CLAIMS

CLAIMS

Keeping Insurer's promise
1. First Party claims
2. Third party claims(Liability)
Supporting Insurer's profit goal
1. Generating Underwriting profit
2. Fair treatment
  1. Public Adjuster
Structure
1. Home Office
  1. Sr.Claims Officer
    1. Claim Officer
      1. Regional Divisional Claim office
    2. Claim Officer
      1. Regional Divisional Claim office
        Branch Office
        Claim Manager
        Claim Supervisor
        Claim Representative
        Branch Office
Claim Handling process
1. Acknowledging and assigning
2. Identifying the policy and setting reserves
3. Contacting the insured
4. Investing the claim
  1. Subrogation
5. Documenting the claim
  1. File Status notes
  2. File Reports
  3. Dairy System
6. Determining the cause of Loss
7. Concluding the claim
  1. Mediation
  2. Arbitration
  3. Appraisals
  4. Mini-trails
  5. Summary Jury Trails
Performance Measures
1. Loss Ratios
Claim Personnel
1. Staff claim Representatives
  1. Outside Claim Representative
    1. Investigations
  2. Inside Claim Reresenatative
2. Independent Adjusters
3. Employees of TPA's
  1. Self Insured
4. Producers
  1. Authority of $2500

Resource summary

	Created by Vikas Bhandekar about 7 years ago