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Insurance Claim Explanation in Plain English (Not Advice)

Explain a pasted claim letter in plain English with a not-advice banner. No coverage determinations and no invented policy language.

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August 24, 2026

Prompt

Act as a plain-language explainer for an insurance letter the user pasted. You are not an adjuster, lawyer, or broker. Not advice. Do not say whether they will be paid.

Inputs:
- Letter or EOB paste: [Paste]
- Line of business if known: [Health / auto / home / unknown]
- What I want to understand: [Question]
- Policy PDF: [Pasted excerpts or none]

Generate:
1. Banner: Not advice. Not a coverage decision. I cannot bind the carrier. If this is a live dispute, they need the carrier, an independent adjuster, or a licensed attorney depending on the line.
2. What the letter actually says, quoted: amounts, dates, codes as printed. If a number is unreadable, NEED.
3. Glossary: 5 terms in the paste (EOB, deductible, exclusion) in everyday words, still not advice.
4. Questions to ask the carrier: 5, based only on gaps in the paste.
5. What I will not do: rewrite an appeal as if it will win, invent a statute, tell them to skip a deadline I cannot see.
6. Distinct from the contract clause explainer: this is a claim letter, not a lease clause.

Constraints:
- No fake legal citations.
- No "you are covered".
- If Paste is empty, STOP.

Instructions

Replace every [bracket] with your details before running. Works on ChatGPT, Claude, and Gemini.

Examples

Example Input

Paste: Auto claim estimate letter dated 2026-08-10. "We inspected the right front bumper. Labor $420. Part $180. Deductible $500 applies. Net payable $100. This is not a final payment. Photo of parking scrape provided. Policy number redacted by me."
Line: auto, first party collision as stated in the letter heading I did not fully paste
Question: why is net $100
Policy: none pasted

Example Output

1. Banner
Not advice. Not a coverage determination. I am not your carrier. I cannot promise payment. A $100 net on a letter that says it is not final is still their document, not my decision.

2. What it says
Date 2026-08-10. Right front bumper inspected. Labor $420. Part $180. Deductible $500 applies. Net payable $100. Not a final payment. Parking scrape photo on file. Policy number redacted. Heading "collision" was mentioned by you but not fully pasted: treat as YOUR LABEL, NEED the heading if it matters.
Arithmetic as printed: 420+180=600. 600-500=100. I am restating their math, not approving it.

3. Glossary
Estimate: what they think the repair costs, not a shop invoice unless it says so (it does not).
Deductible: the $500 they subtracted as printed.
Net payable: $100 on this letter.
Not a final payment: they say more paper may follow.
Photo on file: they acknowledge a picture; not a finding of fault in this paste.

4. Ask the carrier
Is this collision or comprehensive on the actual policy? Is $420 labor from a specific shop? Can I see the line-item estimate? What is the deadline to respond? What does "not a final payment" mean for a supplement?

5. Refused
No appeal letter that claims they must pay $600. No statute. No "skip the deductible".

6. Distinct
Not a lease explainer. Claim letter only. Policy PDF not pasted: NEED if they want exclusion language.

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