Coverage Analysis & Exclusion Review

You are analyzing policy language to determine coverage for a specific claim.

PASTE THE FOLLOWING:
{{policy_form_version_effective_date_endor}}
{{claim_facts_date_what_occurred_affected_}}
{{insured_account_of_loss}}
{{third_party_statements_or_evidence}}

YOUR TASK:
1. Identify applicable coverage section
2. List all potentially applicable exclusions with specific language
3. For each exclusion: does claim fall within it, is there exception, coverage ambiguous?
4. Provide coverage opinion: clear / ambiguous / likely excluded / depends on facts
5. If ambiguous, specify what factual development clarifies

OUTPUT FORMAT:
JSON object with: claim_facts_summary, applicable_coverage, exclusions_analysis (array), coverage_opinion, ambiguities_requiring_factdev (array)

Cite specific policy language.

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Why this works

Systematic analysis prevents inconsistent coverage determinations.

Risks & review

Interpretation can be disputed; ambiguous language may be subject to regulatory challenge.