what is claims management process

What is the Claims Management Process?

Everyone has some insurance nowadays. Basically, you have insurance, and when damage occurs that your insurance policy covers, you can relax because you are insured. This is where Claims Management comes to play.

A claim, regarding insurance, is a formal request made by the insurance policyholder to the insurance company to compensate for the damages that have occurred. After the claim is made the insurance company involved verifies and approves the claim. Then the applicable compensation is made based on the situation.

A Claims Management process is a procedure in which the insured party’s claim for damage compensation is received, verified, and validated. Also, the loss is compensated upon the claim’s approval. The process covers the timeline of a made claim from the minute you file it to the instance of approval or even potential denial.

signing insurance claim form

This is what happens during a Claims Management process:

1. Getting in touch with the insurer 

First off, you have to formally inform your broker that damage has occurred. This is done by filing a claim. You must enlist all circumstances so it can be analyzed by your broker and the claim can progress to the next stage.

2. Claim Investigation

An adjuster is called in to determine the amplitude of loss and gather other circumstantial details. This is where damages are verified, and any inconsistency is determined.

3. Policy Review

As it is stated in the name, during this step your held policy is reviewed and determined which damages or losses are insurable and which are not.

4. Damage Evaluation

An expert is consulted for advice to get a fair evaluation of the cost of damages.

5. Payment

You will be contacted by your insurer regarding the settlement of your claims.

Claims Management is crucial to reduce fraudulent claims. It is a popular criminal law movie element to produce fraudulent claims to obtain insurance money. However, this scenario is just as likely to happen in a real-life scenario, thus it goes without saying how important it is to perform a Claims Management process.

Claims Management software plays an important role in the Claims Management process. It not only supports the workflow but provides an organized environment for decision-making, thus decreasing risks and errors. If you would like to know more about Claims Management, don’t hesitate to contact us! Watch our video to find out more: