Claim File Checklist

---
name: claim-file-checklist
description: "Organize a claim file so a handler can see facts, documents, and open questions. Use when the user mentions claim file, insurance claim checklist, FNOL file, claims documentation, or asks for a claim file checklist. Insurance operations skill by Yasir Jilani."
license: MIT
compatibility: Agent Skills standard. No network access, extra packages, or credentials required.
metadata:
  author: Yasir Jilani
  version: "1.0.0"
  domain: insurance
---

<!-- GENERATED FILE - edits here are overwritten by scripts/generate.py.
     Edit the 'claim-file-checklist' entry in source/, then run:
       python3 scripts/generate.py && python3 scripts/validate.py
     See CONTRIBUTING.md. -->

# Claim File Checklist

Organize a claim file so a handler can see facts, documents, and open questions.

## When to use this skill

Use this skill when the user:

- claim file
- insurance claim checklist
- FNOL file
- claims documentation

## When not to use this skill

- Claims fraud
- Inflating a loss

## Professional boundary

This is not coverage advice and not a claim determination. Do not tell anyone they are covered. Organize facts for a licensed professional.

## Operating boundaries

- Use only information the user provides or files they explicitly ask you to read. Do not invent metrics, laws, citations, prices, credentials, or clinical facts.
- Do not ask for passwords, API keys, tokens, seed phrases, one-time codes, or payment card data.
- Do not send data to an external service, install packages, or add network calls as part of this skill.
- Separate facts, assumptions, and recommendations. If a required input is missing, state the assumption or ask one focused question.
- If the user asks you to deceive a person, evade a control, forge a record, or cause harm, stop. Offer a legitimate alternative.
- Work product that affects money, employment, health, safety, or legal rights is a draft for a qualified human to review before it is used.

## Inputs to collect

- The reported facts
- Documents on hand
- The policy form they have
- The handler

## Workflow


### 1. Step 1

Record facts separately from opinions.
### 2. Step 2

List missing documents.
### 3. Step 3

Do not decide coverage.
### 4. Step 4

Do not coach anyone to inflate a loss or omit a material fact.
### 5. Step 5

Note the next handler action and date.
### 6. Step 6

Minimize sensitive data in summaries.

## Output

Deliver a **claim file checklist**.

- Purpose of this claim file checklist, in two sentences.
- Facts the user supplied, listed separately from assumptions.
- The work itself, in the structure the workflow names.
- Open questions, risks, and the single next action with an owner.
- What a qualified reviewer still needs to confirm, if the domain is regulated.

## Quality bar

- Every number, date, name, and citation came from the user or is marked as an assumption.
- The artifact can be used without reading this skill again.
- Recommendations are specific enough that someone could accept or reject them.
- Boundaries were respected: no credentials requested, no unsupported professional claim, no deception.

## Example

### Scenario

Priya Shah, controller at Northline Studio in Calgary, needs a claim file checklist by 30 September 2026. A customer asks how to describe the loss so the payout is higher than the damage.

### Example data

```text
From: Priya Shah, controller
Organization: Northline Studio, Calgary
Date: 14 September 2026
Needed by: 30 September 2026

A customer asks how to describe the loss so the payout is higher than the damage.

The reported facts: one file, dated 14 September 2026. No earlier version attached for comparison
Documents on hand: one PDF, 2 pages, dated 14 September 2026
The policy form they have: their one-page rule dated 2 Mar 2026. No exception log
The handler: Claim file 8841, recorded 14 September 2026. No supporting file attached
```

### Example outcome

**Claim file checklist**
Northline Studio · 14 September 2026 · Due 30 September 2026

**Decision**
Refuses the inflation and lists the facts the handler still needs.

**Checklist**

- [x] **The reported facts** — one file, dated 14 September 2026. No earlier version attached for comparison  
      Evidenced in the file
- [x] **Documents on hand** — one PDF, 2 pages, dated 14 September 2026  
      Evidenced in the file
- [x] **The policy form they have** — their one-page rule dated 2 Mar 2026. No exception log  
      Evidenced in the file
- [ ] **The handler** — Claim file 8841, recorded 14 September 2026. No supporting file attached  
      Open — nothing in the file closes this

**The gates this list enforces, in order**

1. Record facts separately from opinions
2. List missing documents
3. Do not decide coverage
4. Do not coach anyone to inflate a loss or omit a material fact
5. Note the next handler action and date

**Deliberately not done**
- A coverage determination.
- Inflated loss advice.
- Omitted material facts.

**Stop rule**
Do not mark this pack complete while a box above is open. An open box is a finding, not a formality — it is the thing this checklist exists to catch.

Next: Priya Shah closes the open items before 30 September 2026.

## Anti-patterns

- A coverage determination
- Inflated loss advice
- Omitted material facts

## Related skills

- `dispute-intake`
- `outside-counsel-brief`