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Insurance AI agent · Commission reconciliation

Commission-Reconciliation AI Agent (Carrier Statements)

Match every carrier commission statement line to what the contract says was due, name the shortfalls, overpayments and missing statements, and package the difference — a person approves every adjustment.

Typical delivery
4–6 weeks
Deployment
Your stack
Adjustments
Approver signs
After launch
Agent Care

What this agent does

Finds the difference, moves no money

In

  1. 01

    Take the statement as the carrier sent it — portal export, file, spreadsheet or download — and log what arrived.

  2. 02

    Read the expected side from policy admin: policy, term, premium, and the producer of record on that date.

Reason

  1. 03

    Match each paid line to a policy and a term, through rewrites, mid-term changes, reinstatements and cancellations.

  2. 04

    Recompute what was owed from the commission schedule and the split agreement in force on that effective date.

  3. 05

    Separate a shortfall from a chargeback, a timing difference and a period that never arrived at all.

Decide

  1. 06

    A clean match inside the agreed tolerance closes, logged with the schedule version it cleared against.

  2. 07

    Every difference, unmatched line, missing statement and licensing flag goes to a named approver.

Out

  1. 08

    Package the difference per policy and term: paid, expected, and the clause the expectation rests on.

  2. 09

    Retain the statement as received, the schedule and split version used, and who approved each adjustment.

Product statement

The agent matches, identifies and packages. Every payment, adjustment, write-off and dispute is a named approver's decision, and nothing is released to a producer whose licence and appointment for that business cannot be cleared. A clawback is a decision about someone's earnings — a person makes it, against the agreement it rests on, and it is not applied twice. This page covers commission owed on business already placed; it does not set rates, negotiate schedules or decide what a producer should be paid.

Example workflow

One statement, end to end

  1. 1Statement receivedA carrier statement as it arrived — portal export, file, spreadsheet or download — with the period it covers
  2. 2Expected side assembledPolicies, terms and premium from policy admin, with the schedule and split agreement in force on each effective date
  3. 3Lines matchedEach paid line to a policy and a term, through rewrites, mid-term changes, reinstatements and cancellations
  4. 4Differences classifiedShortfall, overpayment, chargeback, timing difference or a period that never came — each named and quantified

No human action required

Stages 1 to 4 run without a person in the loop — the statement is parsed, the expected side is assembled and every difference is classified before anyone opens the file. Nothing has been paid, adjusted or written off.

5DecisionSplits on whether the match is clean and inside the agreed tolerance
Clean match, inside tolerance

Closes with the versions it cleared.

Any difference or missing line

Goes to a named approver, unresolved.

Commission or finance approver

Takes the pack with paid, expected and the clause behind the difference. Payments, adjustments, write-offs and disputes are theirs alone.

Approve · Adjust · Dispute

Approved — handed back

  1. 6Adjustment recordedOnly what a named approver signed — the ledger entry, the carrier dispute or the producer adjustment
  2. 7Outcome evaluatedMatch rate, discrepancy recall, false differences, licensing coverage and tolerance write-offs, by carrier and format

Approver changes

Every difference an approver reads differently is counted, in both directions.

What should not run autonomously

Human approval stays in control

Outside the boundary — human approval required

8 items

  • Paying, adjusting or clawing back a producer's commission.
    • Writing off a difference outside the signed tolerance.
    • Releasing commission the licensing check cannot clear.
    • Applying a chargeback or reversing a paid entry.

  • Automation boundary

    Agent acts unaided

    • ✓Parse the statement in whatever format the carrier sends.
    • ✓Recompute what was owed from the schedule and split in force.
    • ✓Classify each difference and name the clause behind it.
    • ✓Assemble the pack and route it to a named approver.

    Write actions run only inside the approval boundaries agreed during implementation. The agent may open a case and stage an entry. It may not move money, post an adjustment or release a commission, on any tier or in any configuration, and writes nothing off outside the signed tolerance.

