medpay-below-evergreen

{
  "sql": "SELECT cust_id, first_name, last_name, dob, email, phone, status FROM customers WHERE first_name = 'Raymond' AND last_name = 'Castillo' AND dob = '1974-12-11'"
}

{
  "rows": [
    {
      "cust_id": "CUST-legacy-mismatch",
      "first_name": "Raymond",
      "last_name": "Castillo",
      "dob": "1974-12-11",
      "email": "raymond.castillo@example.com",
      "phone": null,
      "status": "CUSTOMER"
    }
  ],
  "row_count": 1,
  "truncated": false
}

{
  "sql": "WITH auto_policies AS ( SELECT p.policy_id, p.line, p.status, p.effective_date, p.expiration_date, p.term_months, p.final_premium_cents, p.tier_id FROM policies p WHERE p.cust_id = 'CUST-legacy-mismatch' AND p.line = 'AUTO' ) SELECT ap.*, group_concat(c.code, ', ') AS coverages FROM auto_policies ap LEFT JOIN policy_coverages pc ON pc.policy_id = ap.policy_id LEFT JOIN coverages c ON c.coverage_id = pc.coverage_id GROUP BY ap.policy_id, ap.line, ap.status, ap.effective_date, ap.expiration_date, ap.term_months, ap.final_premium_cents, ap.tier_id"
}

{
  "rows": [
    {
      "policy_id": "POL-legacy-mismatch-p_auto",
      "line": "AUTO",
      "status": "ACTIVE",
      "effective_date": "2025-02-20",
      "expiration_date": "2025-08-20",
      "term_months": 6,
      "final_premium_cents": 120468,
      "tier_id": "AUTO:PINE",
      "coverages": "BI, COLL, COMP, PD"
    }
  ],
  "row_count": 1,
  "truncated": false
}

{
  "sql": "SELECT coverage_id, line, code, label, kind, unit, notes FROM coverages WHERE line = 'AUTO' AND code = 'MEDPAY'"
}

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

{
  "sql": "SELECT er.rule_id, er.line, er.tier_id, er.coverage_id, er.state, er.effect, er.condition, er.effective_start, er.effective_end, er.reason_doc, er.notes FROM eligibility_rules er WHERE er.line = 'AUTO' AND (er.coverage_id = 'AUTO:MEDPAY' OR er.coverage_id IS NULL) AND (er.tier_id = 'AUTO:PINE' OR er.tier_id IS NULL) AND (er.state IS NULL OR er.state = (SELECT a.state FROM customers cu JOIN addresses a ON a.address_id = cu.address_id WHERE cu.cust_id = 'CUST-legacy-mismatch')) AND er.effective_start <= '2025-06-01' AND (er.effective_end IS NULL OR er.effective_end >= '2025-06-01')"
}

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

{
  "sql": "SELECT a.state, a.region FROM customers cu JOIN addresses a ON a.address_id = cu.address_id WHERE cu.cust_id = 'CUST-legacy-mismatch'"
}

{
  "rows": [
    {
      "state": "TX",
      "region": "R-SW"
    }
  ],
  "row_count": 1,
  "truncated": false
}

{
  "sql": "SELECT td.included, td.default_value, td.editable FROM tier_coverage_defaults td WHERE td.tier_id = 'AUTO:PINE' AND td.coverage_id = 'AUTO:MEDPAY'"
}

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

{
  "query": "MEDPAY auto coverage code glossary medical payments auto Texas",
  "limit": 5
}

{
  "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-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-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-NE-MIN-LIMITS",
      "title": "NY/NJ minimum auto liability limits",
      "category": "COMPLIANCE",
      "applies_to": "{\"lines\": [\"AUTO\"], \"states\": [\"NY\", \"NJ\"]}",
      "snippet": "New York and New Jersey mandate minimum BI/PD limits above the Sapling tier's\nlimits, so **Sapling auto is not sellable** in those states — quote Pine or higher.\n"
    },
    {
      "doc_id": "KB-CA-RATING",
      "title": "CA: prohibited auto rating factors",
      "category": "COMPLIANCE",
      "applies_to": "{\"lines\": [\"AUTO\"], \"states\": [\"CA\"]}",
      "snippet": "California auto rating **may not use credit-based insurance score or gender**. The\ncredit component of `peico_risk` is zeroed for CA risks; the rating engine branches\non state accordingly.\n"
    }
  ]
}

