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Insurance Claim

A document or request filed by a policyholder stating that an insured event has occurred and that the insurance company should provide coverage. For example, if a person has health insurance and breaks his leg, he must file an insurance claim in order for the insurance company to pay for some or all of the medical expenses. Depending on the policy, a third party may or may not be able to file an insurance claim on behalf of a policyholder.


You file an insurance claim when you send your insurance company paperwork asking the company to pay for any of the expenses your policy covers.


A demand, as of right.

References in periodicals archive ?
Fundamental to any business process undertaking is a clear understanding, articulation and enablement of the claims operating model.
Claims where only the net proceeds of the litigation are reportable as gross income.
The protective claim is intended to preserve the taxpayer's right to a refund, and the overpayment amount can be stated as "$1.
the author of numerous textbooks on the administration and payment of benefit claims for over 25 years and an AADC affiliate member, is president of Limoli and Associates, sums it up this way: "Your clinical record must.
In the same scenario with an occurrence-based liability policy, the policy and limits in force at the time the claim occurred (2003) responds no matter when the claim is made in the future.
This would include what has commonly been referred to as affirmative adjustment requests and/or informal claims, but would not include 'rollover' type adjustments, carrybacks from a later period or simple math errors.
Although this is useful in correcting past errors, the facility inadvertently may discover false claims which could be subject to disclosure.
For Metropolitan, about 11 percent of claims have to do with inpatient services, while 89 percent are associated with ambulatory care.
AdminisTEP's inventory management feature also electronically notifies the sender of claims when there is a problem.
11, the division, which excludes firefighters and uniformed police officers, received about 1,200 claims relating to Sept.
However, recent bankruptcy court rulings have created results similar to bifurcation, by allocating taxes for the year to pre- and postpetition periods and assigning different priorities to the pre-and postpetition tax claims.
TEI appreciates the opportunity to comment on the proposal for managing the claims process.