    • Opening or settling a dispute with a carrier.
    • Changing a split, a schedule or a tolerance.
    • Posting a commission adjustment to the ledger.
  • Touching money held in a fiduciary or client account.

Example output

One statement line, annotated

Everything the agent proposes is attached to the statement line and the agreement it was recomputed from.

Reconciliation output · single statement line

Illustrative example
Statement
Monthly, direct bill
Policy
Rewritten mid-term
Producer
Two-way split
Difference
Paid short, one term
Confidence
92%
Adjustment
None — approver's

As received

The statement in the carrier's own format and period, and the policy, term and producer as policy admin holds them.

Checks cleared

  • Matched to the rewritten term
  • Split agreement in force
  • Licence and appointment clear

Why it is short

The rewrite moved the term; the carrier paid on the schedule that applied before it.

What the score decides

Whether the match may close unattended — never whether the carrier owes it.

Action

ApproveAdjustDispute

Value

Where AI adds value

The same four claims, placed at the point in the workflow where each one applies.

Where the value lands

Value 01 – 04

Every carrier statement

From portals, feeds and files

03Schedules & splits

Recompute from the agreement in force

The commission schedule, the split and the override basis that applied on that effective date — not the ones filed today — read at reconciliation time and stamped with their version.

01Approved path

Close the lines that already agree

A line that matches its policy, its term and its schedule closes without anyone opening the statement, and carries the versions it cleared against.

02Human review

Send the difference up with its clause

A shortfall, a double chargeback or a period that never came reaches a named approver with paid, expected and the agreement behind the expectation — never as a number on its own.

04

Build an evidence trail

Retain the statement as received, the schedule and split version used, the difference found, the approver's decision and what the carrier said 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.

  • Policy admin & agency management

    • Guidewire
    • Duck Creek
    • Sapiens
    • Applied Epic
    • AMS360

  • Carrier statements & feeds

    • Carrier portals
    • statement files
    • Commission download
    • ACORD AL3 and XML

  • Ledger, payments & banking

    • General ledger
    • ERP
    • payment rails
    • Trust accounts
    • fiduciary balances

Agent

Commission reconciliation

  • Matches statements
  • Classifies differences
  • Routes for approval

  • Licensing & agreements

    • NIPR and state records
    • appointments
    • Commission schedules
    • split agreements

  • Observability & evaluation

    • OpenTelemetry
    • Langfuse
    • Supported monitoring/evaluation sources

Integration availability depends on the client's existing systems and API access.

Agent controls

Six layers between the model and an adjustment

Each control wraps the one inside it. A match clears every layer before it closes, and nothing that moves money clears them at all.

L6 · Outermost — last line of defence

Inward → L1 · closest to the model

L6Reconciliation trailStatement as received, versions used, decision taken and who signed it.Record
L5Approver gatePayments, adjustments, write-offs and disputes need a named approver.Gate
L4Tolerance registerEvery write-off inside tolerance is listed, counted and read by a person.List
L3Licensing gateNo payee on a split releases without a cleared licence.Block
L2Version pinningSchedule, split and override basis as they stood on that effective date.Pin
L1Source bindingEvery figure tied to the statement line or policy record it came from.Bind
Model coreProposed match — the paid line, the amount expected, the difference and confidence
L1 – L2
Decide whether the match may stand
L3
Keeps money from an uncleared producer
L4
Stops the quiet write-off
L5 – L6
Give the decision a name, and keep it

How Nestack evaluates it

Evaluate the match — and the difference nobody chased.

Coverage runs the whole depth of the workflow, and every layer is cut by slice.

Surface — the pack an approver opens

  1. E1Match evaluationDid each paid line reach the right policy, term and producer?
  2. E2Recomputation evaluationWas the schedule, split and override basis the one in force that day?
  3. E3Discrepancy recallDid it find what a manual reconciliation of the same period found?
  4. E4Licensing coverageWas every payee on a split cleared before anything released?
  5. E5Slice evaluationHow does performance change by carrier, statement format and line?
  6. E6Business outcomeWhat was written off under tolerance, and what a carrier accepted.

