Assess and settle a covered loss

Step by step

1. Record loss claim Insurance Coordinator

   Insurance Coordinator identifies the exact policy, loss date, report date, claimed amount and evidence for the loss. A veterinary submission may provide care evidence, but it remains a separate record.

   • Record loss and evidence on the exact policy
   • Updates Claims, Policies

2. Decide claim Authorized Underwriter

   Authorized Underwriter examines the loss date, coverage window, exclusion, limit and deductible. The authorized insurer decision records approve, decline or request evidence, benefit and reason. Keep the insurer's authority distinct from the policy review role.

   • Record the authorized benefit result
   • Updates Claims, Policy coverages, Claim decisions
   ApprovalA person approves before the work moves on.

3. Record claim payment Insurance Coordinator

   Insurance Coordinator links the payment to the exact claim and decision, and checks amount, paid date, provider event and verification.

   • Reconcile payout to decision
   • Updates Claim payments, Claims, Claim decisions

4. Check closure Insurance Coordinator

   Insurance Coordinator follows the settled claim and payment evidence before the authorized claim owner closes the case.

   • Confirm settlement evidence before closure
   • Updates Claims, Claim payments

Insurance Coordinator

Prepares and follows operational records; Authorized Underwriter makes independent decisions; App Administrator maintains carrier and membership context; Auditor reads the trail.