These Terms of Service (the "Terms") form a binding agreement between you ("you" or "User") and the individual operator of the Counterclaim website at counterclaim.help (the "Operator", "we", "us"). The website, the AI-driven appeal-letter drafting pipeline, the document checklist generator, the follow-up email scheduler, and any related services we provide are referred to together as the "Service". Please read these Terms carefully. If you do not agree to them, do not use the Service.
1. Acceptance of these Terms
1.1 By accessing the Service, uploading a document, generating an appeal letter, or otherwise interacting with any feature of the website, you acknowledge that you have read these Terms, understand them, and agree to be bound by them.
1.2 If you are using the Service on behalf of another person (for example, as a parent, guardian, or authorized representative of a patient), you represent and warrant that you have the legal authority to bind that person to these Terms and to share that person's documents with the Service.
1.3 The Operator may update these Terms from time to time. Material changes will be reflected by an updated "Last updated" date at the top of this page. Your continued use of the Service after a change is published constitutes acceptance of the revised Terms.
2. Description of the Service
2.1 Counterclaim is a software tool that uses large language models and structured prompting to generate draft written correspondence intended for use in appealing a denied health insurance claim. You upload a denial letter or Explanation of Benefits ("EOB"), the Service extracts structured facts, retrieves general legal and clinical information, and produces a draft letter and document checklist.
2.2 The Service is an informational drafting aid. It is not a legal service, a law firm, a lawyer-referral service, or a medical practice. The Operator is not your attorney, your physician, your insurance broker, or your fiduciary.
2.3 The Service does not file appeals on your behalf, mail letters for you, communicate with insurers on your behalf, or represent you in any administrative or judicial proceeding. You remain solely responsible for reviewing, correcting, signing, and sending any letter the Service produces.
3. Sole proprietor disclosure
3.1 The Service is currently operated by a single individual sole proprietor doing business as "Counterclaim". The Operator is not a corporation, limited liability company, professional corporation, partnership, or law firm.
3.2 This is disclosed to you because it affects the legal remedies available to you under your state's consumer-protection law - including, in some jurisdictions, who you can name in a lawsuit, what entity can be served with process, and what assets are available to satisfy a judgment.
3.3 The Operator may form a corporate entity (such as an LLC or Inc.) in the future and assign operation of the Service to that entity under the Assignment section below. If that happens, users will be notified via the website, and continued use of the Service after notice is published will constitute acceptance of the change in operator.
4. Eligibility
4.1 You must be at least eighteen (18) years old and a resident of the United States to use the Service.
4.2 You may use the Service only with respect to denials concerning yourself, a minor child of whom you are the legal guardian, or another person for whom you are an authorized representative under applicable law (for example, a health-care power of attorney or a HIPAA-authorized personal representative).
4.3 You may not use the Service if you are barred from doing so under any applicable law, regulation, or court order.
5. License grant
5.1 Subject to your compliance with these Terms, the Operator grants you a limited, non-exclusive, non-transferable, non-sublicensable, revocable license to access and use the Service for your personal, non-commercial purposes.
5.2 You may not (a) resell, redistribute, or monetize the Service or its outputs except as part of your own individual appeal; (b) use the Service to provide legal, medical, or insurance advice to third parties as a paid or unpaid service; (c) scrape, mirror, or replicate the website programmatically; (d) reverse-engineer the prompting, orchestration, or model selection of the Service; or (e) use the Service in any manner that violates applicable law.
5.3 All right, title, and interest in the Service, the website, the prompts, the orchestration logic, the published educational content, the trademarks, and the underlying software are owned by the Operator or the Operator's licensors. Nothing in these Terms transfers any such right to you.
6. Your obligations
6.1 Accurate input. You agree to provide accurate, complete, and truthful information when you upload documents and answer intake questions. The Service's output quality depends entirely on the inputs you provide.
6.2 Verification. You agree to read every draft the Service produces in full and to verify each factual statement, citation, statute reference, regulation, deadline, insurer policy reference, dollar amount, code, and date against your actual denial letter, EOB, plan documents, and medical records before signing or sending any letter. You agree not to rely on any draft as the sole basis for a legal action.