Floor — the money that settles, and who it reached

Failure modes

Where each failure originates in the agent

Seven failure modes plotted against the five stages of the agent lifecycle.

Agent lifecycle

Direction of processing →

  1. 01 · Statement intake

    1 mode

    • CR-01

      Rows dropped in a new format

      The export changed shape; the totals still balanced.

    Stage reads

    The statement as the carrier sent it, unchanged

  2. 02 · Matching

    2 modes

    • CR-02

      Wrong term after a rewrite

      Matched to a term the policy no longer has.

    • CR-03

      Chargeback matched twice

      One cancellation clawed back on two statements.

    Stage matches

    Each paid line to a policy, term and producer

  3. 03 · Recomputation

    2 modes

    • CR-04

      Split from a stale agreement

      The producer agreement changed; the old split ran.

    • CR-05

      Override on the wrong basis

      Bonus tier run on written, not earned premium.

    Stage recomputes

    What the schedule and split in force owed

  4. 04 · Difference

    1 mode

    • CR-06

      Closed under tolerance

      A real shortfall small enough that nobody read it.

    Stage packages

    The difference an approver opens, and its clause

  5. 05 · Release

    1 mode

    • CR-07

      Cleared on a lapsed appointment

      Licence checked at match, not again at release.

    Stage tracks

    What was approved, written off, disputed, by whom

  • Sev-1 · a producer or a carrier is paid wrong
  • Sev-2 · a real difference never surfaces
  • Sev-3 · the pack is wrong, an approver catches it
See the complete Insurance failure-mode catalogue

Affected slices

A tolerance decides who absorbs the difference

A tolerance set as a flat amount rather than a proportion writes off hardest against the smallest producers, the newest agencies and anything billed in another currency. Nobody chose that; a threshold did. Nestack reports performance by slice, not only in total.

Slice performance — reported separately, not only in aggregate

Illustrative example
SliceFailure rateLiftLift vs. thresholdStatus
Carriers that changed format5.9%3.6×Review
Cross-border and multi-currency4.1%2.5×Review
Split and sub-broker business3.1%1.9×Watch
Single-producer direct bill1.2%0.7×Normal

Bar: missed-difference lift vs. single-producer direct-bill baseline · scale 0–4.0× · tick marks the 2.0× review threshold

2 of 4 slices over threshold

Evidence-linked improvement

Carriers reject differences; the match is what failed

When a carrier sends one back, the fault is usually the term it was matched to or the schedule version it was recomputed from — not the amount.

Improvement cycle · five stages

Switchback — the path turns at Improve and returns at Learn

  1. 01

    Detect

    Match rate, recall or write-off volume moves on one carrier.

  2. 02

    Diagnose

    Traced to the format, the match, the version pinned or the tolerance.

  3. 03

    Improve

    The parser, the matching rule or the tolerance is changed, re-signed by finance and version-linked.

  4. 04

    Verify

    Re-run against held-out statements, including every rejected difference.

  5. 05

    Learn

    The rejected difference becomes a regression case with its clause attached.

  6. Learn → Detect

    The return edge. Every cycle re-reads the tolerance itself — a threshold that quietly widened, or a write-off nobody put their name to, goes to finance before anything else ships.

Typical build scope

Twelve workstreams across six weeks

The build scope read against the delivery timeline. Week structure follows the six-week plan — discovery, statement and agreement sourcing, matching and recomputation, evaluation, ledger integration, then production validation and handover.

