Create intermediate Works with: Any AI

Insurance Denial Letter Decoder and Appeal Outline

Table output Has example

Decode an insurance denial letter and outline the appeal: why the claim was refused and what evidence to send.

The Open buttons send the prompt text as currently shown below to that site only when you click. Fill in the placeholders first.

[VERIFY] is an editorial flag, not a blank to fill. Wherever the prompt shows [VERIFY], check that item against a reliable source before you use it.

Decode an insurance denial. The denial letter, pasted in full: [DENIAL_LETTER]. My policy summary or key terms I have: [POLICY_TERMS]. My claim documents: [CLAIM_DOCUMENTS]. The deadline in the letter, if any: [APPEAL_DEADLINE].

Return: (1) a plain-language summary of why they say the claim was denied; (2) a table of the policy terms or exclusions they cite, what each means in everyday words, and whether my facts seem to fit or not (without giving legal conclusions); (3) the evidence they say is missing and where I might get it; (4) the appeal steps and deadline as they appear in the letter, with any I should check [VERIFY]; (5) an outline for my appeal letter with headings (my claim, their reason, my response, enclosed evidence, what I ask) and a draft opening paragraph; (6) questions I can ask the insurer to get the file and the reviewer's notes.

Do not tell me whether the denial is right or wrong. Suggest an independent adviser or the insurance regulator for large claims.

I want help, not legal advice. Name no rule I did not supply. Use [JURISDICTION] and [RELEVANT_LAW_OR_POLICY_IF_KNOWN] as given. Point me to a consumer agency. Promise no result.

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Replace each bracketed placeholder with your own details, then paste into Any AI or another assistant.

Why denied: 'water damage from gradual leakage is excluded' (section 4.2).
Plain words: the policy covers sudden bursts, not slow leaks.
Table: Their reason | Policy | My facts | Question
Gradual leak | s.4.2 | pipe burst on 3 Jan, plumber's report says 'split pipe' | Which evidence shows it was gradual?
Appeal outline: my claim; their reason; my response and plumber's report; what I ask. Opening: 'I am appealing the denial dated 20 January because the plumber's report of 4 January shows a sudden split pipe.'