Insurance claims process

2007-04-30 Source: Author:

About insurance claims

Claims process

Time limit for reporting

If an insurance accident occurs, the customer should report it to the insurance company in a timely manner. According to the relevant provisions, the claimant shall notify the Company within ten days from the date when he knows or should know that the insured accident occurred. Otherwise, the claimant shall bear the Company's increased survey, inspection and other expenses due to the delay in notification. However, delays due to force majeure are excluded.

How to report the case

After an insurance accident occurs, the customer should promptly report the case to the agent or the company's customer service hotline. The reporter can be the policy holder, the insured, the beneficiary, or the agent.

Report content

The content of the report should include the insured person, contract number, time of the accident, cause of the accident, incident process, hospital visited, etc., to avoid invalid reports due to incomplete information.

Claim application documents

Different insurance accidents require the preparation of corresponding claim application materials. Claim applicants can refer to the "List of Claim Application Materials" to prepare the corresponding materials. After preparing all the claim application materials , submit it together with the completed "Claim Application Form" or entrust an agent to forward or mail it to the Company's Claims Department.

When filling out the claim application form, please note:

1. The policy information (mailing address and phone number) is for the claimant to send the claim documents or contact the claimant for this claim. If any change is required, the company must be notified in writing (there are relevant items to choose from in the claim application form) to protect your rights and interests.

2. The claim application form should be filled in in detail column by column by the claimant. If the claimant is a minor, the claimant or his guardian should fill in the claim application form and sign it.

3. This application is a formal requirement for applying for insurance benefits. Each field in the application has its purpose, which will help speed up the claim settlement process. If it is unclear or missing, it should be regarded as We apologize for not accepting applications that do not meet the application requirements. Please fill in the details one by one.

4. If you choose to receive insurance benefits by bank transfer, please provide the current savings account number of the Industrial and Commercial Bank of China, China Construction Bank, Shanghai Bank or Bank of Communications Pacific Debit Card account number, and submit the relevant account number together. If you receive a copy of the application form, our company will gradually open this business for other banks.

How to collect claims

Certificates for collecting payment: 1. Customer collects in person: original ID card and payment notice; 2. Agent collects on behalf of agent: agent certificate or ID card, ( If the amount exceeds 500 yuan, the original copy of the customer's ID card, the power of attorney for collection, and the collection notice are required

Payment by automatic transfer: If the automatic transfer has been processed at the POS when applying for insurance or at any time during the validity period of the contract , please pay attention to whether the policy holder and the insured are the same person (claims must be paid to the insured). If not (and the insured is an adult), you need to fill in the "payable payment account" column of the "Bank Automatic Transfer Authorization Form" and submit a copy of the insured's passbook. If the insured is a minor, there is no need to fill in this column if the claim payment goes into the policyholder's account.

What are the insurance claims procedures?

NEWS.SOHU.COM December 21, 2004 16:47 Source: Sichuan News Network-Leshan Daily

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Sichuan News Network-Leshan Daily

The claim settlement procedures and steps of insurance companies generally include:

A Acceptance of reports Acceptance of reports is It means that the insured must report to the insurance company promptly when an insured accident occurs, and the insurance company should log in and file the accident. Generally speaking, reporting is an important part of the insurance company's claim settlement process. It helps the insurance company to understand the accident situation in a timely manner, intervene in the investigation when necessary, and verify the nature of the accident as early as possible; at the same time, the insurance company can also make a claim based on the requirements of the insurance contract and the accident situation. , inform or remind the applicant of the materials required to be prepared, and provide guidance on the methods and methods for collecting relevant materials.

B Acceptance materials and case filing Acceptance filing is the process in which the insurance company reviews the claim application materials provided by the applicant to determine whether the materials are complete, whether additional materials need to be submitted, or the insurance company determines whether to accept the claim. During the case filing process, if the submitted supporting materials are incomplete or unclear, the filer of the insurance company will immediately tell the applicant to submit relevant materials; if the materials are complete and clear, the applicant will be informed immediately of the approximate time required to handle the case. , and inform you how to collect insurance benefits.

C Investigation Investigation is the process by which insurance companies collect relevant evidence to verify the authenticity of insured accidents and materials. The investigation process not only requires the cooperation of relevant departments and agencies, but also the cooperation of the applicant is an indispensable link, otherwise it will affect the timely payment of insurance benefits.

D Review review refers to the process in which the case handler determines the objective facts based on relevant evidence, determines the insurance liability, accurately calculates the payment amount, and makes a claim settlement conclusion.

E-signing and approval refers to the process in which the signer of the claim settlement case reviews the work of the above links and approves the verified cases.

After F notification and collection cases have been signed and approved, the insurance company can notify the beneficiary to bring relevant identity certificates and relationship certificates to handle the payment procedures.

(Yang Hao)

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