Workstream

Week 1Week 2Week 3Week 4Week 5Week 6

  1. 01Workflow discovery and automation-boundary definition.Week 1
  2. 02Carrier and statement-format inventory.Week 1, Week 2
  3. 03Policy-admin and agency-management APIs.Week 1, Week 2
  4. 04Statement parsing and change detection.Week 2
  5. 05Schedule, split and override modelling, pinned by date.Week 2, Week 3
  6. 06Policy, term and producer matching rules.Week 3
  7. 07Chargeback, reversal and timing logic.Week 3, Week 4
  8. 08Licensing and appointment validation.Week 3, Week 4
  9. 09Tolerance policy, register and approval routing.Week 4
  10. 10Match-rate and discrepancy-recall testing.Week 4, Week 5
  11. 11Ledger, payment and dispute-pack integration.Week 5, Week 6
  12. 12Deployment, documentation and Agent Care handover.Week 6

12 workstreams · 6 weeks · bar shows the weeks a workstream is active — several run in parallel

Final 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 carrier, one formatProductionLive reconciliationAdvancedMulti-carrier / multi-entity
Introduced at Pilot
Statement parsing and normalisation✓✓✓
Policy, term and producer matching✓✓✓
Difference classification and pack✓✓✓
Draft mode — nothing is adjusted✓✓✓
Baseline evaluation✓✓✓
Introduced at Production
Schedule and split modelling by date—✓✓
Licensing and appointment validation—✓✓
Tolerance register and approval routing—✓✓
Ledger and payment integration—✓✓
Introduced at Advanced
Overrides, contingents and bonus tiers——✓
Multi-currency and enterprise controls——✓
Build priceFrom $5,000From $8,000Custom quote
Final build price
Confirmed after discovery based on the carriers and statement formats in scope, the policy-admin and ledger systems involved, schedule and split complexity, statement volume, the tolerance and approval controls agreed, and deployment requirements.
Separate from build
Build 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.

  1. 01The carriers, statements and periods in scope

    Workflow discovery and automation-boundary definition

    Week 1

  2. 02Real statements in every format they arrive in

    Statement parsing and format-change detection

    Week 2

  3. 03Access to policy admin or the agency system

    Policy, term and producer matching rules

    Week 2

  4. 04Commission schedules, split and override agreements

    Schedule, split and override modelling, pinned by date

    Week 3

  5. 05Your licensing and appointment source of record

    Licence and appointment validation before any release

    Week 3

  6. 06A period you reconciled by hand, differences and all

    Evaluation suite, discrepancy recall and regression cases

    Week 4

  7. 07The named approver, and the tolerance they will sign

    Tolerance register, approval routing and the audit trail

    Weeks 5–6

Nothing else is required

Deployment, 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 paid or adjusted before week 6; reconciliation runs on a period you have already closed.

Phase

W1

W2

W3

W4

W5

W6

  1. DiscoveryW1
  2. BuildW2 – W3
  3. EvaluateW4 – W5
  4. Pilot & LaunchW5 – W6

Week focus

W1Carriers, formats and who may approve an adjustment

W2Statement parsing, policy-admin access and the expected side

W3Schedules, splits, chargebacks and licensing validation

W4Evaluation suite, recall testing and the tolerance policy

W5Ledger and payment integration, in draft — nothing posts

W6First approved adjustments inside the signed tolerance, then handover

Reading the band
Bars span only the weeks their work is named in. Draft running in week 5 is real — the agent proposes adjustments and posts none.
At the end of W6
Adjustments have been posted only where a named approver signed them, and every release cleared the licensing check.
Duration
Six-week plan shown · typical delivery 4–6 weeks depending on scope confirmed in discovery.

Next step · Insurance AI agent

Reconcile the statement before you argue about the money.

Show us a month of carrier statements in the formats they actually arrive in, the schedules and splits behind them, and who may approve an adjustment. We'll reconcile that month beside your own numbers and show you every line where the two of us disagree.

Typical delivery
4–6 weeks
Deployment
Your agency and finance stack
Adjustments
Approved one by one
After launch
Agent Care available

Nestack Agents · Commission reconciliation & disputes

AGT-INS-12 · Agent Care available after launch

Build a commission-reconciliation agent

Four questions so the call starts from your actual setup — then pick a time that suits you.

About you
Your setup

No obligation. We’ll map the workflow, name the automation boundary and tell you if an agent is the wrong answer.