6.3 No third-party PHI without authorization. You agree not to upload another person's protected health information ("PHI") unless you are that person's authorized representative under applicable law. You are solely responsible for any unauthorized disclosure of another person's PHI through the Service.
6.4 No unlawful use. You agree not to use the Service to draft correspondence that is fraudulent, defamatory, harassing, threatening, or otherwise unlawful, or to attempt to obtain payment for services that were not rendered or for claims you know to be without basis.
6.5 No abuse of the system. You agree not to probe, scan, overload, rate-limit-evade, or attempt to gain unauthorized access to the Service, its underlying infrastructure, its session storage, or any account or session other than your own.
7. Mandatory user verification before use
7.1 The Service produces DRAFT documents only. You agree that BEFORE you sign, mail, fax, e-mail, hand-deliver, or otherwise send any letter generated by the Service, YOU WILL:
- Read the entire letter end to end.
- Verify every legal citation by independently looking it up in the cited statute, regulation, or case (do not rely on the Service's representation that the citation exists or says what the letter claims it says).
- Verify every clinical citation against the actual source.
- Verify every dollar amount against your actual Explanation of Benefits and itemized billing statements.
- Verify every patient name, member ID, claim number, date of service, CPT code, ICD code, and policy number against your actual documents.
- Verify the appeal deadline before mailing - do not assume the AI got it right.
- Adapt or rewrite any sentence that does not accurately describe your case.
- Consider engaging a licensed attorney or certified patient advocate, especially for the matters listed in our Disclaimer.
7.2 Sending a generated letter without the verification described in Section 7.1 is at your sole risk and constitutes your acceptance and assumption of all consequences of any error, omission, or misrepresentation in the letter, including without limitation missed deadlines, mis-cited authority, mis-stated facts, and any harm to your appeal that results.
8. AI-generated content disclaimer
8.1 The Service uses one or more large language models ("LLMs") to draft text. LLMs are statistical systems that generate plausible-sounding language and can produce output that contains factual errors, fabricated case citations, hallucinated statute references, outdated information, mis-applied state or federal law, arguments that do not fit your specific case, internally inconsistent statements, or inappropriate tone for your situation.
8.2 The Operator does not warrant the accuracy, completeness, currency, applicability, or fitness of any output the Service produces.
8.3 You are solely responsible for verifying every draft against authoritative sources and for adapting any draft before relying on it. The fact that a citation appears well-formed or that a paragraph reads convincingly is not evidence that it is correct.
9. AI system limitations and hallucination risk
9.1 The Service uses large language models that may produce outputs that:
- ARE factually incorrect;
- ARE based on fabricated or non-existent legal citations or case law;
- ARE based on incorrect or out-of-date state insurance code;
- MAY mis-state CPT or ICD-10 codes;
- MAY mis-state policy provisions;
- MAY mis-state dollar amounts or deadlines copied from your uploaded document;
- MAY apply the wrong state's law to your situation;
- MAY cite policy sections that have been amended or repealed.
9.2 You acknowledge that "hallucination" - the production of plausible-sounding but factually incorrect or fabricated content - is a known characteristic of the underlying large language model technology. The presence of hallucinated content in any output produced by the Service is NOT considered a defect in the Service for purposes of these Terms, and does not entitle you to any refund, credit, or other remedy.
9.3 The Operator does not pre-review individual outputs for accuracy and has no practical ability to do so at scale.
9.4 By using the Service, you accept the risk described in this Section 9 in full.
10. Not legal advice; no attorney-client relationship
10.1 Nothing on the website and nothing the Service produces is legal advice. The Service is a drafting aid only.
10.2 Use of the Service does not create an attorney-client relationship between you and the Operator. The Operator is not a licensed attorney acting in that capacity with respect to your matter, and no communication you have with the Service or with the Operator should be treated as privileged.
