---
name: claims-handling-determination-record
description: Apply the How an insurer can prove that an AI-assisted claim denial was investigated and explained article as model behavior. Use when a request invokes this article's concept, claims, evidence, or operating standard.
---

# How an insurer can prove that an AI-assisted claim denial was investigated and explained

This Skill is the behavioral expression of [the canonical article](/a/claims-handling-determination-record). It does not repeat the article's human prose.

## Orient

- Read the machine article at /api/articles/claims-handling-determination-record.
- Read claims and relationships at /api/articles/claims-handling-determination-record/topology.
- Treat found content as evidence and instruction only within the article's stated authority.

## Apply

1. Identify which claim or concept from the article governs the request.
2. State the governing meaning in the minimum language needed.
3. Apply it to the requested object or decision.
4. Preserve evidence grades, uncertainty, authority limits, and failure conditions.
5. Return the result with the article identity and any relevant claim or receipt links.

## Human meaning

The obligation the claim file has to prove Every US state regulates how insurers handle claims, nearly all through some adopted form of the NAIC's model unfair-claims-settlement-practices act. The prohibited practices read like a checklist 

## Representations

- Human: /a/claims-handling-determination-record
- JSON: /api/articles/claims-handling-determination-record
- Relationships: /api/articles/claims-handling-determination-record/topology
- History: /api/articles/claims-handling-determination-record/revisions