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.
Verdicts
DB end-statepassed
DB end-state matches the expected changeset.
Judge rubricpassed
judge: The rep correctly identified that the March LIFE_W suitability record didn't cover the new LIFE_T policy, conducted the suitability review by asking the required questions and using the customer's actual answers, concluded SUITABLE (which matches her stated facts), and bound the policy on this call with an accurate summary of terms and dates.
Conversation
Hi, thanks for contacting PEICO — this is the service desk. How can I help you today?
Hi there! I need to activate a term life quote I got last week. It's for $250,000 coverage over 20 years, and I'd really like to get it in force today if possible.
I can help with that. To locate the term life quote and verify your identity, please provide either:
- the quote/policy ID, or
- your full name plus one verification detail on file, such as date of birth, phone number, or email.
Once I find it, I’ll check the required life-insurance suitability/disclosure gates and confirm whether we can bind it effective today.
Sure, I'm Eleanor Whitmore. My email on file is eleanor.whitmore@example.com.
⚙ query_db(SELECT cust_id, first_name, last_name, dob, email, phone, status, address_id …)
{
"sql": "SELECT cust_id, first_name, last_name, dob, email, phone, status, address_id FROM customers WHERE first_name = 'Eleanor' AND last_name = 'Whitmore' AND email = 'eleanor.whitmore@example.com'"
}{
"rows": [
{
"cust_id": "CUST-life-suitable",
"first_name": "Eleanor",
"last_name": "Whitmore",
"dob": "1983-05-22",
"email": "eleanor.whitmore@example.com",
"phone": null,
"status": "CUSTOMER",
"address_id": "ADDR-life-suitable"
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT p.policy_id, p.line, pl.label AS line_label, p.tier_id, p.status, p.ef…)
{
"sql": "SELECT p.policy_id, p.line, pl.label AS line_label, p.tier_id, p.status, p.effective_date, p.expiration_date, p.term_months, p.final_premium_cents, p.rating_inputs, p.created_at FROM policies p LEFT JOIN product_lines pl ON p.line = pl.line WHERE p.cust_id = 'CUST-life-suitable' AND (p.line LIKE 'LIFE%' OR pl.category = 'life') ORDER BY p.created_at DESC"
}{
"rows": [
{
"policy_id": "POL-life-suitable-p_life",
"line": "LIFE_W",
"line_label": "Whole Life",
"tier_id": "LIFE_W:EVERGREEN",
"status": "ACTIVE",
"effective_date": "2025-03-05",
"expiration_date": "2026-03-05",
"term_months": 12,
"final_premium_cents": 185212,
"rating_inputs": "{\"billing\": {\"plan\": \"PAY_IN_FULL\", \"autopay\": true, \"paperless\": true}, \"incidents_5yr\": 0, \"smoker\": false, \"promo_code\": null}",
"created_at": "2025-06-01"
},
{
"policy_id": "POL-life-suitable-q_term",
"line": "LIFE_T",
"line_label": "Term Life",
"tier_id": "LIFE_T:EVERGREEN",
"status": "QUOTE",
"effective_date": "2025-06-01",
"expiration_date": null,
"term_months": 12,
"final_premium_cents": 62526,
"rating_inputs": "{\"billing\": {\"plan\": \"PAY_IN_FULL\", \"autopay\": true, \"paperless\": true}, \"incidents_5yr\": 0, \"smoker\": false, \"promo_code\": null}",
"created_at": "2025-05-27"
}
],
"row_count": 2,
"truncated": false
}⚙ query_db(SELECT p.policy_id, p.line, p.tier_id, p.status, p.effective_date, p.term_mon…)
{
"sql": "SELECT p.policy_id, p.line, p.tier_id, p.status, p.effective_date, p.term_months, p.rating_inputs, p.base_premium_cents, p.final_premium_cents, t.code AS tier_code, t.label AS tier_label, t.sellable, t.retired_on, pl.requires_suitability, pl.requires_underlying FROM policies p JOIN tiers t ON p.tier_id = t.tier_id JOIN product_lines pl ON p.line = pl.line WHERE p.policy_id = 'POL-life-suitable-q_term'"
