1. Investigate and collect evidence, collect, sort out, review survey and damage assessment data.
2. After receiving the notice of survey and loss determination, organize customers and relevant personnel to conduct on-site survey and evidence collection to verify the loss of insurance accidents.
3, meet with customers, check to determine the effectiveness of property rights, find the police and hospital records, determine the responsibility.
4, check the claim form and other records, determine the scope of insurance, all claims within the scope of responsibility, agent claims adjustment.
5. Explain the claim conclusion to customers and agents reasonably, and handle the customer's feedback on survey, loss determination and claim settlement.
6. Filing claims documents, establishing and maintaining claims business database and customer risk files, analyzing customer risk distribution, and putting forward risk management countermeasures to ensure that claims information data is true and accurate.
Extended data:
Claim limitation:
Insurance claims must be filed within the limitation period. If the insured or beneficiary fails to file a claim with the insurer after the limitation period, providing the necessary documents and receiving the insurance money will be regarded as a waiver of rights. Different types of insurance have different time limits. The limitation of life insurance claims is generally 5 years; The limitation of other insurance claims is generally 2 years.
The limitation of claim shall be calculated from the date when the insured or beneficiary knows the occurrence of the insured accident. After the occurrence of an insurance accident, the applicant, insurer or beneficiary shall immediately stop the insurance and report the case, and then make claims.
After the applicant claims, if the insurance company thinks it is necessary to pay the relevant certificates and materials, it shall promptly notify the other party in one lump sum; After the materials are complete, the insurance company shall conduct verification in time, and if the situation is complicated, it shall conduct verification within 30 days and notify the other party of the verification results in writing; Yes, it's an insurance liability.
The insurance company shall pay the compensation within 10 days after reaching the compensation agreement; For those who do not belong to the insurance liability, a notice of refusal to pay compensation shall be issued within 3 days from the date of approval and the reasons shall be explained. The insurer's claim review time shall not exceed 30 days, unless otherwise agreed in the contract. And within 10 days after reaching an agreement on compensation or payment of insurance benefits.
Baidu encyclopedia-insurance settlement of claims