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Workflow

The claim negotiator

Feed it the policy and the denial letter; it finds the coverage language, drafts the dispute, tracks the thread, and never lets a deadline slip — you sign off on every word.

Tools in this workflow

  • OpenClaw
  • Email

Goal: stop losing winnable disputes to fatigue. Insurers, warranty desks, and billing departments count on you giving up; an assistant doesn’t get tired.

  1. Load the paper — give it the policy PDF, the claim, the denial or the bill. It extracts the coverage terms, exclusions, amounts, and — critically — every deadline.
  2. Find the angle — it maps the denial’s stated reason against the policy’s actual language and flags mismatches, missing procedure steps, and comparable cases worth citing.
  3. Draft the dispute — a firm, factual letter: what was covered, what was denied, what the policy says, what you’re requesting, and by when. You review and send; nothing goes out on its own.
  4. Track and follow up — with OpenClaw watching the thread, every reply gets summarized, every “we’ll respond in 30 days” becomes a calendar entry, and silence triggers a drafted escalation.

The same pattern works on medical bills, warranty claims, and service-contract disputes. No assistant? Steps 1–3 work as a plain Claude or ChatGPT session — paste the documents and ask for the mismatch analysis first, the letter second.