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Insurance Claim

An insurance claim is a request made formally to an insurance company for compensation or coverage for a policy event or covered loss.

The insurance company validates the claim, and after approval, it issues the insured or an approved, interested party payment on the insured’s behalf.

Insurance claims cover insurance policies and death benefits, among others. In many cases, third parties can file claims on the insured individual’s behalf, but typically, only the individual or individuals recorded on the policy are qualified to claim payments.

How Different Insurance Claims Work:

Health Insurance Claims

The fees for inpatient hospital stays or surgical procedures are pretty pricey. When providers help policyholders in filling out health insurance claims, it does not need that much effort from patients.

In 2011 over 90 percent of claims were settled electronically.

Policyholders must file paper claims when providers do not partake in electronic transmittals. This kind of insurance claim aids in protecting an individual from the possibility of spending vast amounts of cash due to illness or accidents.

Property and Casualty Claims

As opposed to health insurance claims, the policyholder is responsible for reporting damage to a property he owns. Dependent on the kind of claim, an adjuster assesses and inspects the damage to the property to determine payment.

Once the adjuster verifies the damages, he reimburses or compensates the insured.

Life Insurance Claims

These need the submission of a death certificate, claims form, and sometimes the actual copy of the policy.

Again, the process, especially if it involves a policy with enormous value, would need the carrier to examine it thoroughly. But, again, this ensures that the insured doesn’t fall into a contract exclusion like death due to a criminal act or suicide.