Read the claim file for recovery potential, name the responsible third party, check the bars and date the limitation period — a recovery handler decides whether to pursue, and the agent demands nothing.
Take the claim as it stands — loss detail, policy, payments made, documents, parties and dates.
02
Read the wordings, contracts and statutes that decide whether recovery is available at all.
Reason
03
Name the third party the loss points to, and the liability the file itself supports.
04
Date the limitation period from the insured's cause of action, by jurisdiction and claim type.
05
Check the bars — waiver of subrogation, anti-subrogation, made-whole and statutory prohibitions.
Decide
06
Where nothing in the file points to a third party, the claim carries on down its normal path.
07
Everything else goes to a recovery handler, including files where a bar appears to apply.
Out
08
Assemble the demand pack — payments, the insured's excess, evidence and the governing terms.
09
Retain what was read, the dates relied on, the bars checked and the handler's own decision.
→Product statement
The agent identifies recovery potential and assembles the file. Whether to pursue belongs to a recovery handler, and no demand, no arbitration filing, no negotiation and no settlement is made by the agent — on any tier and in any configuration.
Example workflow
One claim file, end to end
AgentHuman
1Claim file readA claim at payment, at closure or on a periodic sweep, with the payments, documents and parties on it
2Governing terms pinnedThe policy wording, the contracts behind the loss and the statute for that jurisdiction and claim type, with the date read
3Responsible party identifiedThe third party the file points to, and the liability the evidence in the file actually supports, cited to source
4Bars and limitation checkedWaiver, anti-subrogation, made-whole and line-specific bars run, and the limitation date computed with the days left on it
No human action required
Stages 1 to 4 run without a person in the loop — the reading, the bar checks and the limitation date are finished before a handler opens the file. Nothing has been demanded.
5DecisionSplits on whether anything in the file points to a recovery
No recovery indicated
Carries on down its normal claim path.
A recovery, or a bar, appears
Goes to a recovery handler, unpursued.
Recovery handler
Reads the file themselves, decides whether to pursue, and chooses the forum and the wording of any demand.
Pursue · Decline · Send back
Declined — handed back▼
6Handler outcome recordedPursue, decline or send back, in the handler's own words, under their name, with the limitation date attached
7Outcome evaluatedRecall against recoveries handlers found unaided, flag timeliness, false referrals, bar detection and pack completeness, by line and jurisdiction
Handler outcomes
Every file a handler declines, and every recovery they found without it, is counted.
What should not run autonomously
Human approval stays in control
Outside the boundary — human approval required8 items
Issuing a subrogation demand to anyone.
Filing inter-carrier arbitration or court proceedings.
Negotiating, compromising or settling a recovery.
Waiving, releasing or abandoning a recovery right.
Automation boundaryAgent acts unaided
✓Pin the wording, the contracts and the statute that govern the loss.
✓Name the third party the file points to, and cite what supports it.
✓Date the limitation period and count the days left on it.
✓Assemble the demand pack from records the file already holds.
Write actions run only inside the approval boundaries agreed during implementation. A demand is not one of them — a recovery handler issues it under their own authority, and the limitation date is theirs to diary.
Concluding that a bar or waiver applies.
Closing a claim file to recovery.
Dropping the insured's excess from a demand.
Changing the recovery-scoring rules or thresholds.
Example output
One claim file, annotated
Everything the agent marks is attached to the record and the clause it was read from.
Subrogation output · single claim fileIllustrative example
Claim
Contracts
Third party
Limitation
Confidence
Demand
Commercial property, paid
Two, dated
Contractor on site
Dated, not expired
87%
None — handler's
As receivedThe file as it stands and the contracts behind the work, read at their own dates rather than the loss notes.
Evidence usedPayment ledger and excessSigned works contractCause-of-loss report
Why it stays openThe works contract waives subrogation, but only so far as the property policy pays.
ActionPursueDeclineSend back
What the score decidesHow hard the handler should look for a bar the agent missed, not whether to pursue.
Value
Where AI adds value
The same four claims, placed at the point in the workflow where each one applies.
Where the value landsValue 01 – 04
Every paid claimFrom claims, payments and closure
03Bars & limitation
Read the terms that decide it
The policy wording, the lease, works contract or service terms behind the loss, and the statute for that jurisdiction and claim type — read at their own dates and stamped.
01Approved path
Catch it while there is time
The limitation date is computed when the claim is paid, from the insured's own cause of action — not when someone reaches the file.
02Human review
Put the bar in front of a person
A waiver in the contract, an anti-subrogation problem or a made-whole question is handed over as something to decide — never used by the agent to close a file quietly.
04Build an evidence trail
Retain the wordings and contracts read, the limitation date and its basis, the bars checked, the handler's own decision and what came back — on both paths.
Integrations
Typical integrations
Five system groups connect to the same agent. Which of them are in scope is decided in discovery.
Claims & policy adminGuidewire ClaimCenter · Duck Creek Sapiens · payment and closure APIs
Recovery case managementSubrogation case systems · queues Limitation diaries · finance ledger
A score that learns to skip small or uninsured third parties is a proxy for whose excess comes back, and a few jurisdictions carry most of the recoveries never surfaced. Nestack reports performance by slice, not only in total.
