legacy-glossary-coverage-compare
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 correctly explained the three legacy codes in plain language — UMUIM is uninsured/underinsured motorist coverage, RENT_REIMB is rental reimbursement while the car is in the shop, and OEM is an original-manufacturer parts guarantee — AND verified against the customer's actual current policy that all three are still included today, answering yes for each. Telling him any of the three is no longer on his policy is a fail. Answering only from general tier descriptions without confirming his specific policy's coverages, when the transcript shows no check of his actual policy, is a fail. The rep must not change anything or sell anything.
Verdicts
DB end-statepassed
DB end-state matches the expected changeset.
Judge rubricpassed
judge: The rep correctly explained all three codes in plain language, verified against Walter's actual current policy (Heritage tier) that all three are present with specific limits, and did not change or sell anything.
Conversation
Hi, thanks for contacting PEICO — this is the service desk. How can I help you today?
Hi there. I found an old declarations page from way back when I had one of your EVERGREEN plans, and there are a few coverage codes on it I don't understand. I was hoping you could explain what they mean and let me know if I still have them on my policy today.
I'd be glad to help. Could you give me your name or customer ID (or the account details we can use to verify you), and also list out the coverage codes you're seeing on that old declarations page?
Sure. I'm Walter Pennington. The codes I'm confused about are UMUIM, RENT_REIMB, and OEM. I can give you more details to verify the account if you need them.
⚙ query_db(SELECT cust_id, first_name, last_name, dob, email, phone, status FROM custome…)
{
"sql": "SELECT cust_id, first_name, last_name, dob, email, phone, status FROM customers WHERE last_name = 'Pennington' AND first_name = 'Walter'"
}{
"rows": [
{
"cust_id": "CUST-heritage-auto",
"first_name": "Walter",
"last_name": "Pennington",
"dob": "1957-11-02",
"email": "walter.pennington@example.com",
"phone": null,
"status": "CUSTOMER"
}
],
"row_count": 1,
"truncated": false
}I found an account under that name. Before I go further, could you confirm your date of birth and/or the email we have on file, just to verify it's you?
My email on file is walter.pennington@example.com, and my date of birth is November 2, 1957.
⚙ search_kb(UMUIM RENT_REIMB OEM coverage code glossary)
{
"query": "UMUIM RENT_REIMB OEM coverage code glossary"
}{
"results": [
{
"doc_id": "KB-GLOSSARY-AUTO",
"title": "Auto coverage codes, decoded",
"category": "GLOSSARY",
"applies_to": "{\"lines\": [\"AUTO\", \"MOTO\", \"RV\", \"BOAT\", \"CLSC\"]}",
"snippet": "EVERGREEN stores auto coverages under terse codes. Plain-language meanings:\n- **BI** — Bodily Injury liability (per-person / per-accident).\n- **PD** — Property Damage liability.\n- **UM/UIM** (`UMUIM`) — Uninsured / Underinsured Motorist.\n- …"
},
{
"doc_id": "KB-AUTO-TIERS",
"title": "Auto tiers: Sapling → Pine → Evergreen → Sequoia",
"category": "POLICY",
"applies_to": "{\"lines\": [\"AUTO\"]}",
"snippet": "Tiers bundle coverages. Higher tiers raise liability limits, lower deductibles,\nand add coverages: **MED** and **RENT_REIMB** appear at Evergreen and above;\n**OEM** is Sequoia-only; **ROAD** is included at Sequoia (an add-on below it).\n"
},
{
"doc_id": "KB-LEGACY-XWALK",
"title": "Reading an EVERGREEN plan code (legacy → CANOPY)",
