Reclaim

Insurers deny claims that they would have paid if challenged, because most people don't challenge them. The appeal is a document assembly problem with a deadline attached. Reclaim does the assembly.

What it is

Reclaim is a self-help tool for fighting health-insurance claim denials. It reads the denial letter, the policy, and the plan documents; computes the exact appeal deadlines that apply; and assembles a finished, citation-backed appeal packet that quotes the specific policy language and applicable regulations the insurer is counting on the member not reading.

Every output is a draft the user owns, reviews, and sends themselves. Reclaim is not a law firm, does not provide legal advice, and does not create an attorney–client relationship.

What it does well

Deadlines computed, not estimated. ERISA and state-specific timelines differ, and missing one ends the appeal regardless of merit. A deterministic rules engine — not a language model — classifies the plan type and calculates the dates.

Citations that exist. Every citation carries a source and an effective date, drawn from curated content packs. The model never invents a citation, because it is never the thing producing them.

Your documents stay inside the boundary. OCR, embeddings, and inference run on a local Python sidecar. No third-party LLM API sees the contents of a denial letter or a medical record.

Rules engine over vibes. Plan-type classification, deadline calculation, and the required-elements checklist for a given appeal are deterministic, versioned, and tested end-to-end against real ERISA and state scenarios.

Proof of filing. Submission runs through a user-authorized fax and certified-mail conduit that returns proof-of-filing receipts — because "I sent it" is not the same as being able to show you sent it.

Who it's for

Anyone holding a denial letter who suspects the denial is wrong and has no idea what the next step is.

People with chronic or expensive conditions who face this repeatedly and are tired of relearning the process each time.

Caregivers managing someone else's claims alongside their own life.

What it looks like in practice

Someone uploads a denial letter and their plan's summary description. Reclaim identifies the plan as ERISA-governed, computes the internal appeal deadline from the denial date, and builds a required-elements checklist for that appeal type. It pulls the specific policy language the denial relies on, pairs it with the regulation that constrains the insurer's discretion, and assembles a packet. The user reads it, edits it, and sends it — with a certified-mail receipt showing the date it was filed.

What it's not

It's not legal advice, and it doesn't represent anyone. It assembles documents and surfaces facts.

It's not an automatic win. Some denials are correct. Reclaim tells you what the policy actually says, which sometimes means it says the insurer is right.

It's not a cloud AI product. Document content is processed inside the operator's trust boundary, on purpose.

Pricing (planned)

| | | |---|---| | Free | Deadline calculation and denial triage | | Per-appeal | Full packet assembly, citations, filing conduit |

Status

Rules engine first, which is the right order — it's the part where a bug costs someone their filing window. Shipped so far: a deterministic deadline calculator, a rules-only plan-type classifier, a required-elements checklist builder, and federal-ERISA plus California content packs, all covered by end-to-end tests for both ERISA and CA non-ERISA scenarios. Design docs — brief, PRD, SDD, PDD — are complete. Web app, AI sidecar, and submission conduit are the build ahead. Tech: Next.js + .NET 10 rules engine + Python 3.11 FastAPI local-inference sidecar + Postgres with row-level security.