Difference between revisions of "Claims Processing"
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Revision as of 01:12, 6 October 2020
Contents
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.
Within T+4 hours (RESUMPTION)
- 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.
Back >> Sample Recovery Procedures
Within T+4 hours to T+8 hours (RECOVERY)
- 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 (RECOVERY)
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
- 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.
