Health

Additional Benefits Agent

The answer lies not in the law but in the statutes of this particular fund.

Answers what this fund pays, from its own statutes.

Open agent
Public administration

Four processes that take up the most time today

Developed in Germany · Hosted in the EU

Developed in Germany · Hosted in the EU or on-premises

Delivered together with

STACKIT Sovereign hosting in Germany, single-tenant from the first user.
Rödl Legal, tax and compliance expertise for legally sound deployment.
4P Consulting Advisory and implementation for the public sector, starting with the AI readiness assessment.

One question, three places to look, and in the end the answer still does not hold up.

Questions about additional benefits reach customer service every day. The person answering searches the statutes, the benefits manual and an old email, because someone once settled the same point there. If a condition is still unclear, the case goes to benefits case handling and comes back the next day.

1questionDoes the fund pay for the prevention course and, if so, up to what amount?
3places to lookThe statutes, the benefits manual and that old email are opened one after another.
2conditionsThe number of courses per calendar year and the provider's certification are attached to the benefit.
1follow-up queryIf a condition is still unclear, the case goes to benefits case handling.

If the answer, including the cap and condition, is given in the first call, up to 60% of follow-up queries disappear.

The reduction of up to 60% in follow-up queries is this agent's headline figure. The places to look, the conditions and the follow-up query trace a typical enquiry at a fund; they were not counted.

Three steps through the process.

The agent states the cap and condition and cites the provision in the fund's own statutes; in an individual benefit case, the decision stays with the case handlers.

Match the question to the provision in the statutes

The agent recognises which additional benefit is meant and finds the provision in the fund's own statutes. It cites the section and subsection.

Case 2026-09-114, prevention courses, Section 11(2) of the statutes

State the cap and conditions

The agent states the maximum amount and the number of courses per calendar year. It names every condition attached, one by one.

2 courses a year, up to 100 euros per course, certified provider

Hand over the answer with its source

The agent files the answer in the case together with the provision in the statutes. Customer service passes it on during the call.

auskunft_2026-09-114.pdf citing Section 11(2) of the statutes

What the agent does not do.

It does not approve benefits.

It says what the statutes provide. Benefits case handling decides the individual case.

It does not assess medical facts.

Whether a benefit is indicated in a given case is not part of its answer. That remains the responsibility of benefits case handling.

It only knows the version of the statutes that has been loaded.

After an amendment to the statutes, it keeps answering from the old version until the new one is stored.

Connected systems

  • Statutes database
  • policy administration system
  • service centre CRM

Operations

  • Deployment modelEU cloud, private cloud or on-premises
  • Data processingGDPR-compliant, no model training on your data
  • Responsible teamsCustomer service, benefits case handling

The questions that come up before the first meeting.

How quickly is the Additional Benefits Agent ready to use?

A pilot typically runs on your own data within 4 to 6 weeks. The agent connects to your existing systems rather than running as a separate, parallel environment.

Where is the data processed?

EU cloud, private cloud or on-premises. Processing is GDPR-compliant and models are never trained on your data. Details in the Trust Center.

Where does the figure “up to 60% fewer follow-up queries” come from?

It is based on experience from comparable projects and process benchmarks, not a commitment. We work out the realistic effect for your organisation during the assessment before the pilot.

Related agents.

Intake review, case 2026/04711

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