An insurance claim is a formal request made by an insured party to an insurance company for compensation or coverage for a loss or damage covered under an insurance policy. When an insured event occurs, such as an accident, injury, or property damage, the policyholder submits a claim to the insurance company, providing details of the incident and supporting documentation, such as medical bills or repair estimates. The insurance company then investigates the claim to determine its validity and assess the extent of coverage. If the claim is approved, the insurer will provide payment or reimbursement to the policyholder according to the terms of the insurance policy. Insurance claims play a critical role in providing financial protection and assistance to individuals and businesses facing unexpected losses or liabilities.
An insurance claim is an official request submitted to the insurance company demanding payment as per the terms of the policy. The terms of the insurance contract dictate the insurance claim amount. In many cases, before an insurance claim is processed, an investigation is conducted. This type of work is routinely performed by insurance claim adjusters. Thus, an insurance claim may be examined by interviewing the claimant and witnesses, as well as consulting police and hospital records. Depending on a given form of coverage, an insurance claim may be subject to other kinds of scrutiny, such as consulting professionals and inspecting property damage to determine the extent of the insurer’s liability. Additionally, the insurance claim process may require a waiting period, and include various insurance claim riders and sublimits.
This site contains general legal information but does not constitute professional legal advice for your particular situation. Persuing this glossary does not create an attorney-client or legal adviser relationship. If you have specific questions, please consult a qualified attorney licensed in your jurisdiction.
This glossary post was last updated: 29th March, 2024.
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