At present, people's awareness of personal security is improved, and they are also very concerned about all kinds of insurance. In the process of insurance claims settlement, most people know that there is a set of processing procedures for claims settlement, but they don't know the details of some claims settlement processes, but these processes are very important. Let's study together.
1、 Beneficiary reports to insurance company
The first important step in the process of insurance claim settlement is that the beneficiary reports the case to the insurance company. But in fact, no matter the beneficiary or other people, they can inform the insurance company of the ID number and relevant information of the insured, so that the staff of the insurance company can access the relevant information of the insured in the information base of the insurance company.
After reporting the case, the relevant staff of the insurance company will guide the reporter to handle the subsequent other insurance claims. In the insurance law, there are clear requirements for claims. Life insurance can make claims within five years from the occurrence of insurance accidents. In personal insurance, claims can be made within two years after the occurrence of an insured accident. If the above-mentioned period is exceeded, it means that you have waived the right to claim.
2、 Staff of insurance company collect relevant materials of the insured
First, the beneficiary needs to fill in the claim application. In addition, other materials have different specific requirements with different types of insurance. The common part is that the beneficiary should provide the proof of the relationship with the insured. If the application is not made by the beneficiary himself, the applicant shall provide proof of the relationship with the beneficiary and other relevant personnel.
For life insurance and accident insurance claims, special materials such as death certificate or disability degree appraisal report shall be provided. If it is a report of serious illness insurance, the medical report and other materials of the insured shall be provided. The proof materials of health insurance shall include receipts, medical records, operation records, etc. of the hospital. The second important step in the process of insurance claim settlement is to collect the above important information.
3、 Preliminary material review by staff
This is a complicated part in the process of insurance claim settlement. The staff of the audit department will check all materials collected one by one. If it is true that the cause of the accident meets the claim requirements stipulated in the contract, the beneficiary can be contacted to pay the insurance benefits in two to three days.
After this time, I didn't receive any contact from the insurance company, indicating that there are some problems. I can take the initiative to contact the insurance company for information. If the cause of the accident is not within the scope of the insurance company's responsibility, the insurance company will enter the stage of coordination talk and insurance claim investigation.
4、 Conduct coordination talks or insurance claim investigation
In the case that the cause of the insured's occurrence of the insurance accident belongs to the exclusion of the liability of the insurance company, if the amount is relatively small, the insurance company will communicate with the applicant, and the appropriate result will be put into compensation or no compensation. If there is no agreement, it will move to the investigation stage later.
Insurance claims investigation staff will conduct more detailed case investigation. After receiving the detailed results, we will negotiate with the applicant, if the applicant does not accept it, we can appeal.