Claims Processing

Recovery Procedure: Claims Processing

• WHAT
  • CS01 - Claims Processing (Less Maturity and Annuity Payments)

Plan Development Template: Recovery Procedure Page 1 Copyright @ GMH Pte Ltd

Pre-Crisis

• HOW
  • Store Claim Schedules, medical-term dictionary, standard letter templates, policy contracts payment vouchers at offsite office.
  • Coordinate with IT to provide backup for Claims Management System.

Recovery & Resumption

Within T+4 hours

• HOW
  • Grab cheques and important system listings (pre-prepared) in the event of an evacuation
  • Require claimants whom were informed prior to crisis for cheque collection or demanding customers to provide documentary evidence to support their claims.

Within T+4 hours to T+8 hours

• HOW
  • Request from claimants whom were informed prior to crisis for cheque collection to provide documentary evidence to calculate claim amount. E.g. Policy Document
  • Require demanding customers whose payments are due on the day of crisis to submit documentary evidence.
    • For cases without documentary evidence, a copy of the policy is to be extracted from warehouse.
    • Proivde manual Cheque Preparation by Finance.
    • Require claimants’ signatures on legal document as valid discharge and declaration.

After T+8 hours

Plan Development Template: Recovery Procedure Page 2 Copyright @ GMH Pte Ltd

• HOW
  • Access E-Claims to identify cases, outgoing cheques and mails lost in crisis
  • Access Claims Tracking system to identify cases (not registered in E-Claims), outgoing cheques and mails lost in crisis
  • Re-requisition for cheques lost in crisis.
  • Re-type letters which were lost in crisis.
  • Determine the need to resubmit for claims which are in progress.
  • Claims processing and Payment.

Restoration & Return

• HOW
  • Update in the system all data which were manually processed during the crisis.
  • Reconciliation of claims processed manually during crisis.
  • Redirect claim submission back to office.
  • Liaise with Finance on reconciliation of cheques issued during crisis.