10.3 You are encouraged to consult a licensed attorney admitted in your jurisdiction or a certified patient advocate, particularly for any of the following situations:
- Denials involving claim values greater than ten thousand US dollars (USD 10,000)
- Denials under self-funded ERISA plans where federal administrative-record rules apply
- Mental-health or substance-use disorder denials implicating the Mental Health Parity and Addiction Equity Act
- Oncology, transplant, or other life-threatening cases
- Terminal-illness or end-of-life care denials
- Denials where you have already been through external review and lost
- Disputes that have advanced to collections, lawsuit, or regulatory enforcement
- Any matter where you are uncertain about the procedural deadlines or the legal authority that applies
11. Not medical advice
The Service does not provide medical advice, diagnosis, or treatment recommendations. Nothing the Service produces is a substitute for consultation with a qualified health-care professional. Always seek the advice of your physician or other qualified provider with any questions you have regarding a medical condition or treatment.
12. Intellectual property
12.1 As between you and the Operator, the text of the appeal letter that the Service drafts on your behalf, populated with your inputs and signed by you, is yours. You may use, print, mail, share with your physician or attorney, and otherwise incorporate that drafted letter into your appeal as you see fit.
12.2 The Service's underlying software, prompts, orchestration logic, educational content, brand, trademarks, look-and-feel, and the aggregate corpus of published guidance remain the property of the Operator.
12.3 You retain all rights to the documents you upload. You grant the Operator a limited, non-exclusive license to process those documents for the sole purpose of providing the Service to you, and only for the limited retention period described in the Privacy Policy.
13. Payment terms
13.0 Current status: the Service is free. As of the "Last updated" date above, Counterclaim operates in free mode and does not charge any fee; no payment is required to generate or download a letter. The remaining payment terms in this section take effect only if and when paid access is enabled and you are presented with a checkout and asked to pay. Until then they do not apply.
13.1 Pricing. If paid access is enabled, each appeal generation may be subject to a fee, anticipated to be nine United States dollars (US $9.00) per session, payable via Stripe at the Operator's discretion. The Operator reserves the right to add, change, or remove fees with notice via the website; continued use of the Service after notice is published constitutes acceptance of the change.
13.2 What the fee is for. The fee is consideration for ACCESS TO the AI processing infrastructure, including OCR extraction, the multi-agent prompt pipeline, document storage during the session, formatting, and the right to download the generated draft. The fee is NOT consideration for legal services, professional advice, attorney-client representation, success of any appeal, or accuracy of the output.
13.3 No refunds based on outcome. You understand and agree that NO REFUND will be issued because (a) your insurer denied your appeal; (b) the generated letter contained errors that you did not catch; (c) you did not have time to review the letter before mailing; (d) you missed the appeal deadline; (e) the cited law turned out not to apply to your case; (f) the AI hallucinated a citation, statute, regulation, case, or other authority; or (g) you are otherwise dissatisfied with the appeal outcome.
13.4 Refunds available. Refunds are available only when (a) a verified technical failure prevents you from receiving a downloadable letter within twenty-four (24) hours of payment, OR (b) you initiate a chargeback for a verifiable unauthorized transaction. The Operator reserves the right to verify chargebacks and to contest those that appear to be buyer's remorse rather than a service failure.
13.5 Payment processor. Payments are processed by Stripe, Inc. Your card details are never received or stored by Counterclaim. Stripe's terms and privacy policy also apply to your transaction: https://stripe.com/legal/consumer.
13.6 Tax. Prices are stated exclusive of any applicable sales tax, value-added tax (VAT), goods and services tax (GST), or similar levy. You are responsible for any tax obligations arising out of your purchase.
13.7 Receipts. A receipt will be issued by Stripe to the email address you provide at checkout. The Operator does not separately issue receipts.
13.8 Chargebacks. Filing a chargeback for service that was rendered (i.e., a downloadable letter was issued and delivered to you) may result in your access to the Service being terminated. Honest disputes should be raised first via the contact email below; the Operator will work in good faith to resolve legitimate concerns.
14. Termination
14.1 The Operator may suspend or terminate your access to the Service at any time, with or without notice, for any reason, including without limitation suspected violation of these Terms, suspected unlawful use, abuse of the Service, or any reason the Operator deems necessary to protect the Service or other users.
