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LLM_Engineering_OLD/week5/knowledge-base/contracts/Contract with National Claims Network for Claimllm.md
Edward Donner e5c3fcab46 Updated Week 5 with November version
2025-11-04 07:26:42 -05:00

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Contract with National Claims Network for Claimllm

Contract Date: April 20, 2025 Contract Number: CL-2025-E-0198 Parties:

  • Insurellm, Inc.
  • National Claims Network Corp.

Terms

  1. Coverage: Insurellm agrees to provide National Claims Network with enterprise access to the Claimllm platform, including white-label capabilities, unlimited claims capacity, advanced fraud analytics, and dedicated infrastructure to support their nationwide claims operations processing over 100,000 claims annually.

  2. Duration: This agreement is effective for a period of 36 months from the contract date, representing Insurellm's longest-term contract commitment to date.

  3. Payment: National Claims Network shall pay custom Enterprise Tier pricing of $35,000 per month for months 1-12, $38,000 per month for months 13-24, and $41,000 per month for months 25-36, totaling $1,368,000 over the contract term.

  4. Service Level Agreement: Insurellm guarantees 99.95% uptime with financial credits for downtime: 5% monthly credit for each hour of unplanned downtime, maximum 50% monthly credit.

  5. Confidentiality: Both parties agree to maintain the highest level of confidentiality regarding proprietary AI models, fraud detection algorithms, claimant PII, and business strategies.

  6. Data Security: Insurellm commits to maintaining SOC 2 Type II compliance, annual penetration testing, and end-to-end encryption for all data at rest and in transit.

  7. Business Continuity: Insurellm provides disaster recovery with 4-hour RTO (Recovery Time Objective) and 1-hour RPO (Recovery Point Objective).

Renewal

This agreement includes a mutual 120-day renewal notice period. National Claims Network receives guaranteed enterprise pricing for renewal equal to or better than new enterprise customers at renewal time. Contract may be extended in 12-month increments with mutual written agreement.

Features

National Claims Network will receive the complete Claimllm Enterprise suite:

  1. Unlimited Claims Processing: No volume restrictions, supporting National's processing of 100,000+ claims annually with scalability to 500,000+ claims as business grows.

  2. White-Label Platform: Complete branding customization including:

    • Custom domain names (claims.nationalclaimsnetwork.com)
    • Branded mobile apps (iOS and Android)
    • Customized email templates and communications
    • Co-branded claimant portals

  3. Advanced Computer Vision: State-of-the-art damage assessment:

    • Auto damage analysis with 95%+ accuracy on repair estimates
    • Property damage evaluation (roofs, siding, interiors, water damage)
    • Medical imaging analysis for injury claims
    • 3D reconstruction from photo sets
    • Integration with all major estimating platforms

  4. Enterprise Fraud Analytics:

    • Real-time fraud scoring on all claims
    • Social network analysis across 10+ years of historical data
    • Dark web monitoring for organized fraud rings
    • Predictive models trained on 5M+ historical claims
    • Link analysis connecting related parties, addresses, and claims patterns
    • Integration with third-party fraud databases (NICB, ISO ClaimSearch)

  5. Complete API Access: Unlimited API calls supporting:

    • Real-time integrations with 50+ carrier policy systems
    • Bi-directional data sync with National's data warehouse
    • Third-party integrations (repair networks, medical providers, legal vendors)
    • Custom automation workflows

  6. AI-Powered Litigation Prediction: Predictive analytics identifying claims with high litigation probability:

    • Attorney involvement prediction (85%+ accuracy)
    • Recommended settlement ranges based on jurisdiction and case law
    • Early intervention recommendations
    • Litigation cost estimation

  7. Catastrophe Claims Management: Specialized tools for major events:

    • Rapid deployment playbooks for natural disasters
    • Geographic clustering and resource allocation
    • Emergency vendor network activation
    • Real-time damage assessment using satellite imagery
    • Mobile claims units with offline capability

  8. Advanced Vendor Management:

    • Network of 5,000+ preferred vendors nationwide
    • AI-powered vendor matching and assignment
    • Real-time capacity management and scheduling
    • Quality scoring and performance analytics
    • Automated vendor payments and 1099 management

  9. Predictive Analytics Suite:

    • Claim outcome prediction and reserve optimization
    • Subrogation opportunity identification
    • Salvage value estimation
    • Customer satisfaction prediction and intervention triggers
    • Cycle time optimization recommendations

Support

Insurellm commits to comprehensive Enterprise-level support for National Claims Network:

  1. Dedicated Success Team:

    • Executive sponsor (VP level) with monthly strategic reviews
    • Dedicated Customer Success Manager with daily availability
    • Technical Account Manager for system optimization
    • Solutions Architect for ongoing innovation
    • Quarterly executive business reviews with CEO participation

  2. 24/7/365 Premium Support:

    • Guaranteed 10-minute response time for P1 critical issues
    • 30-minute response for P2 high-priority issues
    • 2-hour response for P3 standard issues
    • Dedicated support hotline with no phone tree
    • Private Slack channel with engineering team access
    • Annual on-site support visits (minimum 4 per year)

  3. Comprehensive Implementation:

    • 9-month phased implementation program
    • Dedicated project management office (PMO)
    • Executive steering committee with monthly meetings
    • Migration of 3 years of historical claims data
    • Training for 200+ National Claims Network staff
    • Parallel processing period with legacy system
    • Go-live support with on-site Insurellm team (4 weeks)

  4. Training and Enablement:

    • Role-based training programs (adjusters, supervisors, fraud investigators, IT, executives)
    • Train-the-trainer program for National's learning team
    • Certification programs with continuing education credits
    • Annual user conference attendance (3 attendees)
    • Quarterly advanced training sessions
    • Unlimited access to online learning platform

  5. Custom Development:

    • 1,000 hours annually of custom development included
    • Dedicated development team for National-specific features
    • Priority feature requests with guaranteed roadmap inclusion
    • Beta program participation for all new features
    • Input into product strategy and direction

  6. Integration Services:

    • Enterprise integration with National's systems:
      • Policy administration systems (multiple carriers)
      • Data warehouse and business intelligence platforms
      • Financial systems (SAP, Oracle)
      • Document management (SharePoint, M-Files)
      • Communication platforms (Twilio, SendGrid)
    • Ongoing integration support with 4-hour response SLA
    • Quarterly integration health assessments

  7. Analytics and Reporting:

    • Custom executive dashboard development
    • Real-time operational dashboards
    • Automated daily, weekly, and monthly reporting
    • Ad-hoc analytics support (up to 20 requests/month)
    • Industry benchmarking and competitive analysis
    • Predictive modeling consultation

  8. Continuous Improvement:

    • Quarterly process optimization workshops
    • Annual efficiency audits with recommendations
    • Best practice sharing from across Insurellm customer base
    • Innovation labs to pilot emerging technologies (AI, blockchain, IoT)

Signatures:

Jennifer Rodriguez Title: Chief Executive Officer Insurellm, Inc. Date: April 20, 2025

Amanda Richardson Title: President & Chief Operating Officer National Claims Network Corp. Date: April 20, 2025

This agreement represents a strategic partnership between Insurellm and National Claims Network, establishing National Claims Network as Insurellm's flagship enterprise claims processing partner. This contract supersedes all prior agreements and communications.

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