Claims Procedure
Claims Procedures is the process for what happens when a claim is filed.
Each one is it’s own provisions, but they all fall under the umbrella of claim procedures.
- Now, this is typically done by the doctors office and most people are not involved with this, but as a licensed agent you need to know what it looks like.
- It’s a back and forth process between the insurED and the insurER.
- The insurED has a loss and within 20 days needs to call the insurER to provide Notice of Claim to the insurER.
- The InsurER then sends blank Claims Forms for the insurED to fill out to prove the loss.
- When the insurED fills out the forms and sends them back to the insurER, that is known as submitting Proof of Loss.
- Once the insurED submits proof, they are done and now it’s the insurERs job to pay the claim.
Time Payment of Claims tells them WHEN to pay and Payment of Claims tells them WHO to pay, the insured, the doctor, to hospital-each claim/policy can be different.
Recommended: Gold
The GOLD Course is ALWAYS the recommended class series for all students as it teaches the material in more depth. Over 30 hours of the most in depth classes with a more intensive teaching of the topic. Learn more about P&C GOLD
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