By 
Insurance claims are an integral aspect of the insurance industry, representing the crucial moment when policyholders seek the financial protection they’ve invested in. To gain insight into the dynamics of insurance claims, insurers employ various metrics to track and analyze these transactions. In this blog post, we explore the key terms related to quarterly insurance claims, shedding light on the significance of each and how they contribute to understanding the claims landscape.
- Total Number of Claims Actionable:
The Total Number of Claims Actionable is a comprehensive summation of various claim statuses at the end of the quarter. It comprises:
- Claims Paid: The number of claims successfully processed and settled by the insurers during the quarter, which includes those outstanding at the beginning of the period and new claims intimated and revived during the quarter.
- Claims Declined: These are claims that the insurer has refused to pay during the quarter, based on reasons specified in the policy document or other valid grounds.
- Claims Closed as No Claims: These are claims reported by policyholders, for which the insurer makes provisions for liability. However, the liability does not materialize during the quarter, resulting in the claim being closed without any payout.
- Claims Outstanding: These are claims that are still pending settlement at the end of the quarter, calculated as the difference between the total claims actionable and the claims paid, declined, and closed as no claims.
- Claims Intimated and Revived:
- Claims Intimated: This represents the number of claims reported to the insurers during the quarter. These are new claims that insurers are informed about and are in the process of assessing and processing.
- Revived Claims: These are claims that were previously closed, but policyholders or claimants have revived them during the quarter. This revival can happen for various reasons, prompting insurers to reevaluate the claim for potential settlement.
- Claims Revised:
Claims Revised refer to claims for which the reserves amount has been changed during the quarter. Reserves are set aside by insurers to cover potential claim payouts. A revision in reserves could occur if the initial assessment of the claim changes, impacting the amount required to settle the claim.
Conclusion:
Quarterly insurance claims data provides valuable insights into the performance and dynamics of the insurance industry. By understanding key terms such as total number of claims actionable, claims intimated and revived, claims revised, claims paid, claims declined, and claims closed as no claims, insurers can effectively manage their operations, assess risk exposure, and ensure timely and accurate claim settlements.
For policyholders, this data highlights the significance of prompt claim reporting and adherence to policy terms to maximize the chances of successful claim settlement. Overall, a transparent and efficient claims process is vital for maintaining trust and confidence in the insurance industry, benefitting both insurers and policyholders alike.
