Use case · Coverage

Paid outside the policy. Quietly, and often.

Mysa checks every claim against the policy — in force, peril, limits and exclusions, against the actual wording — and hands the adjuster a coverage position with the clauses it rests on.

See how →
Check a batch of your own claims · first pass on us
On this claim
1
Check the policy
Confirm it’s in force and pull the wording into Coverage.
2
Match the loss to the wording
Test the peril against covered perils and exclusions.
Research agent — Pull the endorsements and prior positions into Coverage.wording.
3
Hand over the position
Write the coverage position and the clauses into Coverage, ready for the adjuster.
Suggested by your decision graph
Re-open the coverage call before you deny.
Source this exclusion was waived on 6 comparable losses under the same endorsement.
Why denying here contradicts your own book — no single file flags the inconsistency.
Adjuster deskLIVE
ReadDecideWordingReasoning
Automated · agentsYour call

In-force, perils and limits ran on their own, against the actual wording. What’s left is your call.

Coverage readiness
Policy in force
Within period · premium current
Peril covered
Rear-end · within scope
Exclusion to review
Wear-and-tear clause may apply · your eyes
Limits applied
Within limit · $500 deductible
Next actions queued
Confirm position · notify insured
Loss date is one day inside the policy period. Confirm before you pay.
Matched the loss to clause 4.2 · exclusion 7 checked.
Position ready

A claim paid outside the policy never looks wrong.

Coverage is careful, clause-by-clause work — exactly what gets compressed on a busy desk. Skip it and you pay what you didn’t owe, or deny what you did.

CV-3301in force · covered—
CV-3302exclusion missed · overpaidmisread
CV-3303in force · covered—
CV-3304out of period · shouldn’t have paidmisread
CV-3305in force · covered—
CV-3306in force · covered—
How it works

The loss, matched to the wording that governs it.

In-force, perils, limits and exclusions — read against the actual policy language, not a summary.

Every claim, against the wording

In force, peril, limits and exclusions checked against the actual policy language — not a summary.

Check
In force
Peril covered
Within limit
Checked, not guessed

The position, with the clauses

The adjuster gets the coverage position and the clause it rests on, so it’s defensible — not a hunch.

Source
Clause 4.2 cited
Exclusion 7 checked
Limit applied
Position sourced

You make the call

Mysa produces the position and the wording behind it; the decision to pay or deny stays with your team.

Decide
Coverage position ready
Clauses attached
Your sign-off
The call stays yours

Starts with your policies. Sharper every file.

Reading wording well is a skill that takes years. Mysa encodes it and keeps learning.

Day one Your wordings, encoded
Your policy forms, endorsements and exclusions, applied from the first file.
Every call Their reading, captured
Every position your team confirms is remembered with the clause it rested on.
Over time Reads like your best coverage hand
It matches the loss to the wording the way your seniors would — and it stays.
Day oneEvery callOver time
On your terms

Your files. Your call.

Sovereign by design

Your cloud, on-prem, or your VPC. Policies and claims never leave your environment.

Your team keeps the call

Mysa produces the position; the decision to pay or deny stays with a human.

Defensible by construction

Every position cites the clause and facts it rests on, logged for a dispute.

Common questions

What is coverage verification?

Confirming a claim is actually covered — that the policy is in force, the peril is covered, and the loss falls within the limits and outside the exclusions — before it’s paid. Coverage verification

How does Mysa verify coverage?

It checks each claim against the policy period, the covered perils and exclusions in the actual wording, and the applicable limits and deductibles, then hands the adjuster a position with the clauses it rests on.

Does Mysa deny claims on its own?

No. It produces the coverage position and the clauses behind it; the adjuster makes the decision. The final call stays human. Human in the loop