Successful insurance acceptance only tells you that your claim application has been accepted, but it does not mean that the compensation will be certain, how to compensate, and how much to compensate. 2. There are seven processes for insurance companies to settle claims, including case acceptance, case filing, preliminary review, investigation, verification, review, approval, case closure, and filing. 3. The Insurance Law stipulates that insurance companies must make an approval within 30 days. 4. Depending on the size of the claim and other circumstances, the insurance company will usually complete the claim approval within 15 days for the sake of market competition and quality service.
Insurance company review methods: 1. Preliminary review and judgment. The following points are mainly reviewed for case review: -Whether the contract is valid: for example, whether it is within the guarantee period or whether it was interrupted due to forgetting to pay. Whether the contract is signed by me. Brother Chao would like to remind you, never forget to pay. Failure to pay will cause the insurance to expire. After the revalidation period, you will need to make a health notification again. -Whether it is within the coverage: For example, if you just bought life insurance, serious illness will definitely not be compensated. If you buy critical illness insurance, ordinary minor illnesses will definitely not be covered. If you buy medical insurance, you will not be compensated if the deductible is not exceeded. -Whether it is within the scope of exemption: the impact will not affect the underwriting result. For example, whether it was caused by a drunken fight or a congenital disease. -The nature of the accident must be clear: what caused the accident and compensation. Whether it is true and whether there is suspicion of fraud. The judgment on filing a case is basically based on the above factors. After the case is formally filed, the claim review process begins. 2. When it comes to claim settlement, the insurance company will conduct an in-depth investigation of your past records and medical history. You can check social security or New Rural Cooperative Medical Care records, hospital records, and physical examination reports. There are many ways to retrieve past claims records among all peers via ID card, launch an investigative company or detective agency, and more.
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