{
  "doc_id": "KB-AUTO-TIERS"
}

{
  "doc_id": "KB-AUTO-TIERS",
  "title": "Auto tiers: Sapling → Pine → Evergreen → Sequoia",
  "category": "POLICY",
  "applies_to": "{\"lines\": [\"AUTO\"]}",
  "body_md": "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"
}

{
  "sql": "SELECT coverage_id, line, code, label, kind, unit, notes FROM coverages WHERE line = 'AUTO' AND code LIKE 'MED%'"
}

{
  "rows": [
    {
      "coverage_id": "AUTO:MED",
      "line": "AUTO",
      "code": "MED",
      "label": "Medical Payments",
      "kind": "limit",
      "unit": "usd",
      "notes": "Evergreen+ only."
    }
  ],
  "row_count": 1,
  "truncated": false
}

{
  "sql": "WITH po AS (SELECT object_type, object_id FROM policy_objects WHERE policy_id = 'POL-legacy-mismatch-p_auto') SELECT v.vehicle_id, v.year, v.make, v.model, v.usage, v.annual_miles, v.financed, a.state, a.region, cu.peico_risk FROM po JOIN vehicles v ON po.object_type = 'vehicle' AND po.object_id = v.vehicle_id JOIN customers cu ON cu.cust_id = v.cust_id JOIN addresses a ON a.address_id = cu.address_id"
}

{
  "rows": [
    {
      "vehicle_id": "VEH-legacy-mismatch-v1",
      "year": 2018,
      "make": "Ford",
      "model": "F-150",
      "usage": "COMMUTE",
      "annual_miles": 16000,
      "financed": 0,
      "state": "TX",
      "region": "R-SW",
      "peico_risk": 616
    }
  ],
  "row_count": 1,
  "truncated": false
}

{
  "as_of": "2025-06-01",
  "facts": {
    "line": "AUTO",
    "region": "R-SW",
    "state": "TX",
    "tier": "AUTO:EVERGREEN",
    "peico_risk": 616,
    "usage": "COMMUTE",
    "annual_miles": 16000,
    "financed": 0,
    "coverages": [
      "BI",
      "PD",
      "COMP",
      "COLL",
      "MED"
    ]
  }
}

{
  "as_of": "2025-06-01",
  "base_premium_cents": 154571,
  "final_premium_cents": 136022,
  "breakdown": [
    {
      "step": "BASE",
      "code": "base",
      "detail": "base_rate $900",
      "factor": null,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "BASE",
      "code": "tier:AUTO:EVERGREEN",
      "detail": "tier factor ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "BASE",
      "code": "region:R-SW",
      "detail": "region factor ×1.12",
      "factor": 1.12,
      "amount_cents": null,
      "running_cents": 100800
    },
    {
      "step": "RISK",
      "code": "factor:risk_score",
      "detail": "risk_score=616 ×1.22",
      "factor": 1.22,
      "amount_cents": null,
      "running_cents": 122976
    },
    {
      "step": "RISK",
      "code": "factor:annual_miles",
      "detail": "annual_miles=16000 ×1.2",
      "factor": 1.2,
      "amount_cents": null,
      "running_cents": 147571
    },
    {
      "step": "COVERAGE",
      "code": "MED",
      "detail": "+ MED $45",
      "factor": null,
      "amount_cents": 4500,
      "running_cents": 152071
    },
    {
      "step": "FEES",
      "code": "policy_fee",
      "detail": "+ policy fee",
      "factor": null,
      "amount_cents": 2500,
      "running_cents": 154571
    },
    {
      "step": "DISCOUNT",
      "code": "SAFE_DRIVER",
      "detail": "−12%",
      "factor": 0.88,
      "amount_cents": null,
      "running_cents": 136022
    }
  ]
}

{}

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