Available with: Microsoft Copilot Studio
Government scenario: Benefit eligibility agent
Scenario
Use Copilot Studio to create a benefit eligibility agent
Automate benefit eligibility decisions with application of policy rules to citizen application data.
Securely gathers demographics, application fields, and uploads from all citizen touchpoints.

AI Agent
Benefit: Automates data collection from citizen uploads, to ensure every application and document is captured.
Gathers various applicant details (like age, income, and family size) from submitted documents and forms, then cleanses and converts them into a consistent format.

AI Agent
Benefit: Converts submitted documents into a consistent format, to maintain uniform eligibility checks.
Applies a comprehensive set of eligibility rules from a centralized policy knowledge base to the standardized applicant data.

AI Agent
Benefit: Applies a set of predefined eligibility rules to the applicant data, to deliver instant, policy-compliant eligibility decisions.
Scores and Identify borderline cases and suggest alternatives along with Storing audit logs of rule logic applied for every determination.

AI Agent
Benefit: Identifies complex cases to get immediate attention and suggest alternatives.
Creates personalized decision letters and provides relevant appeal information based on the eligibility assessment for review.

AI Agent
Benefit: Automates review of Decision Letters & Appeals to improve transparency.
Flags complex or ambiguous applications for manual review by caseworkers or supervisors for human review with full context and audit logs.

AI Agent
Benefit: Filters out resolvable cases and reduces total volume on staff escalations.
1Access Microsoft 365 Copilot Chat at m365copilot.com, or the Microsoft 365 Copilot Chat mobile app and set toggle to “Web”.
2Access Microsoft 365 Copilot Chat at m365copilot.com, the Microsoft 365 Copilot Chat mobile app, or the Microsoft 365 Copilot Chat app in Teams, and set toggle to “Work”.
3AI Agents allow Copilot to access your organization-specific apps. In the past this would have required an API call to get data from a system of record.
The content in this example scenario is for demonstration purposes only. You should evaluate how Copilot aligns with your organization’s business processes, regulatory requirements, and responsible AI principles.
What's next
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