Legal Disclaimer

Last Updated: January 15, 2026

1. Nature of Services

Health Claim Navigator AI provides:

• AI-powered document generation tools for administrative claim management
• Template letters and forms for health insurance claims
• Educational resources and organizational tools
• Document tracking and deadline management assistance

These are self-help tools designed to assist you in preparing administrative documentation. They are not substitutes for professional medical, legal, or insurance advice.

2. No Professional Relationship

Using our services does NOT create:

• An attorney-client relationship
• A doctor-patient relationship
• A fiduciary relationship
• An adjuster-client relationship
• Any form of professional services relationship

3. No Medical Advice

We do not provide:

• Medical diagnoses or treatment recommendations
• Clinical reasoning or medical necessity determinations
• Healthcare provider opinions or medical judgments
• Prescription recommendations or medication advice
• Treatment planning or medical decision-making

4. No Legal Advice

We do not provide:

• Legal advice or opinions
• Insurance coverage interpretations
• Legal strategy or representation
• Regulatory compliance advice
• Representation before insurers, courts, or agencies

5. AI-Generated Content Limitations

Our AI-generated documents and responses:

• Are created by artificial intelligence, not human medical or legal experts
• May contain errors, inaccuracies, or omissions
• Are generic templates that may not fit your specific situation
• Must be reviewed and customized before use
• Require provider-supplied medical necessity content where applicable
• Are not guaranteed to be compliant in your jurisdiction
• May not reflect recent changes in laws, regulations, or medical standards

6. No Guarantee of Results

WE DO NOT GUARANTEE:

• Claim approval or coverage determination
• Any specific settlement or payment amount
• Faster claim processing or resolution
• Favorable insurer response or decision
• Legal or medical compliance
• Protection from claim denial or underpayment
• Success in appeals or disputes

Results depend on many factors outside our control, including your specific policy terms, medical facts, insurer practices, provider documentation, and applicable laws and regulations.

7. User Responsibilities

You are solely responsible for:

• Reviewing and verifying all generated content for accuracy
• Obtaining medical necessity documentation from healthcare providers
• Ensuring accuracy of all information submitted to insurers
• Meeting all claim deadlines and policy requirements
• Complying with your insurance policy terms and conditions
• Obtaining appropriate professional medical and legal advice
• All decisions regarding your healthcare and insurance claims

8. Medical Necessity Content

Critical Requirement: Any medical necessity text, clinical reasoning, or treatment justification must be:

• Provided by your treating healthcare provider
• Referenced from official medical records
• Supplied by qualified medical professionals

We do NOT generate medical necessity determinations, clinical reasoning, or treatment justifications. These must come from your healthcare providers.

9. Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY LAW:

• We are not liable for any damages arising from use of our services
• We are not responsible for claim denials, underpayments, or coverage decisions
• We are not liable for missed deadlines or procedural errors
• Our maximum liability is limited to the amount paid for our services
• We exclude all consequential, incidental, and punitive damages
• We are not responsible for medical outcomes or healthcare decisions

10. Insurance Policy Terms Control

Critical Notice: Your insurance policy terms and conditions always supersede any information or templates we provide. Always refer to your specific policy for:

• Coverage terms, exclusions, and limitations
• Claim filing requirements and procedures
• Appeal deadlines and time limits
• Documentation and evidence requirements
• Your rights and obligations as a policyholder

11. Jurisdiction-Specific Laws

Health insurance laws and regulations vary significantly by state. Our tools:

• May not comply with your specific state requirements
• Cannot account for all jurisdictional variations
• Should be adapted to your location's laws and regulations
• Are based on general principles, not state-specific rules

12. No Emergency Services

Health Claim Navigator AI is not equipped to handle medical or legal emergencies. For urgent situations:

• Medical emergencies: Call 911 or seek immediate medical care
• Urgent health insurance issues: Contact your insurer's emergency hotline
• Legal emergencies: Contact an attorney immediately

13. Indemnification

You agree to indemnify and hold harmless Health Claim Navigator AI, its owners, employees, and affiliates from any claims, losses, or damages arising from:

• Your use of our services and materials
• Information you submit to insurers or healthcare providers
• Your claim handling and healthcare decisions
• Your failure to obtain professional medical or legal advice
• Any actions taken based on AI-generated content

14. Changes to This Disclaimer

We reserve the right to update this disclaimer at any time. Continued use of our services after changes constitutes acceptance of the updated disclaimer.

15. Contact Information

For questions about this disclaimer:

Email: legal@healthclaimnavigator.com
Website: https://healthclaimnavigator.netlify.app

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