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Write an insurance claim denial or reservation of rights letter

A clear coverage-position letter for an insurance claim that quotes the policy, explains the decision, and preserves rights.

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The prompt

Help me draft a coverage-position letter on an insurance claim. Letter type: [full denial / partial denial / reservation of rights / request for more information] Line of business: [e.g. "homeowners", "commercial general liability", "auto", "commercial property"] Claim facts: [date of loss, what happened, what was reported, what our investigation found] Policy details: [policy number placeholder, coverage form and edition, limits, endorsements] Policy language we rely on: [PASTE the insuring agreement, exclusions, conditions, definitions] State or jurisdiction: [STATE] Draft the letter: 1. Claim identification block (placeholders for insured, claim number, date of loss). 2. A summary of the facts as we understand them, inviting the insured to correct anything wrong. 3. The relevant policy language, quoted exactly. 4. Our position, applying each provision to the facts step by step. For a reservation of rights, state each specific issue reserved - no blanket reservations. 5. What we will do next and any information we need, with a deadline. 6. The insured's rights: appeal or reconsideration, the state insurance department contact, and any state-required notices - marked [CONFIRM state requirements]. Rules: - Quote only policy language I provide; never paraphrase it in a way that changes meaning, and never invent provisions. - Plain, neutral tone. Explain the reasoning so a non-lawyer can follow it. - Flag any fact that seems to cut against our position so we can address it before sending. - Check the letter against state unfair claims practices timing rules. Coverage positions on significant claims should be reviewed by coverage counsel.

Highlighted [brackets] are blanks to replace with your own details.

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What to fill in

  • STATE
  • CONFIRM state requirements

How this prompt is built

This prompt follows the Chain-of-Thought structure (Chain-of-thought prompting). A chain-of-thought prompt asks the model to work through a problem step by step before giving its answer, which tends to help on reasoning, planning and multi-part questions.

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