Every insurance company has a dedicated department that deals with claims reported to them. There are however several challenges that the claims officers will face on day to day management of claims. Here is a list of challenges face;
- Non – disclosure of information
- Fraud / Corruption
- Identity theft
- Falsified documentation
- Early claims due to unnatural deaths
- Doctors / Service providers
- Fraud is a problem in all industries
- Losses are quite significant
- Assessors should not be overly suspicious
- There has been a challenge in interpretation of the Three types of non – disclosures
- Innocent – pay in full
- Negligent – proportionate remedy
- Deliberate or without care – decline or cancel from inception
- Arbitrators would want us to charge relevant premium and pay claim but its been challenging