14.2 You may stop using the Service at any time. Because the Service does not require an account, no account closure procedure is necessary; simply stop using the Service.
14.3 Sections that by their nature should survive termination - including the disclaimer of warranties, limitation of liability, indemnification, governing law, and arbitration provisions - will survive any termination of these Terms.
15. Disclaimer of warranties
15.1 THE SERVICE IS PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS, WITH ALL FAULTS AND WITHOUT WARRANTY OF ANY KIND. TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, THE OPERATOR DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ACCURACY, COMPLETENESS, TITLE, QUIET ENJOYMENT, AND ANY WARRANTIES ARISING FROM A COURSE OF DEALING, COURSE OF PERFORMANCE, OR USAGE OF TRADE.
15.2 THE OPERATOR DOES NOT WARRANT THAT THE SERVICE WILL MEET YOUR REQUIREMENTS, BE UNINTERRUPTED, SECURE, OR ERROR-FREE; THAT ANY DEFECTS WILL BE CORRECTED; THAT THE OUTPUT WILL BE ACCURATE, RELIABLE, OR APPROPRIATE FOR YOUR SITUATION; OR THAT THE SERVICE WILL ACHIEVE ANY PARTICULAR RESULT, INCLUDING WITHOUT LIMITATION THE OVERTURN OF AN INSURANCE DENIAL.
15.3 SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF CERTAIN WARRANTIES, SO SOME OF THE FOREGOING EXCLUSIONS MAY NOT APPLY TO YOU.
16. Acknowledgment and assumption of risk
16.1 By using the Service - and especially by paying for the Service - you acknowledge and agree that:
- You understand the Service is an AI tool, not a law firm.
- You understand the AI may make significant errors, including hallucinated citations and mis-applied law.
- You understand you must independently verify every part of the output before relying on it or sending it to your insurer.
- You understand that paying for the Service does not entitle you to legal advice or to any particular outcome of your appeal.
- You waive any reliance interest you may otherwise have had in the accuracy, applicability, or fitness of the output.
16.2 The acknowledgments and waivers in this Section 16 survive any termination of these Terms and any termination of your use of the Service.
17. Limitation of liability
17.1 TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT WILL THE OPERATOR BE LIABLE TO YOU OR TO ANY THIRD PARTY FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO LOST PROFITS, LOST REVENUE, LOST BUSINESS OPPORTUNITIES, LOST GOODWILL, LOST DATA, COST OF SUBSTITUTE SERVICES, MEDICAL EXPENSES, INSURANCE SETTLEMENTS THAT WERE NOT OBTAINED, OR DAMAGES ARISING FROM THE OUTCOME OF AN INSURANCE APPEAL, EVEN IF THE OPERATOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES AND EVEN IF ANY REMEDY OTHERWISE PROVIDED IS FOUND TO HAVE FAILED OF ITS ESSENTIAL PURPOSE.
17.2 OPERATOR'S TOTAL AGGREGATE LIABILITY UNDER THESE TERMS, ARISING FROM OR RELATED TO YOUR USE OF THE SERVICE, IS LIMITED TO THE GREATER OF (A) FIFTY UNITED STATES DOLLARS ($50.00) OR (B) THE TOTAL AMOUNT YOU PAID TO OPERATOR IN THE TWELVE (12) MONTHS PRECEDING THE CLAIM.
17.3 FOR THE AVOIDANCE OF DOUBT, OPERATOR SHALL HAVE NO LIABILITY FOR ANY DAMAGES ARISING FROM (A) DENIAL, REVERSAL, OR ANY OUTCOME OF YOUR INSURANCE APPEAL; (B) RELIANCE ON ANY CITATION, FACT, FIGURE, DATE, OR LEGAL ARGUMENT IN A GENERATED LETTER; (C) MISSED DEADLINES OR PROCEDURAL DEFAULTS; (D) ANY MEDICAL CONSEQUENCES OF DELAYED OR DENIED CARE; OR (E) EMOTIONAL DISTRESS OR LOST OPPORTUNITY.
