Templates
Operations
Insurance Claims Audit Checklist
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Insurance Claims Audit Checklist

1
Claim receipt confirmation
2
Verify client’s policy active status
3
Confirm the incident occurred within the coverage period
4
Validate the cause of loss
5
Review supporting documentation
6
Approval: Documentation
7
Check claim history of the policyholder
8
Assess value of loss/damage
9
Calculate amount payable after deducting Deductibles/ Excess
10
Approval: Payable Amount
11
Prepare preliminary claim report
12
Submit preliminary report to Manager
13
Approval: Manager
14
Finalize and submit claim report
15
Prepare claim settlement letter
16
Delivery of the claim settlement letter to policy holder
17
Close Claim File