}{
"rows": [
{
"policy_id": "POL-life-suitable-q_term",
"line": "LIFE_T",
"tier_id": "LIFE_T:EVERGREEN",
"status": "QUOTE",
"effective_date": "2025-06-01",
"term_months": 12,
"rating_inputs": "{\"billing\": {\"plan\": \"PAY_IN_FULL\", \"autopay\": true, \"paperless\": true}, \"incidents_5yr\": 0, \"smoker\": false, \"promo_code\": null}",
"base_premium_cents": 72000,
"final_premium_cents": 62526,
"tier_code": "EVERGREEN",
"tier_label": "Evergreen",
"sellable": 1,
"retired_on": null,
"requires_suitability": 1,
"requires_underlying": null
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT pc.policy_id, c.coverage_id, c.code, c.label, c.kind, c.unit, pc.value…)
{
"sql": "SELECT pc.policy_id, c.coverage_id, c.code, c.label, c.kind, c.unit, pc.value, pc.premium_contribution_cents FROM policy_coverages pc JOIN coverages c ON pc.coverage_id = c.coverage_id WHERE pc.policy_id = 'POL-life-suitable-q_term'"
}{
"rows": [
{
"policy_id": "POL-life-suitable-q_term",
"coverage_id": "LIFE_T:CONVERT",
"code": "CONVERT",
"label": "Conversion Option",
"kind": "flag",
"unit": "bool",
"value": "true",
"premium_contribution_cents": null
},
{
"policy_id": "POL-life-suitable-q_term",
"coverage_id": "LIFE_T:FACE",
"code": "FACE",
"label": "Death Benefit (Face Amount)",
"kind": "limit",
"unit": "usd",
"value": "25000000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-life-suitable-q_term",
"coverage_id": "LIFE_T:TERM_LEN",
"code": "TERM_LEN",
"label": "Level Term Length",
"kind": "feature",
"unit": "years",
"value": "20",
"premium_contribution_cents": null
},
{
"policy_id": "POL-life-suitable-q_term",
"coverage_id": "LIFE_T:WAIVER",
"code": "WAIVER",
"label": "Waiver of Premium Rider",
"kind": "flag",
"unit": "bool",
"value": "true",
"premium_contribution_cents": null
}
],
"row_count": 4,
"truncated": false
}⚙ query_db(SELECT suit_id, cust_id, line, income_cents, dependents, existing_coverage_ce…)
{
"sql": "SELECT suit_id, cust_id, line, income_cents, dependents, existing_coverage_cents, stated_need, horizon, risk_tolerance, completed_at, outcome FROM suitability_records WHERE cust_id = 'CUST-life-suitable' AND line = 'LIFE_T' ORDER BY completed_at DESC"
}{
"rows": [],
"row_count": 0,
"truncated": false
}⚙ query_db(SELECT rd.disclosure_id, rd.code, rd.title, rd.when_required, rd.free_look_da…)
{
"sql": "SELECT rd.disclosure_id, rd.code, rd.title, rd.when_required, rd.free_look_days, rd.mandatory, rd.state, rd.condition, rd.doc_id, dd.delivered_at, dd.channel, dd.acknowledged, dd.notes FROM required_disclosures rd LEFT JOIN disclosure_deliveries dd ON rd.disclosure_id = dd.disclosure_id AND dd.policy_id = 'POL-life-suitable-q_term' WHERE rd.line = 'LIFE_T'"
}{
"rows": [
{
"disclosure_id": "DISC-LIFET-FREELOOK",
"code": "FREE_LOOK",
"title": "Free-look period",
"when_required": "AT_BIND",
"free_look_days": 30,
"mandatory": 1,
"state": null,
"condition": null,
"doc_id": "KB-DISC-FREELOOK",
"delivered_at": "2025-05-27",
"channel": "ESIGN",
"acknowledged": 1,
"notes": "Delivered and acknowledged in the quote e-sign packet."
},
{
"disclosure_id": "DISC-LIFET-CONVERT",
"code": "CONVERSION",
"title": "Conversion-option terms",
"when_required": "AT_BIND",
"free_look_days": null,
"mandatory": 0,
"state": null,
"condition": "coverage CONVERT included",
"doc_id": "KB-AUTO-TIERS",
"delivered_at": "2025-05-27",
"channel": "ESIGN",
"acknowledged": 1,
"notes": "Conversion-option terms delivered with the quote."
