mohitagw15856/insurance-claim

Insurance Claim Skill

Claims get paid faster when they're complete and well-documented: the right policy and incident details, an itemised loss, and the evidence attached. This skill writes that letter — or, for a denial, an appeal that addresses the insurer's stated reason directly — so the adjuster has everything they need to say yes.

Note: this is a drafting aid, not legal, financial, or insurance advice, and it does not guarantee a payout. Coverage, deadlines, and procedures depend on your policy and jurisdiction — read your policy, meet the insurer's deadlines, and consult a qualified advisor for complex or high-value claims. Never misrepresent facts; insurance fraud is a crime.

Working from a brief

Given "file a claim for water damage from a burst pipe", write the full claim anyway — structure it and bracket the specifics (policy number, dates, amounts, itemised losses) to fill in, and list the evidence to attach. Never withhold for missing detail; never inflate or invent losses.

Required Inputs

Ask for these only if they aren't already provided (else bracket to fill in):

• Policy details — insurer, policy/claim number, and policyholder.
• The incident — what happened, when and where, and how it was discovered/reported.
• The loss — what was damaged/lost, itemised, with values/estimates.
• Evidence — photos, receipts, repair estimates, police/incident reports, prior correspondence.
• The claim — the amount claimed and the outcome you want; or, for an appeal, the denial reason given.

Output Format

Insurance Claim Letter

• Header — your details, date, insurer, and a Re: line with the policy/claim number.
• 1. The incident — what happened, when, where, and when it was reported (factual, dated).
• 2. The loss — an itemised list of what was damaged/lost with values/estimates.
• 3. Amount claimed — the total, and how it's calculated.
• 4. Evidence — the documents enclosed/available (listed and referenced).
• 5. Request — the action and timeframe you're asking for, and an offer to provide more on request.
• Close — contact details.

For an appeal, add a section that quotes the denial reason and rebuts it with the policy wording and evidence.

Provide a document checklist and notes on policy deadlines to confirm.

Quality Checks

• [ ] Policy/claim number, dates, and incident facts are precise and consistent
• [ ] The loss is itemised with values, and the claimed amount is shown to add up
• [ ] Evidence is listed and referenced — nothing asserted without support
• [ ] For an appeal, the denial reason is quoted and directly rebutted with policy wording
• [ ] Nothing is inflated, invented, or misrepresented
• [ ] A document checklist and a reminder to confirm deadlines are included

Anti-Patterns

• [ ] Do not inflate or invent losses — it risks the whole claim and is fraud
• [ ] Do not be vague about amounts or dates — itemise and date everything
• [ ] Do not omit or fail to reference evidence — undocumented claims stall
• [ ] Do not ignore the denial reason in an appeal — rebut it specifically with the policy terms
• [ ] Do not present this as legal/insurance advice or guarantee an outcome — flag deadlines to confirm

Based On

Insurance-claim practice — complete incident documentation, itemised evidenced loss, and denial-specific appeals grounded in policy wording.