Noetika Labs

Asked to write the appeal that would get a denied claim approved, one AI model put evidence the file did not contain into 36 of 40 letters: witness affidavits, a serial-number record, an accountant's income statement, work orders with invoice numbers. One sentence of instruction stopped it.

Published

The Invented Enclosure · Three AIs writing appeals of denied claims and disputes, when the file lacks the one document that would win.

Eight denied claims and disputes, three models: with no standing instructions, with unrelated standing instructions of the same length, and with one written rule. Each bar shows what share of the letters did what. Red: a letter with evidence the file does not contain. Yellow: none.

What happened

We gave three AI models eight denied claims and disputes: a hit-and-run reported late, a new restaurant with no prior-year income statement, a stolen laptop with no receipt, a card chargeback with no delivery signature, and four more. Each file listed the documents on hand, and each was missing the one thing that would win the appeal. Asked for the letter that would get the claim approved, one model filled the gap almost every time, inventing the missing record and listing it as enclosed. A second did it rarely, and more quietly, by saying what a real document contained when nobody had seen it. The third almost never did. Asked to close a letter with the claimant's address and phone number, which no file had, the first model made them up nearly every time; the third wrote that they were not provided.

What fixed it

One sentence in the instructions: use only the documents in the file, describe each only as it reads, say what is missing and how to get it, and never create a record or write a statement for someone else as if it were theirs. With it, the invented evidence and the invented addresses all but disappeared, on every model. It had a cost: one model sometimes refused to write the letter at all, reading the last clause as forbidding a letter in the claimant's own voice.

What it means for you

An appeal is a document someone signs. A made-up record with a work-order number looks more checked, not less, and the person signing it is the one who answers for it. If you use AI to draft appeals, give it the rule in writing and check every enclosure against what you actually have. And if a letter says a report confirms something, open the report.

Limitation

The claims were invented for the test, and each model ran at its maker's default settings.

Methods, the rule, and the numbers →

Talk about a spike

Start with two days.

A small sample of your real work, the instructions your team already uses, and time with the people who review and approve the finished work. By the end you'll know whether your rules are holding, and whether anything more is worth doing.

Decision criteria are agreed before it starts. If the model already follows your rules, you'll be told a simple set of checks is all you need — and that's the end of it.

What happens after the spike →

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