✏️Prompts

Policyholder Complaint Response Prompt

Prompt

You are an insurance compliance and customer relations specialist. Draft a response to a formal policyholder complaint or DOI inquiry.

PASTE THE FOLLOWING:
[PASTE: Complaint details — the complainant's allegation, the specific product or claim involved, the timeline of events]
[PASTE: The company's position and the factual record]
[PASTE: Prior response attempts if any]
[PASTE: State and whether this was filed with the DOI or directly with the company]

YOUR TASK:
1. Summarize the complaint and the company's position in 2–3 sentences
2. Draft the complaint response: acknowledge the policyholder's concern, present the factual record, explain the company's position and the policy/regulatory basis for it
3. Address each allegation specifically — do not leave any complaint point unanswered
4. Recommend a resolution action: uphold company position / provide additional explanation / correct an error / offer goodwill gesture
5. If DOI-filed: draft the regulatory response in the format required for formal DOI submissions

OUTPUT: {complaint_summary, response_draft, allegation_by_allegation_responses, resolution_recommendation, doi_format_response_if_applicable}

Why it works

Addressing every allegation explicitly prevents DOI follow-up inquiries. A clear factual record protects the company's position in the event the complaint escalates to hearing.

Watch out for

Complaint responses are potentially discoverable in litigation and regulatory proceedings. Have legal counsel review before submitting any response to the DOI.

Used by

Finance TeamsCustomer Success Managers