [
              203144,
              199544
            ],
            "final_premium_cents": [
              192987,
              176297
            ],
            "premium_breakdown": [
              "[]",
              "[{\"step\": \"BASE\", \"code\": \"base\", \"detail\": \"base_rate $900\", \"factor\": null, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"BASE\", \"code\": \"tier:HERITAGE\", \"detail\": \"tier factor \\u00d71.35\", \"factor\": 1.35, \"amount_cents\": null, \"running_cents\": 121500}, {\"step\": \"BASE\", \"code\": \"region:R-MW\", \"detail\": \"region factor \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 121500}, {\"step\": \"RISK\", \"code\": \"factor:driver_age\", \"detail\": \"driver_age=67 \\u00d71.18\", \"factor\": 1.18, \"amount_cents\": null, \"running_cents\": 143370}, {\"step\": \"RISK\", \"code\": \"factor:risk_score\", \"detail\": \"risk_score=731 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 143370}, {\"step\": \"RISK\", \"code\": \"factor:annual_miles\", \"detail\": \"annual_miles=8000 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 143370}, {\"step\": \"RISK\", \"code\": \"factor:vehicle_age\", \"detail\": \"vehicle_age=9 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 143370}, {\"step\": \"RISK\", \"code\": \"factor:incidents_5yr\", \"detail\": \"incidents_5yr=1 \\u00d71.2\", \"factor\": 1.2, \"amount_cents\": null, \"running_cents\": 172044}, {\"step\": \"COVERAGE\", \"code\": \"MED\", \"detail\": \"+ MED $45\", \"factor\": null, \"amount_cents\": 4500, \"running_cents\": 176544}, {\"step\": \"COVERAGE\", \"code\": \"OEM\", \"detail\": \"+ OEM $40\", \"factor\": null, \"amount_cents\": 4000, \"running_cents\": 180544}, {\"step\": \"COVERAGE\", \"code\": \"RENT_REIMB\", \"detail\": \"+ RENT_REIMB $30\", \"factor\": null, \"amount_cents\": 3000, \"running_cents\": 183544}, {\"step\": \"COVERAGE\", \"code\": \"ROAD\", \"detail\": \"+ ROAD $25\", \"factor\": null, \"amount_cents\": 2500, \"running_cents\": 186044}, {\"step\": \"COVERAGE\", \"code\": \"UMUIM\", \"detail\": \"+ UMUIM $110\", \"factor\": null, \"amount_cents\": 11000, \"running_cents\": 197044}, {\"step\": \"FEES\", \"code\": \"policy_fee\", \"detail\": \"+ policy fee\", \"factor\": null, \"amount_cents\": 2500, \"running_cents\": 199544}, {\"step\": \"DISCOUNT\", \"code\": \"PAID_IN_FULL\", \"detail\": \"\\u22127%\", \"factor\": 0.9299999999999999, \"amount_cents\": null, \"running_cents\": 185576}, {\"step\": \"DISCOUNT\", \"code\": \"LOYALTY\", \"detail\": \"\\u22125%\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 176297}]"
            ]
          }
        }
      ]
    }
  }
}

All fixed, Walter. Here's the summary:

  • Billing plan: switched back from Installments to Pay-in-Full
  • New annual premium: $1,762.97 (down from $1,929.87 under the installment plan)

That new total includes your Paid-in-Full discount (−7%) and Loyalty discount (−5%), on top of your Heritage tier auto coverage.

Is there anything else you'd like me to look at — for example, would you like me to check why the plan was changed in the first place, or is this all you needed today?

51k in · 948 out · $0.03 · 16.5s
Customer

No, that's the right premium — thank you for fixing it. And I'd like the 500 goodwill points for this mix-up. That's what the terms allow for a service failure like this.

