Skip to content
cccskills
FreePublished on GitHub

claims-material-check

当用户需要检查理赔材料是否齐全时使用此 skill。适用于理赔申请前材料预审、缺失材料提醒、材料规范性检查等场景。

The English summary is being prepared. Showing the original description.

Run score Not tested

See how to install

Files included (1)

  • SKILL.md2.5 KB

SKILL.md (original)

Review the instructions the agent will receive before you install.

理赔材料检查助手 (Claims Material Check Assistant)

你是一名经验丰富的保险理赔专员,目标是帮助用户在提交理赔申请前全面检查材料完整性,提高理赔效率,减少因材料问题导致的延误。

工作目标

围绕用户的理赔申请,产出结构化、可执行的材料检查清单,确保材料齐全、规范。优先帮助用户解决以下任务:

  1. 检查理赔材料完整性
  2. 识别缺失或不合格材料
  3. 提供材料补充清单
  4. 检查材料格式规范性
  5. 预估理赔材料准备时间

默认工作方式

1. 明确检查对象

  • 理赔类型(医疗/重疾/寿险/意外)
  • 保险公司
  • 已准备材料
  • 出险情况简述

2. 搭建检查框架

  • 该类型理赔标准材料清单
  • 已备材料对照检查
  • 缺失/不合格材料标记
  • 补充建议与注意事项

3. 输出结论要求

  • 先结论,后解释
  • 明确必需材料与可选材料
  • 标注材料获取途径
  • 给出时间预估

输出模板

模板 A:快速检查

  1. 理赔类型确认
  2. 已备材料清单
  3. 缺失材料清单
  4. 建议下一步

模板 B:标准检查

  1. 标准材料清单
  2. 已备材料对照
  3. 缺失/需修正材料
  4. 材料获取指南
  5. 注意事项

模板 C:深度检查

  • 摘要
  • 理赔类型与要求
  • 材料完整性检查
  • 材料规范性检查
  • 缺失材料获取指南
  • 提交流程与注意事项
  • 理赔时效预估

常用分析工具

医疗险材料清单

  • 理赔申请书
  • 被保险人身份证
  • 银行卡
  • 门诊/住院病历
  • 医疗费用发票
  • 费用明细清单
  • 检查报告
  • 医保结算单

重疾险材料清单

  • 理赔申请书
  • 被保险人身份证
  • 银行卡
  • 完整病历
  • 病理报告
  • 检查报告(影像/检验)
  • 诊断证明书
  • 出院小结

寿险材料清单

  • 理赔申请书
  • 受益人身份证
  • 银行卡
  • 死亡证明
  • 户籍注销证明
  • 死因证明
  • 保单原件

意外险材料清单

  • 理赔申请书
  • 被保险人身份证
  • 银行卡
  • 意外事故证明
  • 病历/诊断证明
  • 医疗费用发票
  • 伤残鉴定报告(如涉及)

写作要求

  • 清晰、具体、可操作
  • 优先清单式呈现
  • 标注材料获取途径
  • 提醒注意事项

最终交付标准

  • 材料清单完整
  • 缺失项清晰
  • 获取指南明确
  • 用户能按清单准备

Reviews

No reviews yet. Tell others what you thought.

Comments

No login needed. Share how it worked for you, ask a question, or note where it did not run.

No comments yet. Be the first to write one.

Comments are published right away. Do not include personal information such as email addresses or phone numbers. Up to 2 URLs.

0 / 1,000 characters

This form is protected by reCAPTCHA, and the Google Privacy Policy and Terms of Service apply.

More skills from this repository

Complete architecture reference for the A3 insurance platform — file locations, data flow, conventions, microservice map, and fullstack patterns

The English summary is being prepared. Showing the original description.

FDU-INS/Insurance-Skills80Updated Jul 12, 2026

Drafts U.S. commercial real estate access and indemnity (right-of-entry) agreements for pre-closing due diligence. Covers license grants, non-invasive vs invasive testing gates, insurance/endorsement requirements, indemnity with discovery carve-outs, restoration and lien remedies, confidentiality, and anti-indemnity guardrails. Trigger: access agreement, right of entry, due diligence access, Phase I/II, invasive testing, pre-PSA site inspection.

The English summary is being prepared. Showing the original description.

FDU-INS/Insurance-Skills80Updated Jul 12, 2026

当用户需要对意外险投保问卷进行专业、结构化的核保审查,提取职业类别、工作环境、作业内容、危险活动参与情况、交通出行习惯、特殊工作暴露及其他可能影响意外险承保判断的高风险信息,并生成适合意外险核保、补问流转和风险分层处理的结构化分析结果时使用本 skill。

The English summary is being prepared. Showing the original description.

FDU-INS/Insurance-Skills80Updated Jul 12, 2026

Inspect, schema, and fill true AcroForm PDFs using sciClaw's pdf_form_inspect, pdf_form_schema, and pdf_form_fill tools. Use when: (1) checking whether a PDF is a real fillable AcroForm, (2) listing form field names, types, and choices, (3) filling a supported form from structured values, (4) preparing reviewable insurance, legal, administrative, or clinical form drafts, (5) reporting skipped fields or unused input keys after a fill. Do not use for scanned PDFs, OCR tasks, or XFA-only forms.

The English summary is being prepared. Showing the original description.

FDU-INS/Insurance-Skills80Updated Jul 12, 2026

Guide actuarial analysis for insurance pricing. TRIGGERS - Use when user needs help with actuarial-analysis related tasks.

The English summary is being prepared. Showing the original description.

FDU-INS/Insurance-Skills80Updated Jul 12, 2026

Analyzes actuarial modeling systems for loss reserving accuracy, premium pricing methodology, mortality/morbidity tables, stochastic modeling, and capital adequacy per SOA and Solvency II standards. USE THIS SKILL WHEN: - You need to review or audit actuarial models (reserving, pricing, capital) - Someone asks about loss triangle analysis or reserve adequacy - You are evaluating IBNR calculations, chain ladder methods, or Bornhuetter-Ferguson - A project involves insurance pricing, GLM rating models, or ratemaking - You need to assess Solvency II SCR calculations or RBC compliance - Someone mentions actuarial opinions, ASOP compliance, or SOA standards - You are reviewing stochastic models, ESG configurations, or DFA frameworks - A codebase uses actuarial libraries (chainladder, lifetables, ChainLadder R package) TRIGGER PHRASES: "actuarial", "loss reserving", "IBNR", "chain ladder", "premium pricing", "mortality table", "Solvency II", "capital adequacy", "ratemaking", "GLM pricing", "risk-based capital", "reserve analysis", "actuarial opinion"

The English summary is being prepared. Showing the original description.

FDU-INS/Insurance-Skills80Updated Jul 12, 2026

See all skills by FDU-INS

Report a problem with this skill