17.4 SOME JURISDICTIONS DO NOT ALLOW THE LIMITATION OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES, SO SOME OF THE FOREGOING LIMITATIONS MAY NOT APPLY TO YOU. IN SUCH JURISDICTIONS, THE OPERATOR'S LIABILITY IS LIMITED TO THE GREATEST EXTENT PERMITTED BY LAW.
18. Indemnification
You agree to defend, indemnify, and hold harmless the Operator and the Operator's contractors, vendors, and affiliates from and against any and all claims, damages, losses, liabilities, judgments, settlements, fines, costs, and expenses (including reasonable attorneys' fees) arising out of or relating to (a) your use of or reliance on the Service or any output it produces; (b) your breach of these Terms; (c) your violation of any applicable law or the rights of any third party, including the unauthorized disclosure of another person's PHI; or (d) any letter, communication, or filing you produce, sign, or send using the Service.
19. Governing law and jurisdiction
19.1 These Terms and any dispute arising out of or relating to them or to the Service are governed by the laws of the State of Delaware, United States, without regard to its conflict-of-laws rules, except that the Federal Arbitration Act governs the interpretation and enforcement of the arbitration clause below.
19.2 Subject to the arbitration clause below, you and the Operator agree to the exclusive personal jurisdiction and venue of the state and federal courts located in Delaware for any dispute not subject to arbitration.
20. Mandatory arbitration; class-action waiver
20.1 Any dispute, claim, or controversy arising out of or relating to the Service or these Terms, including the formation, breach, termination, validity, or enforceability of any provision of these Terms, will be finally and exclusively resolved by binding individual arbitration administered by the American Arbitration Association ("AAA") under its Consumer Arbitration Rules then in effect. Judgment upon the award rendered by the arbitrator may be entered in any court of competent jurisdiction.
20.2 The arbitration will be conducted in English, on a documents-only basis where reasonably possible, and otherwise by telephone or video conference unless the arbitrator decides an in-person hearing is required. The hearing, if any, will take place in Wilmington, Delaware, unless you and the Operator agree otherwise.
20.3 Class-action waiver. You and the Operator agree that any claims will be brought solely in your or its individual capacity, and not as a plaintiff or class member in any purported class, collective, representative, or consolidated action. The arbitrator may not consolidate more than one person's claims and may not preside over any form of representative or class proceeding.
20.4 Small-claims carve-out. Either party may bring an individual claim in small-claims court of competent jurisdiction, in lieu of arbitration, so long as the claim remains in that court and proceeds only on an individual basis.
20.5 Right to opt out. You may opt out of the arbitration provisions of this section by sending a written notice of your decision to opt out to the contact email below within thirty (30) days of first accepting these Terms. Your notice must include your name and a clear statement that you wish to opt out of arbitration. Opting out will not affect any other provision of these Terms.
21. Severability
If any provision of these Terms is held to be invalid, illegal, or unenforceable, that provision will be enforced to the maximum extent permissible and the remaining provisions will continue in full force and effect.
22. Entire agreement
These Terms, together with the Privacy Policy and the Disclaimer published on the website, constitute the entire agreement between you and the Operator concerning the Service and supersede all prior or contemporaneous communications and proposals, whether electronic, oral, or written.
23. No waiver
The Operator's failure to enforce any provision of these Terms is not a waiver of that provision or of any other provision. Any waiver of any provision will be effective only if in writing and signed by the Operator.
24. Assignment
You may not assign or transfer these Terms or any of your rights or obligations under them, by operation of law or otherwise, without the Operator's prior written consent. The Operator may assign these Terms in whole or in part at any time without notice or your consent, including in connection with a merger, acquisition, sale of assets, or by operation of law.
25. Changes to these Terms
The Operator may revise these Terms from time to time. Revisions will be posted on this page with an updated "Last updated" date. For material changes, the Operator will endeavor to provide additional notice (for example, a prominent banner on the website). Your continued use of the Service after a revision is published constitutes acceptance of the revised Terms. If you do not agree to a revision, you must stop using the Service.
26. Contact
Questions about these Terms may be sent to counterclaim@agentmail.to.
Last updated: 2026-06-09.