Leela
Insurance claims handling
IC-01
Draft

Maintain a complete claim file

Requirement

Record the coverage reviewed, communications, investigation steps and decision rationale in a dated file. Retain the file under the applicable schedule and litigation holds.

Trigger

Event-driven

At claim receipt and every material handling action

Action

Record the coverage reviewed, communications, investigation steps and decision rationale in a dated file. Retain the file under the applicable schedule and litigation holds.

Evidence
  • Claim chronology and supporting records

    Controlled record with date, owner, source and review history

Owner

Claims operations lead

Leela can
Monitor

Leela can watch for the trigger, keep the clock, and flag what is late.

Leela can track evidence, dates and exceptions once the scope and connected data are configured; a person resolves regulatory judgments.

Applies

Tell Leela about your company to see whether this applies.

Status
Setup needed

Tell Leela how you handle it today, or hand it over: see what’s next.

What’s next?