# Reply to a complaint, for customer service teams in insurance: prompt chain Turn a customer's complaint and the facts on your file into a calm reply that acknowledges the concern, states only the facts on the record, says what will happen and when, makes no promise or admission beyond them, and waits for a person to approve it. **Made for:** Customer service representatives, claims coordinators and team leads at an insurer or agency who draft the first reply to a customer's complaint about a policy, a claim or a renewal. ## Before you start Have these ready: - **The complaint** (required): Paste the complaint letter or email as it arrived. Leave out account, claim and card numbers unless your reply must quote them, and leave out private details the reply does not need. - **What the record shows** (required): Paste the facts from your file, such as dates, call notes, delivery or case notes. Include only what you can point to in the file. If a fact is not on file, leave it out. - **What will happen and when** (required): List the steps your team has agreed to take, with who does each one and by when, in your own words. The reply will promise only these. - **Who signs the reply** (optional): The name, job title and a way to reach you, as you want them to appear at the end of the reply. Leave empty to end with a line asking the customer to reply to the message. **How to use this chain** 1. Open a new chat in any AI assistant. 2. Copy the Step 1 prompt, replace every [PASTE HERE: ...] slot with your material, and send it. 3. Keep each answer: later steps ask you to paste it in. Run each step in the same chat or a new one; a new chat keeps steps from blurring together. 4. After a step that has a check, run the check before you move on. ## Step 1: List what the customer says Pick out each point in the complaint, quoted word for word, and mark whether it says what happened, what the customer wants or how they feel. Copy this prompt: ````text You are an experienced customer service reviewer who reads a complaint closely before anyone replies. The complaint comes from an insurance customer about a policy, a claim or a renewal, and the reply goes out in the insurer's name before any decision beyond the record is made. Your task is to list each separate point the customer makes in the complaint below. The complaint: [PASTE HERE: The complaint] Rules: - A point is one thing the customer says happened, one thing they want, or one way they feel. Split a sentence that holds two points. - Quote each point from the complaint word for word, as short as you can. Do not correct it and do not reword it. - In the Kind column, write exactly one of: happened, wants, feels. - One row for each point, in the order the complaint gives them. Do not add a point the customer did not make and do not guess what they mean. - Do not leave out a point because it is hard to answer or because it is rude. Return one markdown table and nothing else: | # | What the customer says (quote) | Kind | ```` **You get back:** A numbered table of the customer's points, each quoted from the complaint and marked happened, wants or feels. **Check after Step 1: Every point is quoted word for word from the complaint** Check by eye: Each quote in the What the customer says (quote) column appears in the complaint, with shortened fragments in the same order. If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. ## Step 2: Match each point to the record For each point about what happened, quote what the file shows and say whether it agrees, agrees in part, or is not on file. Copy this prompt: ````text You are a careful case reviewer who checks what a customer says against the file. The complaint comes from an insurance customer about a policy, a claim or a renewal, and the reply goes out in the insurer's name before any decision beyond the record is made. Your task is to find, for each point below whose Kind is happened, what the record shows. The customer's points: [PASTE HERE: the answer from Step 1 (List what the customer says)] The record: [PASTE HERE: What the record shows] Rules: - One or more rows for each point whose Kind is happened, one passage in each row. Leave out the points marked wants or feels. - In the Point # column, give the number from the points table. - Quote what the record shows word for word, as short as you can while keeping the facts. The same passage may serve two points. If nothing in the record speaks to the point, write exactly None found in that cell. - In the Result column, write exactly one of: confirmed, partly confirmed, not on record. Use confirmed only when the record says the same as the point. Use partly confirmed when the record says part of it, or says something different. Use not on record when nothing speaks to it. - Use only the record above. Do not use what is usual in a case like this, do not guess a cause, and do not join two passages into one quote. Return one markdown table and nothing else: | # | Point # | What the record shows (quote) | Result | ```` **You get back:** A table that puts a quoted passage from the record beside each point about what happened, with a result for each. **Check after Step 2: Every passage is quoted word for word from the record** Check by eye: Each quote in the What the record shows (quote) column appears in the what the record shows, with shortened fragments in the same order. If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. ## Step 3: Match each request to what will happen For each thing the customer wants, quote the step your team has agreed to take and when, or say that none was agreed. Copy this prompt: ````text You are a customer service lead who turns agreed actions into answers for a customer. The complaint comes from an insurance customer about a policy, a claim or a renewal, and the reply goes out in the insurer's name before any decision beyond the record is made. Your task is to find, for each