Home Knowledge Claims Here is a basic Claims Decision Making Process

Here is a basic Claims Decision Making Process

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This basic process involves obtaining satisfactory answers to the following questions before approving a claim:

  • Was the policy in-force when the loss was incurred?
  • Was the claimant actually covered by the policy?
  • Is the policy contestable?
  • What is the nature of the loss?
  • Has the insured event occurred?
  • What benefits are payable?
  • Who receives the benefit?

This basic process involves obtaining satisfactory answers to the following questions before approving a claim:

  • Was the life assured a key man in the business of the beneficiary in key man policies?
  • Have all the requirements that have been requested been received?
  • Have the necessary specialists been consulted on potentially contentious claims and claims which are to be declined.

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