Extract data from claim denial letters

A denial of claim letter is the notice an insurer sends to tell a claimant that a filed claim will not be paid, in whole or in part. It arrives after a claim has been reviewed, and for the policyholder it is the trigger for an appeal rather than the end of the matter. Property, health, disability, and liability insurers all issue them, and the letter follows a predictable shape: it references the policy number and the original claim number, states the amount claimed, gives one or more reasons for the denial, cites the specific policy exclusion or clause relied on, and, above all, sets out the claimant's right to appeal and the deadline to file it. Reasons and the appeal window are what a claimant or a public adjuster acts on. One denial rarely rests on a single line: it can cite a policy exclusion, a coverage limit, late notice of loss, or insufficient documentation, and each reason usually points to a numbered section of the policy. That appeal deadline is a hard date, and missing it can forfeit the claim, so it has to be read exactly, alongside the appeal instructions and the contact for reconsideration. Behind the decision, the claims adjuster who signed it and the date the letter was issued frame the timeline any appeal has to work within. Talonic reads the denial letter into structured fields and a reasons table. A letter dated 2026-06-22 from Summit Mutual Insurance to claimant Gregory Painter, denying claim CLM-2026-77120 on policy HO-4471982, a property claim for 18,450.00 USD on a dwelling in Cedar Falls, Iowa, reported 2026-05-02, returns its primary denial reason of policy exclusion, the specific water-damage exclusion clause cited, an appeal deadline of 2026-08-21, and each denial reason as its own row keyed to a policy section, so a claimant or a public adjuster works the appeal from fields. Senior claims adjuster Karen Liu signed the decision. Captured as written, the letter and its cited exclusions carry no determination about whether the denial is correct or the claim is payable.

What gets extracted from claim denial letters

How extraction works for claim denial letters

Denial letters are generated by carrier claims systems and by adjusters, and they arrive as letters and scanned PDFs whose reason paragraphs and appeal instructions sit in different places. Talonic classifies the letter and maps it to the correspondence and claims field set in the Field Registry, which separates the letter header of sender, recipient, subject, and date from the claim fields and from the denial reasons. Each denial reason returns as a row with its category, its full text, and the policy section it cites, the appeal deadline parses to an ISO 8601 date, and the claim timeline returns as a history table. Every value carries a confidence score and pixel-region provenance under DIN SPEC 91491 conformity, so a claimant or a public adjuster can verify the cited exclusion and the deadline against the source letter. Read as written, the letter yields its fields, so whether the denial is valid and whether the claim is payable stay decisions for the insurer, the appeal, or a regulator, not the extraction.

Sample extraction

A property claim denial letter citing an exclusion and late notice

{
  "from": "claims@summitmutual.example",
  "to": "gregory.painter@example.com",
  "subject": "Denial of claim CLM-2026-77120 under policy HO-4471982",
  "letter_date": "2026-06-22",
  "document_number": "DN-2026-77120",
  "letter_sender": "Summit Mutual Insurance, Claims Department",
  "letter_recipient": "Gregory Painter",
  "policy_number": "HO-4471982",
  "claim_number": "CLM-2026-77120",
  "claim_date": "2026-05-02",
  "claim_amount": 18450,
  "currency": "USD",
  "coverage_type": "property",
  "primary_denial_reason": "policy exclusion",
  "policy_exclusion": "Section I, Exclusion 3(c): loss caused by surface water and flooding is excluded",
  "body_summary": "The reported loss resulted from surface water entering the dwelling, which is excluded under the policy, and notice was provided outside the prompt-notice condition.",
  "appeal_deadline": "2026-08-21",
  "appeal_instructions": "Submit a written appeal with supporting documentation to the Claims Review Unit within 60 days of this letter.",
  "contact_information": "Claims Review Unit, +1 800 555 0164, appeals@summitmutual.example",
  "claim_adjuster_name": "Karen Liu",
  "claimant.address": "88 Willow Bend Rd, Cedar Falls, IA 50613",
  "salutation": "Dear Mr. Painter",
  "signatory": "Karen Liu, Senior Claims Adjuster",
  "denial_reasons": [
    {
      "reason_id": "R1",
      "reason_category": "policy exclusion",
      "reason_text": "Loss caused by surface water and flooding is excluded from coverage.",
      "policy_section_reference": "Section I, Exclusion 3(c)",
      "sequence_order": 1
    },
    {
      "reason_id": "R2",
      "reason_category": "timing",
      "reason_text": "Notice of loss was provided 46 days after the event, exceeding the prompt-notice condition.",
      "policy_section_reference": "Conditions, Section E",
      "sequence_order": 2
    }
  ],
  "claim_history": [
    {
      "event_date": "2026-05-02",
      "event_type": "claim filed",
      "event_description": "Claimant reported water damage to the dwelling.",
      "status_after_event": "under review"
    },
    {
      "event_date": "2026-06-22",
      "event_type": "denial issued",
      "event_description": "Claim denied for policy exclusion and late notice.",
      "status_after_event": "denied"
    },
    {
      "event_date": "2026-08-21",
      "event_type": "appeal deadline",
      "event_description": "Last date to file a written appeal.",
      "status_after_event": "appeal window open"
    }
  ]
}

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