}
],
"row_count": 2,
"truncated": false
}⚙ query_db(SELECT er.rule_id, er.line, er.tier_id, er.coverage_id, er.state, er.effect, …)
{
"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 = 'LIFE_T' AND (er.tier_id IS NULL OR er.tier_id = 'LIFE_T:EVERGREEN') AND (er.effective_end IS NULL OR er.effective_end >= '2025-06-01') AND er.effective_start <= '2025-06-01'"
}{
"rows": [],
"row_count": 0,
"truncated": false
}⚙ search_kb(life term suitability required disclosures bind rules, 5)
{
"query": "life term suitability required disclosures bind rules",
"limit": 5
}{
"results": [
{
"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,…"
},
{
"doc_id": "KB-DISC-WHOLE-LIFE",
"title": "Whole life disclosures: surrender, cash value, not an investment",
"category": "COMPLIANCE",
"applies_to": "{\"lines\": [\"LIFE_W\"]}",
"snippet": "Before binding whole life, disclose and record: (1) **surrender charges** apply for\nthe first several policy years and reduce early cash value; (2) cash value accrues\nslowly and may be borrowed against, reducing the death benefit; (3) whole…"
},
{
"doc_id": "KB-DISC-FREELOOK",
"title": "Free-look period",
"category": "COMPLIANCE",
"applies_to": "{\"lines\": [\"LIFE_T\", \"LIFE_W\", \"HLTH\"]}",
"snippet": "The customer may cancel within the **free-look period** (30 days for life, 10 days\nfor supplemental health) after policy delivery for a full refund of premium paid.\nThe period and refund right must be disclosed at bind and recorded.\n"
},
{
"doc_id": "KB-PROMO-SPRINGSAVE25",
"title": "SPRINGSAVE25 terms",
"category": "PROMO",
"applies_to": "{\"lines\": [\"AUTO\"]}",
"snippet": "$75 off auto in the Midwest/Southwest, spring 2025 only. Offer window 2025-03-20 through 2025-06-21; does not apply after 2025-06-21. Applicability is determined by the offer window as of the quote date."
},
{
"doc_id": "KB-EVERGREEN-CLASSIC",
"title": "Evergreen Classic (Home, retired 2018) — wind/hail math",
"category": "UNDERWRITING",
"applies_to": "{\"lines\": [\"HOME\"]}",
"snippet": "Retired 2018-01-01. Uses a legacy flat-capped wind/hail deductible (1.5% of\ndwelling, capped) rather than the current percentage math. Not re-bindable.\n"
}
]
}⚙ get_doc(KB-SUITABILITY)
{
"doc_id": "KB-SUITABILITY"
}{
"doc_id": "KB-SUITABILITY",
"title": "Suitability requirement for Life & Health",
"category": "COMPLIANCE",
"applies_to": "{\"lines\": [\"LIFE_T\", \"LIFE_W\", \"HLTH\"]}",
"body_md": "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, tight-budget customer is a mis-sale. Required disclosures: free-look\nperiod, surrender charges, and that whole life is **not an investment account**.\n"
}I found your PEICO profile and the term life quote:
- Quote/policy ID: POL-life-suitable-q_term
- Coverage: $250,000
- Term length: 20 years
- Riders/options: conversion option and waiver of premium
- Current quoted premium: $625.26
- Status: QUOTE
Your disclosures for the free-look period and conversion option show as delivered and acknowledged. However, term life requires a completed suitability record before I can put it in force, and I don’t see one on file for this term life quote.
To complete that suitability step, please provide:
- Approximate annual income
- Number of dependents
- Existing life insurance coverage amount, if any
- Your stated need for the policy, such as family protection, mortgage protection, income replacement, final expenses, etc.
- Planning horizon: short, medium, or long
- Risk tolerance: low, medium, or high
Once I have those, I’ll determine the required outcome and, if suitable, bind it effective today.
Okay, I get it — didn't we do all this in March when I bought the whole-life policy? But I'll answer. Household income is about $145,000. I have two dependents, kids ages 8 and 11. For existing coverage, I've got the $100,000 whole-life policy with you from March, plus $150,000 through my employer, so $250,000 total right now. The need is income replacement — to protect their lifestyle while they're young and dependent on me. Long horizon, medium risk tolerance. And I'm a non-smoker.
