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Arrange the following steps in a logical sequence of the claim settlement procedure in the Insurance:(A) Scrutinisation(B) Investigation of an assessm
Question

Arrange the following steps in a logical sequence of the claim settlement procedure in the Insurance:
(A) Scrutinisation
(B) Investigation of an assessment
(C) Claim form
(D) Notice of loss
(E) Settlement and Arbitration
Choose the correct answer from the options given below:

A.

A, B, C, D, E

B.

C, A, D, B, E

C.

C, B, A, E, D

D.

D, C, A, B, E

Correct option is D

The claim settlement procedure in insurance follows a structured sequence to ensure that the claim is valid, properly assessed, and settled fairly. The correct sequence of steps in claim settlement is:

  1. Notice of Loss (D):

    • The first step in the claim settlement process is that the insured person must notify the insurance company about the loss or damage as soon as possible.
    • This notice initiates the claim process and helps the insurer prepare for the next steps.
  2. Claim Form (C):

    • After notifying the insurer, the insured person needs to fill out and submit the claim form with essential details like policy number, type of loss, date, and location.
    • This serves as an official request to process the claim.
  3. Scrutinization (A):

    • Once the claim form is submitted, the insurance company scrutinizes the provided documents to check whether all necessary information is available and correct.
    • This step helps prevent fraudulent claims and ensures compliance with policy terms.
  4. Investigation & Assessment (B):

    • The insurer conducts a thorough investigation and assessment of the claim, which may involve loss assessment reports, verification of damages, and professional inspection.
    • This step ensures that the claim amount is justified and that no fraudulent activities are involved.
  5. Settlement & Arbitration (E):

    • After investigation, the insurer processes the settlement based on the claim assessment.
    • If any disputes arise, the matter may go into arbitration before the final settlement is issued.

Thus, the correct sequence is:
D (Notice of Loss) → C (Claim Form) → A (Scrutinization) → B (Investigation & Assessment) → E (Settlement & Arbitration).

Information Booster:

  1. Types of Insurance Claims:

    • Life Insurance Claims(Death claims, Maturity claims)
    • General Insurance Claims(Health, Vehicle, Property, Fire, Marine, etc.)
  2. Key Principles of Claim Settlement:

    • Utmost Good Faith– The insured must provide true information.
    • Indemnity Principle– The claim amount should compensate for actual loss, not profit.
    • Subrogation– The insurer can take legal action against third parties responsible for the loss.
    • Contribution– If multiple insurers are involved, they share liability.
  3. Common Reasons for Claim Rejection:

    • Incorrect or false information in the claim form.
    • Delay in claim intimation.
    • Non-disclosure of material facts.
    • Policy lapse due to non-payment of premium
  4. Importance of Arbitration in Claim Settlement:

    • Arbitration is a dispute resolution process where a neutral third party settles disagreements between the insurer and the insured.
    • This ensures fair and unbiased decision-making in claim-related conflicts.

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