Slice performance — reported separately, not only in aggregateIllustrative example
Slice
Failure rate
Lift
Lift vs. threshold
Status
Short-limitation jurisdictions
6.3%
3.3×
Review
Public-entity and government losses
5.0%
2.6×
Review
Contract-governed property losses
3.7%
1.9×
Watch
Routine motor, carrier at fault
1.3%
0.7×
Normal
Bar: missed-recovery lift vs. routine motor baseline · scale 0–4.0× · tick marks the 2.0× review threshold2 of 4 slices over threshold
Evidence-linked improvement
A recovery a handler found unaided is a miss
Recall is measured against the recoveries your handlers found without the agent, and against the categories the scoring quietly stopped surfacing.
Improvement cycle · five stagesSwitchback — the path turns at Improve and returns at Learn
01Detect
Recall, flag timeliness or false-referral rate moves in a slice.
02Diagnose
Traced to the sweep, the terms read, a bar test or the score.
03Improve
The rule, source or threshold is changed, re-approved by the recovery lead and version-linked.
04Verify
Re-run against held-out files, including every recovery a handler found unaided.
05Learn
The missed file becomes a regression case with its limitation date marked.
Learn → DetectThe return edge. Every scoring change is re-run against the categories it could drop — a cohort that goes quiet stops the change from shipping.
Typical build scope
Twelve workstreams across six weeks
The build scope read against the delivery timeline. Week structure follows the six-week plan — discovery, rule and jurisdiction mapping, limitation logic and bar tests, evaluation, handler workflow, then production validation and handover.
WorkstreamWeek 1Week 2Week 3Week 4Week 5Week 6
01Workflow discovery and automation-boundary definition.
02Recovery-rule and jurisdiction mapping.
03Claims, policy and payment-ledger integration.
04Limitation logic by jurisdiction and claim type.
05Contract and wording retrieval scoping.
06Waiver, anti-subrogation and made-whole tests.
07Demand-pack format sign-off with handlers.
08Excess completeness and finance reconciliation.
09Forum and arbitration routing rules.
10Recall, timeliness and cohort-slice evaluation.
11Case management and legal-panel handover.
12Observability, deployment and Agent Care handover.
12 workstreams · 6 weeks · bar shows the weeks a workstream is active — several run in parallelFinal scope and sequence confirmed in discovery
Engagement tiers
What each tier includes
Rows are the capabilities named in each tier's scope. Higher tiers include everything below them.
Capability✓ in scope · — not at this tierPilotOne line, one jurisdictionProductionProduction recovery integrationAdvancedMulti-line / multi-jurisdiction
Introduced at Pilot
Recovery screening and scoring✓✓✓
Limitation dating and flagging✓✓✓
Waiver and bar checks✓✓✓
Demand pack for handlers✓✓✓
Handler pursuit gate✓✓✓
Baseline and cohort-recall evaluation✓✓✓
Introduced at Production
Claims and recovery case integration—✓✓
Excess completeness reporting—✓✓
Observability and audit trail—✓✓
Introduced at Advanced
Forum routing and arbitration support——✓
Multi-jurisdiction and enterprise controls——✓
Build priceFrom $5,000From $8,000Custom quote
Final build priceConfirmed after discovery based on the lines and jurisdictions in scope, the wording and contract sources read, claims and recovery-system integrations, claim volume, handler workflow controls and deployment requirements.
Separate from buildBuild pricing is separate from recurring Agent Care, which covers managed monitoring, evaluations, incidents and verified improvements after launch.
What we need from you
What you bring, and what we build with it
Each input maps to a piece of build scope and a week in the delivery timeline.
You bringWe build with it
01The lines, jurisdictions and claim types in scope→Workflow discovery and automation-boundary definitionWeek 1
02Your recovery rules and the bars you already apply→Recovery-rule and jurisdiction mapping, and the limitation logicWeek 2
03Access to claims, policy admin and the payment ledger→Guidewire or Duck Creek, and your recovery case systemWeek 2
04The contracts, leases and wordings behind your losses→Contract retrieval scoping and the waiver and bar testsWeek 3
05Real files, including recoveries your handlers found late→Evaluation suite, regression cases and failure-mode testingWeek 4
06Named recovery handlers and a recovery lead→Handler workflow, pack format and recall trackingWeek 4
07Your policy on excess recovery and who may issue a demand→Excess completeness checks, the handler gate and the audit trailWeeks 5–6
Nothing else is requiredDeployment, documentation and Agent Care handover are ours.
Delivery timeline
Four phases across six weeks
Phases are drawn over the weeks they actually occupy. Nothing is demanded in any of them; week 5 measures recall against the recoveries your handlers found.
PhaseW1W2W3W4W5W6
DiscoveryW1
BuildW2 – W3
EvaluateW4 – W5
Pilot & LaunchW5 – W6
Week focusW1Lines and jurisdictions in scope; who may issue a demandW2Limitation logic, claims, policy and payment-ledger integrationW3Contract retrieval, the bar tests and the demand-pack formatW4Handler workflow, evaluation suite, cohort slices and failure-mode testingW5First live packs, recall measured against handler-found recoveriesW6Handlers work live files from agent packs, then handover
Reading the bandRecall in week 5 is measured against files your handlers worked in the same period, not a retrospective sample. Each bar covers its own weeks only.
At the end of W6Handlers have worked live files from agent packs, and every demand in that period was issued by a handler under their own authority.
DurationSix-week plan shown · typical delivery 4–6 weeks depending on scope confirmed in discovery.
Next step · Insurance AI agent
Build a subrogation agent around the recovery team you already have.
Show us how a paid claim gets looked at for recovery today, the jurisdictions and claim types you work across, and who may issue a demand. We'll date the limitation period on a week of your own closed files and show you every recovery that was already out of time.
