# Coverage Gap Map is an insurance MCP. AI Agent Connect

> Coverage Gap Map connects your AI agent to insurance policy data. It lets your agent check specific expenses against policy clauses, limits, and exclusions. You can use it to monitor category caps, verify incident eligibility, and pull together final adjuster reports without manual cross-referencing.

## Overview
- **Category:** finance
- **Price:** Free
- **Endpoint:** https://edge.vinkius.com/vk_preview_iO20HgQjeB7JzMKhvWjPooh5dV9pW53yXZO6et0m/ai-agent-connect
- **Tags:** insurance, claims, policy, coverage, audit

## Description

You can stop manually hunting through policy documents to see if a claim fits. This MCP gives your AI client direct access to policy clauses and expense data. When you feed a list of expenses to your agent, it compares every line item against the specific limits and exclusions in the policy. It catches when a requested amount hits a category cap or when an incident falls under a specific exclusion. Instead of spending hours auditing claims, you let your agent do the heavy lifting of matching data points. It identifies exactly where a claim stands, which items are covered, and where the gaps are. This makes the transition from raw expense data to a finished adjuster report much faster.

## Tools

### analyze_expense_coverage
This tool checks if specific expenses are covered under the policy terms.

### generate_claim_action_summary
This tool aggregates all findings into a high-level report for adjusters.

### identify_policy_limit_violations
This tool monitors whether total requested amounts exceed established policy caps.

### validate_incident_eligibility
This tool determines if a specific incident is excluded by the policy language.

## Prompt Examples

**Prompt:** 
```
Analyze these expenses against the policy: items: [{'itemId': '1', 'description': 'Water damage repair', 'amount': 500}], policy: [{'clauseId': 'C1', 'clauseText': 'Covers water damage', 'type': 'coverage', 'limitAmount': 1000}], incident: 'Pipe burst in kitchen'.
```

**Response:** 
```
The expense for water damage repair is covered under clause C1.
```

**Prompt:** 
```
Check if the total for 'Mitigation Cost' exceeds the limit of 500. Expenses: [{'itemId': '2', 'category': 'Mitigation Cost', 'amount': 600}].
```

**Response:** 
```
The total requested amount of 600 for Mitigation Cost exceeds the limit of 500 by 100.
```

**Prompt:** 
```
Is a claim for 'Flood damage' eligible if the policy excludes 'Natural disasters'?
```

**Response:** 
```
No, the claim is not eligible because flood damage falls under the natural disasters exclusion.
```

## Capabilities

### Expense Matching
Your agent compares individual line items to policy clauses.

### Limit Monitoring
The agent flags when requested amounts exceed category caps.

### Exclusion Checking
Your agent verifies if an incident is barred by policy language.

### Report Generation
The agent compiles findings into summaries for adjusters.

## Use Cases

### Claim Auditing
Verify that every expense submitted in a claim is actually covered by the policy.

### Limit Enforcement
Check if a claimant is asking for more money than their category limits allow.

### Eligibility Verification
Confirm an incident is not excluded before proceeding with a claim.

### Adjuster Reporting
Turn a set of analyzed expenses into a clean summary for final review.

## Benefits

- Automates the comparison between expense data and policy text.
- Flags limit violations without manual calculation.
- Identifies policy exclusions automatically.
- Produces adjuster-ready summaries from raw data.

## How It Works

You connect your AI client to the Vinkius hosted MCP and start querying policy data.

1. Connect your AI client to the Coverage Gap Map MCP via Vinkius.
2. Provide your agent with the policy terms and expense data.
3. The agent uses the tools to match expenses, check limits, and verify exclusions.
4. The agent produces a summary or identifies a gap based on your request.

## Frequently Asked Questions

**What does this MCP do?**
It connects your AI agent to insurance policy data to identify coverage gaps, limit violations, and eligibility issues.

**Can I use this with Claude or Cursor?**
Yes, you can use this with any MCP-compatible client like Claude, Cursor, or Windsurf.

**How does it handle policy limits?**
It uses the identify_policy_limit_violations tool to check if requested amounts exceed the caps set in the policy.

**Does it help with claim summaries?**
Yes, the generate_claim_action_summary tool aggregates all findings into a summary for adjusters.

**Do I need to host this myself?**
No, Vinkius hosts and manages the MCP for you. You just connect your client and start working.

**How does the tool identify coverage gaps?**
The tool uses `analyze_expense_coverage` to compare expense descriptions against policy clauses and incident details to find mismatches or exclusions.

**Can I check if I have exceeded my policy limits?**
Yes, the `identify_policy_limit_violations` tool sums expenses by category and compares them against defined policy limits.

**Does this tool handle incident exclusions?**
Yes, `validate_incident_eligibility` checks the incident description against policy exclusions to determine if the claim is eligible.