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Concept and process life insurance claims


									Concept and process life insurance claims
Concept and process life insurance claims
The definition of life insurance claims
Life insurance claims is the insurer to cover the insured property accidents, insurance
claim the contractual relationship request, under the terms of the insurance contract,
agreement, audit insurance and deal with the insurance compensation law.
The insured or beneficiary access to life insurance protection and realization of its
essential security interests of way
The insurer to fulfill the obligation for the insurance contract
Operating a concrete manifestation of the quality of life
The significance of insurance claims and claims
Through claims and claims for the community in the production of financial security.
The insured or the beneficiary of the insurance benefits enjoyed realized.
Insurance coverage of quality inspection.
Can further improve and enhance the disaster loss prevention.
Make the insurance cost be fully realized.
The content of life insurance claims
1, in the usual sense of the death, disability, serious illness, injury care, hospital care
and preventive medical care insurance benefits
2, occurrence of the insured due to the return of premium
3, as applicable to the subject of the refund of duty exemption policy cash value
4, due to terminate the insurance contract and the refund of premium
5, Waiver of Premium
The functions of life insurance claims
? achieve protection
? and regulations
? strengthen brand
Protection function is the most essential function of life insurance
Terms reviewed and standardized test
Review and test the quality clerk
Review and test the new contract underwriting operations and management of such
Statistical analysis of data, prompt feedback
Reasonable, reliable and convenient services should be community

The purposes and principles of life insurance claims
? purpose of claims
The principles of claim
Satisfy the insurance policy holders should have protection
Provide proactive, enthusiastic, sincere, thoughtful service
Principles from the real
The principle of fairness
Principle of efficiency
Claims in the life insurance business in the position
? claims for Development
? claim the benefit

A report admissible
Report Definition
Report form
    Report registration
    Report Login
Placed on file
Placed on file rule: the conditions placed on file the conditions placed on file the
application materials the applicant
Return items
Processes: review Registration No files placed on file transfer
Claims Audit
Audit Points
   ?Audit objects and links
   ?Address the audit results
Claims Conclusion
    Normal payment
    Accommodation payment
    Termination payments
    Not covered
Investigation and evidence collection
The main methods of investigation
That the approved
Report writing
Claims basis, the closed archive
Note claims calculated
   ?Confirm eligibility of recipients
   ?Claims files on File
   ?Premium waiver
Claims statute of limitations
International Claim Association (ICA)
International Claim Association was founded in 1909 and headquartered in
Washington, is the world's largest association claims, the
world's life insurance, health insurance and disability insurance claims
management plays an important role. The host of the qualifying examination are also
the world renowned, their professional qualifications issued by the claims and
certification are recognized worldwide, is a very small number of prevailing in the
global life and health insurance claims on the professional qualification.
International Claim Association (ICA) Code of Conduct (1)
Any claim or claims of the parties that he should be courteous, fair, reasonable
treatment cum quickly received claims for the echo.
International Claim Association (ICA) Code of Conduct (2)
The applicant claims should be fast fact check, an objective assessment of claims,
cum obligations become clear enough in the claims should be fair and just claims
International Claim Association (ICA) code of conduct (3)
Each claims the applicant shall be subject to the same treatment and consideration and
the policy terms should be associated only included.
International Claim Association (ICA) Code of Conduct (4)
Needless to claim the applicant was forced to take necessary legal means to obtain the
amount of the claim, not a policy or policies for which no successful claim as part of
other policy or policies affecting another part of the claim.
International Claim Association (ICA) Code of Conduct (5)
In recognition of our responsibility to promptly pay the payment of all the application
should also have the responsibility to buy insurance to protect the public from false or
should not be responsible for claims from the increase in cost.
International Claim Association (ICA) Code of Conduct (6)
Processes and practices must be established to prevent the background and get special
treatment, should also be careful to save a secret cum right claims settlement record.
International Claim Association (ICA) Code of Conduct (7)
Implementation of reasonable standards and appropriate manpower, systems,
processes and achieve efficient claims service, these standards should be able to
eliminate unnecessary delays and requirements, adherence to cum too technical
assessment and verification excessive. To encourage and assist claims personnel in the
administrative claims further develop their knowledge, skills and expertise.

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