Health

Benefit Decision Agent

If someone mixes up the law, guidelines and statutes, the reasoning will not stand up to an objection.

Keeps the law, guidelines, the fund's statutes and procedural law cleanly apart.

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.

Four levels per case, and each one lives in a different source.

The application is in the specialist application, the entitlement provision in the law, the interpretation in the guideline, the supplement in the fund's own statutes. The case officer opens four sources, keeps the dates and versions straight and writes the reasoning from them. If the case comes back as an objection, the same ground is covered again, often by someone else with a different reading.

4legal levelsThe law, guidelines, statutes and procedural law all apply to the same benefit case.
2versionsGuideline and statutes exist in different versions, and the case belongs to one of them.
35 minutesof looking up per caseMost of it goes on assigning each reference to its level.
2reviews of the same caseOnce in the benefits unit, then again in the objections unit.

With the four levels separated and set side by side with references, review effort falls by 55%.

The 55% reduction in review effort is this agent's headline figure. Four levels, two versions, the time spent looking things up and two review rounds describe a typical case in a benefits unit; they are illustrative, not measured.

Three steps through the process.

The benefits case officer decides the benefit case; the agent only separates the four legal levels and presents the derivation with references.

Separate the four legal levels

The agent reads the case and assigns every relevant provision to its level. For each provision it records the reference and the version.

Reference list for case LE-2026-3318, 9 provisions across 4 levels

Derive the entitlement step by step

The agent puts the review steps in the order in which they depend on each other. Where one level restricts another, it says so.

Derivation in 6 review steps, step 4 refers to the statutes as at January 2026

Submit the decision paper for signature

The agent compiles the derivation, references and open points into a decision paper. It goes to the benefits case officer for signature.

entscheidungsvorlage_LE-2026-3318.docx, 3 pages, 2 open points

What the agent does not do.

It does not decide the benefit case.

It presents the derivation with references. The benefits case officer signs approvals and rejections.

It does not decide which level prevails in case of doubt.

If the guideline and the statutes diverge, it sets out both readings side by side with references. The specialist decides which applies, and in case of doubt the objections unit.

It cannot see a legal source that is not connected.

An amendment to the statutes that has not yet been loaded does not appear in the derivation. At every reference, it shows which version was loaded.

Connected systems

  • Benefits specialist application
  • guidelines database
  • document management

Operations

  • Deployment modelEU cloud, private cloud or on-premises
  • Data processingGDPR-compliant, no model training on your data
  • Responsible teamsBenefits case officers, objections unit

The questions that come up before the first meeting.

How quickly is the Benefit Decision 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 “55% less review effort” 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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