Question

In: Nursing

Summarize the steps a claim must go through in order to be processed and payment received.

Summarize the steps a claim must go through in order to be processed and payment received.

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Expert Solution

ANS)

There are 5 steps a claim must go through in order to be processed and payment received.They are,

1) Contact your broker- For getting the claim,firstly an individual must contact his/her insurance policy agent or broker and the broker must understand your condition and start the proceedings.After that an adjuster would begin the proceedings for getting the claim.

2) Claim inspection starts- Just after the claim has registered,it would require to be inspected by an experienced adjuster to decide the cost of damages which is covered by your insurance policy.Any witness can be provided to fast up the procedures.

3) Policy review - After finishing the inspection,the adjuster may go through the policy vigilantly to decide what is or what is not covered in the policy and tell you about the applicable deductibles which might bear to your case.

4) Injury/damage assesment is performed - For correctly assessing the range of damage,the adjuster hire other officers for further checking and finishing the evaluation.

5) Setting up the payment - After all the damages has been resolved,the adjuster will communicate with you about the settlement of your claim or the payment.The time for getting the payment will rely on the complication and seriousness of the condition.

THANKS!!!


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