point below whose Kind is wants, the step your team has agreed to take. The customer's points: [PASTE HERE: the answer from Step 1 (List what the customer says)] What will happen and when: [PASTE HERE: What will happen and when] Rules: - One row for each point whose Kind is wants. Leave out the other points. One point may have more than one row. - In the Point # column, give the number from the points table. - Quote what will happen and when from the list above word for word, as short as you can. Keep any day, date or number of days the list gives. If the list does not speak to the point, write exactly None found in that cell. - In the Owner column, write the person or team the list names for that step, or Not named. - Use only the list above. Do not invent a step, a date or a person, and do not turn "we will look into it" into a result. Return one markdown table and nothing else: | # | Point # | What will happen and when (quote) | Owner | ```` **You get back:** A table that puts the agreed step and its timing beside each request, or None found. **Check after Step 3: Every step is quoted word for word from your list** Check by eye: Each quote in the What will happen and when (quote) column appears in the what will happen and when, with shortened fragments in the same order. If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. ## Step 4: Write the reply Write a short, calm reply that states the confirmed facts, says what will happen and when, and promises nothing else. Copy this prompt: ````text You are an experienced customer service writer who replies to complaints in plain, kind words. The complaint comes from an insurance customer about a policy, a claim or a renewal, and the reply goes out in the insurer's name before any decision beyond the record is made. Your task is to write the reply to the customer from the points, the record and the agreed steps. The complaint: [PASTE HERE: The complaint] The customer's points: [PASTE HERE: the answer from Step 1 (List what the customer says)] What the record shows: [PASTE HERE: the answer from Step 2 (Match each point to the record)] What will happen and when: [PASTE HERE: the answer from Step 3 (Match each request to what will happen)] Who signs the reply (if this is empty, end by asking the customer to reply to this message): [PASTE HERE: Who signs the reply] Rules: - Open by thanking the customer and saying you have read the complaint. Name their main worry in their own words. Say you are sorry for the worry, the delay or the trouble they describe. Do not say you are sorry for a fault. - Then write a short paragraph that starts "Here is what our record shows." Use only the rows marked confirmed or partly confirmed. For a partly confirmed row, say what the record shows and no more. For a point marked not on record, say the record does not show it. State a fact the record gives in neutral words, even if it is not flattering. Do not add a cause, a reason or a view on who was at fault. - Then write a short list that starts "Here is what will happen next." Use only the rows of the steps table. Keep each date as the table gives it. If a step has no date, say you will confirm the date and do not make one up. If a request has no step, say that you are looking into it and will write again, only if the steps table says so; otherwise say that you have passed it on. - Close with the sign-off. - Do not admit liability or fault. Do not promise an outcome such as a payment, a refund, an approval or a decision. Do not say what a policy or contract covers. Do not give legal, medical or financial advice. Do not blame a person, a team or another company by name. - Use plain words in sentences of about 15 words. Keep the reply under 250 words, not counting the last line. - After the reply, add one blank line and then exactly this line: Check this reply with your manager or your compliance team before you send it. Return the reply as plain text, ending with that line, and nothing else. ```` **You get back:** A short reply to the customer that ends with the reminder line. **Check after Step 4: The reminder to check the reply with your manager or compliance team is in the final text** Check by eye: The answer contains the text fragment "Check this reply with your manager or your compliance team before you send it." (including inside a longer word). If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. ## Final checks Run these on the finished result. **Final check 1: Every point is marked happened, wants or feels** Check by eye: Every row of the table has one of "happened", "wants" or "feels" in the Kind column. If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. **Final check 2: Every result is one of the three allowed words** Check by eye: Every row of the table has one of "confirmed", "partly confirmed" or "not on record" in the Result column. If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. **Final check 3: No number appears that your complaint, record, steps and sign-off do not have** Check by eye: Every number in the answer also appears somewhere in at least one of "the complaint", "what the record shows", "what will happen and when" and "who signs the reply"; this does not check what each number means. If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. **Final check 4: Every fact in the reply is on the record** Open a new chat (so the check is not swayed by the work) and paste this check prompt: ````text You are a careful reviewer. You do not fix or rewrite the work; you only decide whether it passes one check. The check: Every fact in the reply is on the record Read the reply. List each statement of fact in it about what happened, such as a date, an action or an event. Is each one shown by a row of the table below marked confirmed or partly confirmed? Does the reply state as fact anything marked not on record, or anything the table does not have? Answer FAIL and quote each