Main Responsibilities
Receive and Review Claims
- Acknowledge receipt of claims filed by policyholders (e.g., due to accidents, property damage, or medical issues).
- Review the details of the claim and assess whether the event is covered by the insurance policy.
Investigate the Claim
- Contact the claimant to gather information.Insurance Claim Agent
- Visit the scene of the incident if needed (e.g., accident site, damaged property).
- Collect relevant documents such as photographs, police reports, medical records, or repair estimates.
- Interview witnesses or other involved parties as required.
Assess the Damage or Loss
- Evaluate the extent and nature of the damage or loss.
- Work with professionals such as repair contractors, medical personnel, or auto mechanics to assess the costs involved.
Determine Liability
- Analyze the circumstances of the claim to determine fault (if applicable).
- Ensure the claim meets policy conditions and terms.
Settle the Claim
- Calculate the appropriate payout amount.
- Approve and issue payment or deny the claim with a clear explanation.
- Communicate the decision to the claimant and respond to any questions or concerns.
Maintain Documentation
- Keep detailed records of all communications, investigations, and decisions.
- Ensure all processes comply with legal standards and internal company policies.