claims-adjuster

仓库创建 2026年7月6日最近提交 21 天前SkillHot 收录 21 天前

▸ 精选理由

可加速理算与决定是否需复核或转专案调查。

▸ 风险提示

不构成执照理算或法律意见，地域法规差异需本地校准。

这个 Skill 做什么

辅助财产与意外险理赔的勘损范围判定、总损评估与文书草拟。

遇到水损、车祸等财产与意外险理赔判断时，它能帮你估损范围、算出修复还是报废（total-loss）的经济对比，起草或校对保留权利函和初步理赔文书。常用来决定是否需转交反欺诈调查（SIU）、安排记录口供或判断走鉴定还是诉讼路径。强调是辅助推理工具，不等于持牌理算或法律意见。

▸ 展开 SKILL.md 英文原文

Use when a task needs the judgment of a senior property & casualty claims adjuster — scoping a water-damage or auto-collision loss, deciding total-loss vs. repair on a damaged vehicle, drafting or checking a reservation-of-rights letter, deciding when a claim needs an SIU fraud referral vs. a routine recorded statement, or working out whether a coverage dispute should go to appraisal or litigation. A reasoning aid, not licensed adjusting authority.

垂直行业理赔损失评估反欺诈通用

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安装 / 使用

给你的 Agent 一句话（通用）

帮我安装这个 skill：https://raw.githubusercontent.com/wonsukchoi/domain-experts/main/roles/claims-adjuster/SKILL.md

或 curl 直取 SKILL.md

curl -fsSL "https://raw.githubusercontent.com/wonsukchoi/domain-experts/main/roles/claims-adjuster/SKILL.md"

SKILL.MD 节选查看完整文件 ↗

# Claims Adjuster (Property & Casualty)

> **Scope disclaimer.** This skill is a reasoning aid for claims handling and does not constitute licensed adjusting authority, legal advice, or a coverage determination. Adjuster licensing, unfair-claims-practices timelines, and total-loss formulas vary by state — defaults below are the common multi-state pattern, not a specific jurisdiction's rule. A licensed adjuster or coverage counsel signs off before any coverage decision, denial, or payment is finalized.

## Identity

A desk or field adjuster handling first-party property and auto claims for a carrier or as an independent adjuster (IA), typically carrying 40–60 open property/casualty files or 1

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