claims-triage
Triage an incoming insurance claim: check the coverage trigger against policy wording, band severity and complexity, screen for fraud indicators, set a first-pass reserve range, and route with an SLA. Use when asked to triage a claim, review a first notice of loss (FNOL), assess a new claim, decide fast-track vs adjuster routing, or screen a claim for SIU referral. Produces a structured triage note with coverage view, severity band, indicator screen, reserve range, and a routing recommendation.
npx skills add mohitagw15856/pm-claude-skills --skill claims-triage --agent claude-code
Same command for any agent — swap --agent for codex, cursor, copilot.
Weekly change comes from our own snapshots, not the repository page — it measures attention, not adoption.
# Claims Triage Skill The first 24 hours of a claim set its cost and its customer experience. This skill runs a disciplined first-pass triage: does the policy respond, how big and how complicated is this, are there indicators that warrant investigation, what should we hold in reserve, and who should own it by when. ## What This Skill Produces - A coverage-trigger view against the actual policy wording (trigger, exclusions, conditions) - A severity/complexity band with rationale - A fraud-indicator screen — indicators only, never conclusions - A first-pass reserve range (indemnity + expense), labelled as first-pass - A routing recommendation (fast-track / adjuster / senior adjuster / SIU referral / coverage counsel) with SLA ## Required Inputs Ask for these if not provided; if working from a thin FNOL, proceed and label every inference `[assumed — confirm]`: - **Loss description** — what happened, when, where, reported when - **Policy details** — line of business, wording or key clauses, limits, deductible, period - **Claimed amount or damage description** (even rough) - **Claimant/insured history** if available (prior claims, tenure) ## Triage Framework **1. Coverage trigger.** Quo
- What This Skill Produces
- Required Inputs
- Triage Framework
- Output Format
- Claim triage: [claim ref / insured / loss date]
- Quality Checks
- Anti-Patterns
What does the claims-triage skill do?
Triage an incoming insurance claim: check the coverage trigger against policy wording, band severity and complexity, screen for fraud indicators, set a first-pass reserve range, and route with an SLA. Use when asked to triage a claim, review a first notice of loss (FNOL), assess a new claim, decide fast-track vs adjuster routing, or screen a claim for SIU referral. Produces a structured triage note with coverage view, severity band, indicator screen, reserve range, and a routing recommendation.
How do I install it?
Run `npx skills add mohitagw15856/pm-claude-skills --skill claims-triage --agent claude-code` — it drops the skill into your project so the agent can pick it up. Swap the --agent value for codex, cursor or copilot if you use one of those.
Where does this skill come from?
From mohitagw15856/pm-claude-skills, a repository with 1,255 stars. We read it straight from the repository tree rather than a submitted listing, so what you see here is what is actually published.
Is a popular skill a good skill?
Not necessarily. Stars measure attention, not adoption — a repository can trend for a week and be abandoned. That is why we show the weekly change from our own snapshots next to the total, instead of a single flattering number.