Appeal a $600 insurance denial and file a state complaint with Claude (partial)
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Prompt Recreated prompt
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My insurance denied a claim for a specialist visit. Here are the policy sections, the EOB and my notes on every call. Explain the gap in plain English, help me build a timeline and draft an appeal.
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Before you start, ask me 1–3 short questions about the details below and wait for my answers. Once I've answered, confirm the plan in one line and run the whole task start to finish. Goal: Appeal a denied health insurance claim with a clear timeline, and prepare a regulator complaint if the appeal stalls. Questions to ask me first: - What was the service, the date, the amount, and the reason given for the denial? - Do you have the plan document, the EOB and any letters? - What deadlines are on the denial letter? Inputs (fill in or confirm): - Denial letter and EOB: [DENIAL / EOB] - Policy sections: [POLICY TEXT] - Call and letter log (date, who, what was said): [LOG] - State: [STATE] - Appeal deadline: [DEADLINE] Rules: - Explain each line of the EOB in plain words and show where it differs from what the policy says. - Build a dated timeline using only my records; mark any gaps. - Describe appeal steps and protections in general terms and say this is not legal advice; point me to my state insurance department to confirm. - Keep letters short, factual and polite, with the claim number on every page. Checkpoint: Show me the timeline and the main argument before drafting any letter, and wait for my corrections. If you get stuck: If my records don't support a point, leave it out and tell me what document would prove it. Verify before you finish: Check every date, amount and claim number in the letters against my documents. Output: A plain-English summary, a timeline table, an appeal letter and, if needed, a draft complaint to the state insurance department. Done when: I have an appeal ready to send by the deadline and a complaint ready if it stalls.
AI tool
Outcome
After a routine specialist visit turned into a denied claim, Brett Chereskin had over $600 at stake. Chereskin pasted the policy sections and the explanation of benefits (EOB) into Claude for plain English, built a dated timeline of every call and letter, and got a read of the appeal steps and protections that might apply ('Not legal advice'). Claude helped draft the appeal. When the insurer's internal appeal stalled, Chereskin and Claude drafted a formal complaint to the state department of insurance in 'a focused hour'. The complaint is filed, but 'I don't know yet how it resolves.'
Evidence: Described by posterThe person describes what happened in words, without screenshots or video.
Known limitations
PartialThe source says it only partly worked, or had a significant problem a person had to deal with.
What went wrong: The complaint has been filed, but the result is still unknown.
Source
- Posted
- by Brett Chereskin
- Last checked
- Method:
- How we verify
https://www.brettchereskin.com/blog/claude-insurance-appeal-regulator-complaint
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