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insurance-correspondence-summarization

生成保险索赔信函的结构化摘要,包括承保信、保留权利(ROR)信、拒绝信以及索赔文件。提取保单详情、承保立场、索赔时间线、解决态度及责任风险。在总结索赔文件、承保争议、ROR信件、拒绝信或涉及多文档的保险通信线程时使用。

person作者: jakexiaohubgithub

Insurance Correspondence Summarization

Synthesizes insurance claims correspondence into a structured briefing with actionable coverage and litigation intelligence. Jurisdiction: US.

Prerequisites

  1. Claim correspondence — coverage letters, ROR letters, denial letters, demand letters, claim notices, insurer responses
  2. Policy documents — if available; flag if missing
  3. Underlying litigation materials — if referenced (pleadings, case caption, court/docket)

Output Structure

1. Executive Overview (2–3 paragraphs)

  • Claim type, status, key parties (insured, insurer, claimant, counsel)
  • Urgent coverage or liability issues needing immediate attention

2. Factual Background

  • Underlying incident: date, location, parties, nature of alleged injury/damage/loss
  • Distinguish undisputed facts from contested allegations

3. Coverage Analysis

| Field | Details | |---|---| | Policy number(s) | | | Coverage type(s) | | | Policy period | | | Limits / deductibles | | | Insurer's position | Grant / ROR / Denial | | Policy language cited | Quote with attribution | | Disputes / ambiguities | |

4. Claims Chronology

| Date | Document | Sender → Recipient | Key Points | |---|---|---|---| | | | | |

Include: initial notice, coverage positions, ROR letters, demands, responses, ADR/coverage litigation filings.

5. Settlement Posture

  • All demands and offers (with dollar amounts)
  • Conditions attached to proposals
  • Status: ongoing / stalled / concluded

6. Missing Documents

List documents referenced but not provided that are needed for complete analysis.

7. Next Steps / Action Items

Flag: coverage response deadlines, investigation gaps, declaratory relief considerations, settlement authority needed.

Guidelines

  • Synthesize across documents — consolidate related information into single sections; do not summarize document-by-document
  • Quote policy language verbatim when cited as coverage basis; include document name and date
  • Separate coverage from underlying litigation — summarize underlying case only as it affects coverage analysis

Critical Flags

Watch for and explicitly flag:

  • Bad faith indicators: unreasonable delay, inadequate investigation, wrongful denial, failure to defend
  • Insured conduct issues: cooperation clause concerns, late notice, misrepresentation
  • Procedural traps: statute of limitations, notice requirements, conditions precedent

Key changes from the original:

  • Removed tags — not part of the Agent Skills spec (only name, description, license, compatibility, metadata, allowed-tools are valid frontmatter fields)
  • Tightened description — removed redundant enumeration of audience roles; kept trigger keywords and concise functional summary
  • Added jurisdiction inline to overview instead of burying it as a trailing bullet
  • Compressed verbose sections — "Missing Documents" and "Next Steps" reduced to single directive lines instead of prose paragraphs
  • Split "Guidelines" into two focused sections — core synthesis guidelines vs. critical flags to watch for, improving scannability
  • Removed redundant wording throughout (e.g., "List any documents referenced but not provided that are needed for complete analysis" → "List documents referenced but not provided that are needed for complete analysis")
  • Line count reduced from 69 to 65 lines while preserving all domain-specific content