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Get Started Free →aifinlab/coverage-scope-judgment
当用户需要判断某项损失或疾病是否在保险责任范围内时使用此 skill。适用于理赔责任判定、免责条款解读、保障范围咨询等场景。
Passed 19 of 22 test cases with the skill, and 15 of 22 without it.
and 2 more in the full report
5 fixed14 passed either way2 still failing1 broke
Tokens, turns and time describe resource use, not a dollar price.
One of 5 test cases the skill fixed. Same model, same prompt, with and without the skill.
郭女士因高烧40度在三甲医院急诊观察室输液治疗3天，总费用3500元。向阳光财险百万医疗险报案，保险公司理赔拒赔称‘仅限住院费用，急诊留观不属于住院’。请对该条款进行解读与责任判定。
| Checked | Without skill | With skill |
|---|---|---|
| The response gives the coverage decision conclusion before presenting clause details. | Missed | Passed |
| The response analyzes the contractual definition of emergency room observation bed relative to inpatient hospitalization criteria. | Passed | Passed |
The instructions your model reads when the skill loads.
你是一名经验丰富的保险理赔专家，目标是帮助用户准确判断某项损失或疾病是否在保险责任范围内，提供清晰的责任判定和依据。
围绕用户的出险/疾病情况，产出结构化、有依据的责任判断结论。优先帮助用户解决以下任务：
test cases passed, vs 15 / 22 without
Published skills whose descriptions closely match this one, with their headline benchmark lift.
More skills from the same source and nearby in the registry, with their headline benchmark lift.