statement that has no support. What the record shows: [PASTE HERE: the answer from Step 2 (Match each point to the record)] The work to check (the answer from Step 4 (Write the reply)): [PASTE HERE: the answer from Step 4 (Write the reply)] Reply with exactly PASS or FAIL on the first line. On the second line, say in one sentence why. If it fails, name the exact item or line that fails. Do not add anything else. ```` If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. **Final check 5: The reply admits no fault and gives no cause or blame** Open a new chat (so the check is not swayed by the work) and paste this check prompt: ````text You are a careful reviewer. You do not fix or rewrite the work; you only decide whether it passes one check. The check: The reply admits no fault and gives no cause or blame Read the reply. A plain fact from the record, stated in neutral words, is fine. Does the reply go further and admit that the company was at fault, made an error, broke a rule or a promise, or is liable? Does it give a reason or a cause that the record does not state? Does it blame a named person, team or other company? Does it say sorry for a fault rather than for the customer's worry or trouble? Answer FAIL and quote each such phrase. The work to check (the answer from Step 4 (Write the reply)): [PASTE HERE: the answer from Step 4 (Write the reply)] Reply with exactly PASS or FAIL on the first line. On the second line, say in one sentence why. If it fails, name the exact item or line that fails. Do not add anything else. ```` If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. **Final check 6: The reply promises only the agreed steps** Open a new chat (so the check is not swayed by the work) and paste this check prompt: ````text You are a careful reviewer. You do not fix or rewrite the work; you only decide whether it passes one check. The check: The reply promises only the agreed steps Read the reply. Does it promise or suggest any outcome, such as a payment, a refund, an approval, a decision in the customer's favor, or that something is or is not covered? Does it promise a step, a date or a person that the table below does not have? Answer FAIL and quote each such phrase. What will happen and when: [PASTE HERE: the answer from Step 3 (Match each request to what will happen)] The work to check (the answer from Step 4 (Write the reply)): [PASTE HERE: the answer from Step 4 (Write the reply)] Reply with exactly PASS or FAIL on the first line. On the second line, say in one sentence why. If it fails, name the exact item or line that fails. Do not add anything else. ```` If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. **Final check 7: Every request has an answer in the reply** Open a new chat (so the check is not swayed by the work) and paste this check prompt: ````text You are a careful reviewer. You do not fix or rewrite the work; you only decide whether it passes one check. The check: Every request has an answer in the reply Look at the customer's points below. For each point whose Kind is wants, does the reply give an answer, either the agreed step with its timing or a plain statement that it has been passed on? Does the reply ignore any request? Answer FAIL and name each request that has no answer. The customer's points: [PASTE HERE: the answer from Step 1 (List what the customer says)] The work to check (the answer from Step 4 (Write the reply)): [PASTE HERE: the answer from Step 4 (Write the reply)] Reply with exactly PASS or FAIL on the first line. On the second line, say in one sentence why. If it fails, name the exact item or line that fails. Do not add anything else. ```` If it does not pass: Run the step once more, and add what was wrong to the end of the prompt. If it still does not pass, fix it by hand and make a note of it. **Final check 8: A person who can speak for your organization approves the reply before it is sent** Ask yourself: Read the reply next to the complaint and the file. Check each fact against the file yourself, and make sure every step and date is one your team has really agreed to. Ask your manager, your compliance team or your lawyer first if the complaint is formal, mentions a regulator, a deadline or legal action, or involves an injury or a dispute about who is at fault. Only a person can decide what your organization says and does, and the reply must be one you are willing to stand behind. If it does not pass: Carry on, but write down the problem so whoever uses the result knows about it. ## What you end up with - A table of the customer's points, each quoted and marked as what happened, what they want or how they feel. - A table that shows what the record confirms, confirms in part, or does not hold for each point. - A table of the steps your team has agreed to for each request. - A short reply that states the facts, says what will happen and when, and promises nothing else. ## Changing this chain - This template builds a first draft of a reply. It does not decide the complaint, say who is at fault or give legal advice, and the last line of the reply says to have a person check it. - Paste only what your organization lets you put into an AI tool. Leave out account, card and claim numbers and any private detail the reply does not need. - The record must hold facts you can point to in your file. A fact that is not on file is left out of the reply, and the reply says the record does not show it. - The steps are yours. The template never invents a step or a date, so give each one with a day or a number of days, and say who does it. - If your organization has a formal complaints process with set deadlines, follow it, and send the draft to your manager or compliance team before it goes. - To change the tone, add a line to the reply step about your house voice, and keep the rules about promises and fault as they are. --- From Logic Lab (logiclabhq.com). Free to use and adapt, with credit.