⚙ query_db(SELECT suit_id, line, income_cents, dependents, existing_coverage_cents, stat…)
{
"sql": "SELECT suit_id, line, income_cents, dependents, existing_coverage_cents, stated_need, horizon, risk_tolerance, completed_at, outcome FROM suitability_records WHERE cust_id = 'CUST-life-suitable' ORDER BY completed_at DESC"
}{
"rows": [
{
"suit_id": "SUIT-POL-life-suitable-p_life",
"line": "LIFE_W",
"income_cents": 14500000,
"dependents": 2,
"existing_coverage_cents": 25000000,
"stated_need": "estate planning + final expenses",
"horizon": "LONG",
"risk_tolerance": "MEDIUM",
"completed_at": "2025-03-05",
"outcome": "SUITABLE"
}
],
"row_count": 1,
"truncated": false
}⚙ price_check(POL-life-suitable-q_term, 2025-06-01)
{
"policy_id": "POL-life-suitable-q_term",
"as_of": "2025-06-01"
}{
"as_of": "2025-06-01",
"facts": {
"line": "LIFE_T",
"tier": "EVERGREEN",
"region": "R-NE",
"state": "NY",
"term_months": 12,
"peico_risk": 760,
"age": 42,
"billing_plan": "PAY_IN_FULL",
"autopay": true,
"paperless": true,
"loyalty_tier": "Sprout",
"status": "CUSTOMER",
"has_bundle": false,
"active_lines": 1,
"is_new_first_policy": false,
"promo_code": null,
"coverages": [
"CONVERT",
"WAIVER"
],
"face": 250000,
"smoker": false,
"term_len": 20
},
"base_premium_cents": 72000,
"final_premium_cents": 62526,
"breakdown": [
{
"step": "BASE",
"code": "base",
"detail": "$2.6/$1k @age42 × face $250,000.0",
"factor": null,
"amount_cents": null,
"running_cents": 65000
},
{
"step": "BASE",
"code": "tier:EVERGREEN",
"detail": "tier factor ×1.0",
"factor": 1,
"amount_cents": null,
"running_cents": 65000
},
{
"step": "BASE",
"code": "term_len",
"detail": "20yr term ×1.0",
"factor": 1,
"amount_cents": null,
"running_cents": 65000
},
{
"step": "BASE",
"code": "region:R-NE",
"detail": "region factor ×1.0",
"factor": 1,
"amount_cents": null,
"running_cents": 65000
},
{
"step": "COVERAGE",
"code": "WAIVER",
"detail": "+ WAIVER $45",
"factor": null,
"amount_cents": 4500,
"running_cents": 69500
},
{
"step": "FEES",
"code": "policy_fee",
"detail": "+ policy fee",
"factor": null,
"amount_cents": 2500,
"running_cents": 72000
},
{
"step": "DISCOUNT",
"code": "PAID_IN_FULL",
"detail": "−7%",
"factor": 0.9299999999999999,
"amount_cents": null,
"running_cents": 66960
},
{
"step": "DISCOUNT",
"code": "PAPERLESS",
"detail": "−$25",
"factor": null,
"amount_cents": -2500,
"running_cents": 64460
},
{
"step": "DISCOUNT",
"code": "AUTOPAY",
"detail": "−3%",
"factor": 0.97,
"amount_cents": null,
"running_cents": 62526
}
]
}⚙ search_kb(term life suitability income replacement dependents existing coverage outcome…)
{
"query": "term life suitability income replacement dependents existing coverage outcome SUITABLE rules",
"limit": 5
}{
"results": [
{
"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,…"
},
{
"doc_id": "KB-DISC-WHOLE-LIFE",
"title": "Whole life disclosures: surrender, cash value, not an investment",
"category": "COMPLIANCE",
"applies_to": "{\"lines\": [\"LIFE_W\"]}",
"snippet": "Before binding whole life, disclose and record: (1) **surrender charges** apply for\nthe first several policy years and reduce early cash value; (2) cash value accrues\nslowly and may be borrowed against, reducing the death benefit; (3) whole…"
},
{
"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-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"
}
]
}⚙ create_suitability_record(CUST-life-suitable, LIFE_T, 14500000, 2, 25000000, Income replacement to prot…)
{
"cust_id": "CUST-life-suitable",
"line": "LIFE_T",
"income_cents": 14500000,
"dependents": 2,
"existing_coverage_cents": 25000000,
"stated_need": "Income replacement to protect dependents' lifestyle while children are young and dependent",
"horizon": "LONG",
"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 replacement to protect dependents' lifestyle while children are young and dependent",
"horizon": "LONG",
"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"
]
}
}
]
}
}
}Thank you — and yes, I do see the March whole-life suitability record. Because this is a separate term life policy, PEICO requires a separate suitability record for the term product before binding.
Based on what you provided — $145,000 household income, 2 dependents, $250,000 existing coverage, income-replacement need, long horizon, and medium risk tolerance — the term life quote is suitable, and I filed that required record.
Your term life policy is now ACTIVE, effective today, 2025-06-01.
Summary:
- Policy: POL-life-suitable-q_term
- Coverage: $250,000
- Term length: 20 years
- Includes: conversion option and waiver of premium rider
- Premium: $625.26
- Free-look period: 30 days from policy delivery, during which you may cancel for a full refund of premium paid
One note: EVERGREEN shows the policy term record expiring 2026-06-01, which is the annual policy term/admin renewal date; the life coverage itself is the quoted 20-year level term.
Perfect — that's exactly what I needed. Thank you for getting that done today! I appreciate it.
⚙ end_conversation()
{}{
"ok": true,
"note": "Deliver your closing message now."
}You’re very welcome, Eleanor. I’m glad we could get your term life policy active today. Thank you for choosing PEICO, and have a great day!