Observing insurance claims industry, for firms and organizations.

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2023-05-31 04:14:41 1038 Views

When we talk about the Insurance Industry in the USA as a main and important supporter of all types of businesses, industrial, commercial, agricultural, financial, and touristic, briefly all life activities need insurance to stay and continue the work cycle, to cover the cost of running their business as well the wages of the employees and finally to make profits which is the main target of any business.

Firms or organizations, either big or small businesses need mostly all types of commercial liability insurance as fire and flood insurance, workers’ compensation, commercial vehicles insurance, products insurance, general liability insurance…. etc. Individuals need life, health, travel, personal and public liability insurance, and home maid insurance. Claims are always mentioned in every single detail of insurance policy of any type of insurance, for example (in case of an accident call the claims department, and fill up the claim sheet or application to ask for compensation or indemnities.

The claims department in any insurance or reinsurance company can be considered the second most important unit after the underwriting department, the continuity of the insurance company in this market depends on the way this company deals with its claims, or in other words the streamlines claims process to enhance customers services, centered on people or insureds and organize their claims as well pay within the limits of coverage and as soon as possible to avoid lawsuit which may cost the company more money and waste the time.

Most insurance companies today and especially those top-ranked, gave the claims departments great consideration and care through recruiting well-experienced claims managing directors or what they call Senior Claims Decision Makers to handle that sensitive unit and keep a balance between the clients’ claims the financial position of the company as well in a daily changeable market.

As a concept, an insurance claim can be defined as a formal request by a policyholder which is the insured for the coverage or the sum insured, after a covered loss occurs, the insurance company through its claims department will take care of, and once it accepted and approved, the payment will be issued either to the insured or the interested party on behalf of the insured. There is no doubt that clients today want quicker underwriting as well as claims solving. To meet the rapid advance, most insurance companies started digitalizing Auto Claims as a top priority and working on other claims also which are more complicated and need time to handle.

Claims Management and its importance to Insurance Companies

As insurance coverage and risks are growing day after day, claims management is increasingly complex and becomes a great challenge to insurance companies, where the wrong decisions in solving some claims and the bad managing of claims may lead to a great financial loss for the company. It is true that underwriting is an important unit in any insurance company for the number of policies it sells and the benefits it brings for the company, but it is true also that Claims Management is equal in importance to Underwriting and is a more sensitive job in any insurance business. It is not only the proactively managing and resolving a claim, resulting from any source of covered risk, such as natural disaster, cyberattack, bodily injuries, material damages, and losses.
In a complex environment today, where risks are occurring frequently, claims management becomes very hard, even the most experienced claims manager needs to develop his knowledge as well as his capacity to keep his company in a safe financial position. Based on what was mentioned the Claims Manager should develop strategies to reduce the claims, to keep his company away from lawsuits. 

Consequently, the expert Claims Manager can help solve the claims as quickly as possible, at a low cost to his company and with complete acceptance of the client.

 FAQ About Claims Industry

What is the best and quick way to make a claim?

 Usually and normally, panic is the first reaction of anyone involved in an accident, the priority first is to take care of injuries, and if there is none, the following steps must be followed:
- Call the nearest police station if it is necessary to record the details of the accident.
- Document everything and exchange information with the other party or parties 
-Contact your insurance company or your agency
- Fill out your claim within 24 hours and submit it, it would be better if it is available online.

How do I know if my claim will be covered, and if there is a deductible on it?

It is better first to contact your agent or broker and give him all details, to help your eligibility for coverage of the loss, regarding deductibles which are mentioned in any policy, and it is a portion requested to be paid by the insured before the insurance company start-up processing the claim and pay the insured the costs of the loss.
What are the documents requested to be submitted by the beneficiaries for life insurance claims?
After the death of the holder of the life insurance policy, the legal heirs or the first beneficiaries, such as his widow and children are requested to prepare and submit the following documents with the claim form:
- Original policy document
- Death Certificate
- Birth Certificate
- Any other document requested by the Insurer.