Fake health insurance prior authorization denial demanding credential upload to file an appeal — real prior-auth denials arrive via EOB statements and authenticated insurer portals.
healthcare-prior-auth-denial-phish
What this tier means
High-confidence threat indicator — phishing, impersonation, BEC, or scam pattern. Strong contributor to the trash decision.
How Gorganizer detects this
Fake health insurance prior authorization denial demanding credential upload or insurance ID to "appeal" — identity theft targeting patients and healthcare workers. Real prior-auth denials are delivered via Explanation of Benefits (EOB) statements, certified mail, and authenticated insurer member portals; they never arrive as cold emails with click-to-appeal links. Detection: prior authorization denied/rejected vocabulary + appeal/verify insurance/upload documents action + no List-Unsubscribe + no In-Reply-To + not protected sender. Trash score: +3. Source: GC1-R21; HHS Office of Inspector General healthcare fraud advisory; APWG healthcare impersonation 2025.
False-positive guard
Every signal in Gorganizer feeds a multi-module score — never a sole verdict. This is a threat-tier signal — it adds a strong contribution to the trash score. The full pipeline still requires convergence across multiple modules + a margin over the safety floor before deletion happens, and Gmail's trash (30-day recovery) is always used — never permanent delete.
About the scoring engine
Gorganizer's scoring engine emits over 1,800 signals across six modules — headers, sender, subject, body, attachments, and structural metadata. Every email is scored by every module independently; the final verdict requires multiple modules to agree and the trash score to beat the safety floor by a margin.
Sacred safety guards — never delete starred emails, replies, calendar invites, receipts/invoices, or attachments — apply unconditionally regardless of any signal.
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