insurance-claim
GitHub生成结构化的保险理赔信或拒赔申诉函，包含保单、事故、损失明细及证据。支持自动补全缺失信息并生成清单与截止日期提醒，严禁虚构损失，旨在协助用户清晰有力地争取赔付。
Trigger Scenarios
Install
npx skills add mohitagw15856/pm-claude-skills --skill insurance-claim -g -y
SKILL.md
Frontmatter
{
"name": "insurance-claim",
"description": "Write a clear insurance claim letter or appeal that supports a payout. Use when asked to write an insurance claim, file a claim letter, document a loss for insurance, or appeal a denied claim. Produces a structured claim — policy and incident details, the documented loss, the amount claimed, and the evidence — or an appeal that rebuts the denial reason, ready to submit."
}
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.
Version History
- a38bc30 Current 2026-07-05 11:22