"category": "HOWTO",
"applies_to": "{\"lines\": [\"AUTO\"]}",
"snippet": "PEICO is migrating from the legacy **EVERGREEN** mainframe to **CANOPY**. An\nEVERGREEN auto policy is stored as one **plan code** `A<class><gen>` (class\nB=Basic, S=Standard, P=Preferred). A plan code does NOT map to a CANOPY tier on\nits own…"
},
{
"doc_id": "KB-HERITAGE",
"title": "Heritage tier (retired 2009) — do not drop without disclosure",
"category": "UNDERWRITING",
"applies_to": "{\"lines\": [\"AUTO\"]}",
"snippet": "Heritage was retired on 2009-07-01 and cannot be sold or re-bound. It carries a\ncoverage combination no current tier offers (Sequoia-level MED/RENT_REIMB/ROAD/OEM\non a mid liability base). A customer who drops Heritage **loses that combinat…"
},
{
"doc_id": "KB-TX-MOTO",
"title": "TX: motorcycle custom-parts coverage unavailable",
"category": "UNDERWRITING",
"applies_to": "{\"lines\": [\"MOTO\"], \"states\": [\"TX\"]}",
"snippet": "Due to a historical licensing limitation, Custom Parts & Equipment coverage is\n**not available on motorcycle policies in Texas**.\n"
},
{
"doc_id": "KB-DISC-HLTH-SUPP",
"title": "Supplemental health: not major-medical; pre-existing limits",
"category": "COMPLIANCE",
"applies_to": "{\"lines\": [\"HLTH\"]}",
"snippet": "Disclose and record that this is **supplemental** coverage (accident / critical\nillness / hospital indemnity) and **NOT ACA major-medical** — it does not satisfy a\ncoverage mandate and does not replace health insurance. Pre-existing conditi…"
},
{
"doc_id": "KB-CONDO-MASTER",
"title": "Condo loss assessment & the HOA master policy",
"category": "POLICY",
"applies_to": "{\"lines\": [\"CONDO\"]}",
"snippet": "Loss Assessment coverage responds to charges levied by the HOA. Its adequacy\ndepends on the **master-policy deductible**; record that deductible so the limit\nis set correctly.\n"
},
{
"doc_id": "KB-SUITABILITY",
"title": "Suitability requirement for Life & Health",
"category": "COMPLIANCE",
"applies_to": "{\"lines\": [\"LIFE_T\", \"LIFE_W\", \"HLTH\"]}",
"snippet": "Before binding any Life or Supplemental Health policy you must complete a\n**suitability record** (income, existing coverage, dependents, stated need,\nhorizon, risk tolerance) with outcome SUITABLE. Selling **whole life** to a\nshort-horizon,…"
}
]
}⚙ query_db(SELECT policy_id, line, tier_id, status, effective_date, expiration_date FROM…)
{
"sql": "SELECT policy_id, line, tier_id, status, effective_date, expiration_date FROM 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"
}
],
"row_count": 1,
"truncated": false
}⚙ get_doc(KB-GLOSSARY-AUTO)
{
"doc_id": "KB-GLOSSARY-AUTO"
}{
"doc_id": "KB-GLOSSARY-AUTO",
"title": "Auto coverage codes, decoded",
"category": "GLOSSARY",
"applies_to": "{\"lines\": [\"AUTO\", \"MOTO\", \"RV\", \"BOAT\", \"CLSC\"]}",
"body_md": "EVERGREEN stores auto coverages under terse codes. Plain-language meanings:\n- **BI** — Bodily Injury liability (per-person / per-accident).\n- **PD** — Property Damage liability.\n- **UM/UIM** (`UMUIM`) — Uninsured / Underinsured Motorist.\n- **COLL** — Collision (you hit something); **COMP** — Comprehensive (theft, glass, weather, animal).\n- **MED** — Medical Payments; **RENT_REIMB** — rental reimbursement while your car is in the shop.\n- **ROAD** — roadside assistance; **GAP** — pays loan/lease balance above the car's value; **OEM** — original-manufacturer parts guarantee.\n"
}⚙ get_doc(KB-HERITAGE)
{
"doc_id": "KB-HERITAGE"
}{
"doc_id": "KB-HERITAGE",