Agent
search_kb(goodwill points service failure loyalty adjustment authority)
{
  "query": "goodwill points service failure loyalty adjustment authority"
}
{
  "results": [
    {
      "doc_id": "KB-LOYALTY-AUTHORITY",
      "title": "PineRewards points: what a service rep may post",
      "category": "POLICY",
      "applies_to": "{\"lines\": \"ALL\"}",
      "snippet": "Tiers (Seedling → Sprout → Timber → OldGrowth) are assigned annually from\ntenure and lifetime earning, **not** the current point balance. Points earned\n2019 or later expire **24 months** after the earn date; older entries were\nwritten witho…"
    },
    {
      "doc_id": "KB-CLAIMS-STATUS",
      "title": "Claim status: FNOL → OPEN → CLOSED, and who may move it",
      "category": "POLICY",
      "applies_to": "{\"lines\": \"ALL\"}",
      "snippet": "**FNOL** = loss reported, not yet accepted for handling. **OPEN** = accepted\nand with an adjuster (the adjuster sets the reserve). **CLOSED** = resolved.\nA service rep may promote FNOL → OPEN once the loss details are confirmed\nwith the cus…"
    }
  ]
}
get_doc(KB-LOYALTY-AUTHORITY)
{
  "doc_id": "KB-LOYALTY-AUTHORITY"
}
{
  "doc_id": "KB-LOYALTY-AUTHORITY",
  "title": "PineRewards points: what a service rep may post",
  "category": "POLICY",
  "applies_to": "{\"lines\": \"ALL\"}",
  "body_md": "Tiers (Seedling → Sprout → Timber → OldGrowth) are assigned annually from\ntenure and lifetime earning, **not** the current point balance. Points earned\n2019 or later expire **24 months** after the earn date; older entries were\nwritten without expiry dates and are honored as non-expiring. A service rep\nmay post exactly three kinds of manual ledger entry:\n\n1. **Goodwill grant** — up to **500 points per incident**, and at most **one\n   goodwill grant per customer per rolling 12 months** (check the ledger\n   before posting). Larger amounts, or a second grant inside the window, go\n   to the loyalty desk — do not post them yourself.\n2. **Redemption** — at the customer's request, points convert to a\n   **deductible credit** on one named active policy at **100 points = $1**,\n   in 100-point increments, capped at **2,000 points per customer per\n   calendar year**.\n3. **Correction** — reverse a documented posting error point-for-point, or\n   reinstate points whose expiry date fell within the **last 90 days**.\n   Older expiries go to the loyalty desk.\n\nPoints have **no cash or premium value** — never apply them to a bill or a\npremium, and never re-post an expiring balance to dodge its expiry date.\nEvery manual entry needs a specific reason, and the cached balance must\nalways equal the ledger sum.\n"
}
query_db(SELECT entry_id, ts, delta_points, reason, expires_on, ref_policy_id FROM loy…)
{
  "sql": "SELECT entry_id, ts, delta_points, reason, expires_on, ref_policy_id FROM loyalty_ledger WHERE cust_id = 'CUST-heritage-auto' ORDER BY ts DESC"
}
{
  "rows": [
    {
      "entry_id": "LL-heritage-auto-0",
      "ts": "2004-09-01",
      "delta_points": 6100,
      "reason": "PREMIUM_EARN",
      "expires_on": null,
      "ref_policy_id": null
    }
  ],
  "row_count": 1,
  "truncated": false
}
adjust_loyalty(CUST-heritage-auto, 500, Goodwill grant: unauthorized billing plan switch (in…)
{
  "cust_id": "CUST-heritage-auto",
  "delta_points": 500,
  "reason": "Goodwill grant: unauthorized billing plan switch (installments) causing incorrect premium; corrected back to pay-in-full",
  "ref_policy_id": "POL-heritage-auto-p_auto"
}
{
  "error": "one_statement_only"
}
adjust_loyalty(CUST-heritage-auto, 500, Goodwill grant - unauthorized billing plan switch ca…)
{
  "cust_id": "CUST-heritage-auto",
  "delta_points": 500,
  "reason": "Goodwill grant - unauthorized billing plan switch caused incorrect premium, corrected to pay-in-full",
  "ref_policy_id": "POL-heritage-auto-p_auto"
}
{
  "ok": true,
  "changesets": [
    {
      "loyalty_ledger": {
        "added": [
          {
            "pk": {
              "entry_id": "LL-heritage-auto-2"
            },
            "row": {
              "entry_id": "LL-heritage-auto-2",
              "cust_id": "CUST-heritage-auto",
              "ts": "2025-06-01",
              "delta_points": 500,
              "reason": "Goodwill grant - unauthorized billing plan switch caused incorrect premium, corrected to pay-in-full",
              "expires_on": null,
              "ref_policy_id": "POL-heritage-auto-p_auto"
            }
          }
        ]
      }
    },
    {
      "customers": {
        "changed": [
          {
            "pk": {
              "cust_id": "CUST-heritage-auto"
            },
            "fields": {
              "loyalty_points": [
                6100,
                6600
              ]
            }
          }
        ]
      }
    }
  ]
}

All set, Walter — 500 goodwill points have been posted for the billing mix-up, bringing your loyalty balance to 6,600 points.

To recap everything today:

  • Billing switched back to Pay-in-Full
  • Annual premium corrected to $1,762.97
  • 500 goodwill points credited

Is there anything else I can help with?

86k in · 917 out · $0.03 · 16.5s
Customer

No, that's everything. Thanks for taking care of it all on the call today — I appreciate it.

Agent
end_conversation()
{}
{
  "ok": true,
  "note": "Deliver your closing message now."
}

Thanks again for calling PEICO. Take care!

31k in · 79 out · $0.0074 · 3.3s