CD
Claim Denial Decoder
🔵 Stable🕐 updated 2026-07-18
🔷 SkillSpec L3
pm-decoders
Decode an insurance claim denial letter — what the cited reason actually means, whether it's commonly overturnable, and the appeal letter that answers it point by point. Use when someone asks 'my insurance claim was denied what do I do', 'decode this denial letter', 'can I appeal this denial', or 'write my insurance appeal'. Produces the denial decode with overturn-likelihood framing, the evidence checklist, the point-by-point appeal letter, and the escalation ladder past the insurer.
What to give it
▸The denial letter text — the cited reason codes/language, and the stated appeal deadline. No letter yet? First move is requesting the denial in writing with the specific policy basis.
▸The claim story — what was claimed, when, the loss or treatment, and any prior authorizations or adjuster interactions.
▸The policy language — if available — the appeal's strongest sentences quote the policy against the denial.
▸What's already been sent — and what the insurer claims it never received (the classic).
✅ The bar it holds itself to
Every skill in this library self-verifies — these are this skill's own quality checks, straight from its definition.
✓The appeal answers the denial's exact cited words, quoted back
✓Every assertion in the appeal points to an attached document
✓Appeal-odds framing is honest — hopeless denials are named as such with the alternative path
✓The escalation ladder notes which rungs are jurisdiction/plan-dependent
✓All deadlines extracted into one box, with the send-date recommendation inside them
✓The disclaimer line appears verbatim in the artifact
⚠️ What it refuses to do
Do not write an outrage letter — adjusters route anger to the bottom of the pile; evidence moves files
Do not argue grounds the denial didn't cite — answer what was asserted, nothing more
Do not promise overturn odds as percentages — frame as reason-type patterns, not statistics
Do not let the appeal miss its deadline while gathering perfect evidence — file adequate-and-on-time, supplement after
Do not skip the reframe when it's a valuation dispute — "denied" and "lowballed" have different playbooks
Install
npx pm-claude-skills add --agent claude # or codex · cursor · gemini · hermes
# or one-line MCP (every skill, any client):
claude mcp add pm-skills -- npx -y pm-claude-skills-mcpRelated skills
🔌 Embed this skill
Drop this on your blog, docs, or site — it renders a "Run this skill" card:
<div data-pm-skill="claim-denial-decoder"></div>
<script src="https://mohitagw15856.github.io/pm-claude-skills/embed.js" async></script>💬 Discussion
Claim Denial Decoder is one of 599 open-source professional AI agent skills — all SkillSpec L3.
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