"title": "Heritage tier (retired 2009) — do not drop without disclosure",
"category": "UNDERWRITING",
"applies_to": "{\"lines\": [\"AUTO\"]}",
"body_md": "Heritage was retired on 2009-07-01 and cannot be sold or re-bound. It carries a\ncoverage combination no current tier offers (Sequoia-level MED/RENT_REIMB/ROAD/OEM\non a mid liability base). A customer who drops Heritage **loses that combination\npermanently**. Disclose the downgrade trap before any tier change off Heritage.\n"
}⚙ query_db(SELECT pc.coverage_id, c.label, c.notes, pc.value FROM policy_coverages pc JO…)
{
"sql": "SELECT pc.coverage_id, c.label, c.notes, pc.value FROM policy_coverages pc JOIN coverages c ON c.coverage_id = pc.coverage_id WHERE pc.policy_id = 'POL-heritage-auto-p_auto'"
}{
"rows": [
{
"coverage_id": "AUTO:BI",
"label": "Bodily Injury Liability",
"notes": "Per-person / per-accident. Limit rises by tier.",
"value": "10000000/30000000"
},
{
"coverage_id": "AUTO:COLL",
"label": "Collision",
"notes": "Deductible falls by tier.",
"value": "50000"
},
{
"coverage_id": "AUTO:COMP",
"label": "Comprehensive",
"notes": "Deductible falls by tier.",
"value": "50000"
},
{
"coverage_id": "AUTO:MED",
"label": "Medical Payments",
"notes": "Evergreen+ only.",
"value": "500000"
},
{
"coverage_id": "AUTO:OEM",
"label": "OEM Parts Guarantee",
"notes": "Sequoia only.",
"value": "true"
},
{
"coverage_id": "AUTO:PD",
"label": "Property Damage Liability",
"notes": "Limit rises by tier.",
"value": "5000000"
},
{
"coverage_id": "AUTO:RENT_REIMB",
"label": "Rental Reimbursement",
"notes": "Per-day/max. Evergreen+ only.",
"value": "90000"
},
{
"coverage_id": "AUTO:ROAD",
"label": "Roadside Assistance",
"notes": "Included at Sequoia; add-on elsewhere.",
"value": "true"
},
{
"coverage_id": "AUTO:UMUIM",
"label": "Uninsured/Underinsured Motorist",
"notes": "Optional below Evergreen. Glossary KB decodes UM/UIM.",
"value": "10000000/30000000"
}
],
"row_count": 9,
"truncated": false
}Thanks, Walter — verified! Here's what those codes mean and where you stand today:
What the codes mean:
- UMUIM — Uninsured/Underinsured Motorist coverage. Pays for injuries caused by a driver who has no insurance or not enough insurance.
- RENT_REIMB — Rental Reimbursement. Covers a rental car while your vehicle is in the shop after a covered claim.
- OEM — Original-Manufacturer-Parts Guarantee. Ensures repairs use genuine parts from your car's manufacturer rather than aftermarket equivalents.
Do you still have them? Yes — good news. You currently have an active AUTO policy (POL-heritage-auto-p_auto) on the Heritage tier, and all three are on it right now:
- UMUIM: 100,000/300,000 limits
- RENT_REIMB: $900/day-max reimbursement
- OEM: included
One important note for your records: Heritage is a retired, grandfathered tier (retired in 2009) — it's not sold anymore. It happens to combine coverages (MED, RENT_REIMB, ROAD, and OEM) that no currently-sold tier offers together. If you ever moved off Heritage to another tier, you would permanently lose that exact combination — it can't be re-created or re-bound later. So I'd flag: hang onto this tier unless you have a specific reason to change it.
Is there anything else you'd like me to look into?
Perfect — that's exactly what I needed. Thanks for breaking those down and confirming they're still on my policy. I appreciate you letting me know about the Heritage tier situation too. That's really helpful.
⚙ end_conversation()
{}{
"ok": true,
"note": "Deliver your closing message now."
}Take care!