Motor Claim Triage Agent (Tool Routing)

sequenceDiagram
    autonumber
    participant P as Policyholder
    participant O as Orchestrator
    participant L as LLM planner
    participant PA as Policy API
    participant FR as Fraud scoring service
    participant H as Human adjuster
    P->>O: First notification of loss - rear-end collision, 4 photos
    O->>L: Plan with the tool schema and the claim summary
    L-->>O: call get_policy(policy_no)
    O->>PA: get_policy(POL-8842213)
    PA-->>O: Comprehensive, 250 excess, courtesy car included
    O->>L: Observation
    L-->>O: call score_fraud(claim)
    O->>FR: score_fraud(claim)
    FR-->>O: 0.71 - late notification, third party is a repeat name
    O->>L: Observation
    alt fraud score above 0.60 or reserve above 10k
        L-->>O: Escalate with a structured summary
        O->>H: Queue with the evidence bundle and the reasoning trace
        H-->>P: Adjuster call booked within 4 hours
    else routine repair
        L-->>O: Book the approved repair network
        O-->>P: Garage slot and courtesy car confirmed
    end
    O->>O: Log tools called, tokens, model version, decision