Claims Management Services

Overview

When a loss occurs, businesses need a streamlined and strategic approach to claims handling. Delays, disputes, or inadequate documentation can lead to financial setbacks, reputational damage and operational disruptions. A well-managed claims process ensures businesses recover quickly while minimizing financial exposure.

EDME Edge

• Claims advocacy
• Data analytics
• Claims specialists
• Reduced claims management time
• Analysis report, in case of non-coverage
• End-to-end assistance for grievance lodging
  

We do understand that it is quite hectic task for you to coordinate with insurance company and their appointed surveyor, which is why, we have a specialist claims management team that is well familiar with approach of insurance company and surveyors.
They use their knowledge and experience for our client’s benefit because we very well understand the importance of our client’s satisfaction, who are the pillars of our existence.
Just to add that our team is also well qualified on Insurance subjects so our customers keep dependency on our guidance
Other than delivering excellent customer experience, we do add value in terms of managing claims for our clients.

As a professional insurance broker, we represent our clients to insurance company and their appointed surveyor, which means that we are your partners. Unlike insurance agents who represent insurance company, we represent you so be rest assured to get the best advice from us.
- One of our prime endeavors is to reduce the time taken for settlement of your claim.
- We act as our client’s advocate during the process of claim settlement, during technical arguments with surveyors and insurance companies.
- Just as you are master of your business, be rest assured that we are proficient in our field also and you can really depend on us. So, it makes no sense for you to try and understand the difficult terrains of Insurance subject when we are readily available at your service.
- We keep you in loop at every step of the claims process so that you are well informed of what’s happening and what’s not.
- In case of an unfortunate event of non-admissibility of the claim on which we are convinced, we present to you the same with a detailed note and face to face meeting to make you understand the reasons for non-coverage to your satisfaction.
- If we are not convinced of the rejection, we guide you through the entire process of lodging grievance with the Grievance Cell of the Insurance Company, and if necessary, thereafter, helping you lodge your complaint with Insurance Ombudsman or Consumer Forum as applicable. We discuss and elaborate with your advocate to make them understand the technicalities so that they get grounds to fight the case in Legal Forum, in your favor.
- We help you find the right valuer for your properties who can assess the correct Value to be opted as ‘Sum Insured’ in your insurance policy because you know that if your property is not adequately insured, the net payable claims get reduced proportionately to the extent your property is ‘Under Insured’.
- We keep tab of your timelines to respond and send real time reminders to you to get back with the information requested so that there are minimal or No Reminders from Surveyor or Insurance Company.
- We create customized reports as per your needs in presenting the settled and pending claims in your policies along with reason for pendency.

How We Do It

Our claims team comprises competent industry professionals who are well conversant with the process and possess a high degree of knowledge in this field.
Coordinating with insurance companies is their daily affair and they understand thought process of the insurance company, very well. Our claims team utilize their knowledge and expertise for benefit of our clients.
As soon as a claim is reported to us, we assign a dedicated team member to your service who will make the whole claims process simpler and easier for you.

The said member will;

1. Obtain the information required to lodge the claim from you, analyze the information regarding its primary admissibility in terms of policy conditions and then register the intimation with the insurance company
2. Follow up with insurance company for appointment of surveyor and once appointed, shall make an initial call to surveyor introducing himself and then inform you about the contact details of the appointed surveyor.
3. Wherever necessary, our claims coordinator shall visit to loss, especially during surveyor’s visit.
4. Once inspection is carried out, we shall follow up surveyor to share his Letter of Requirement.
5. Once Letter of Requirement is received, we guide our client suitably and assist them in drafting Notes, Letters, Format, etc. as is necessary. Wherever necessary, we even talk to their vendors, guiding them to provide the documents and information in the desired format of surveyor / insurance company.
6. We scrutinize the documents sent by our client before onward submission to surveyor / insurance company there by ensuring error free documentation.
7. Keep in regular contact with your insurance company and surveyor, notify them of any updates received from your side so that they can share their observations if any.
8. Participate in meetings and discussions with surveyors and insurance companies with you or on your behalf (as necessary)
9. In case you have any query regarding the insurance company or surveyor, our team members shall act on your behalf to get answers from them.
10. Follow up with surveyor / insurance company for sharing assessment of claim upon submission of Final Claim bill and supporting documents.
11. Analyze their assessment and notify them if they have made errors or missed out to consider something in their assessment. Only when we are satisfied with the accuracy of the assessment, do we share it with you for your consideration and advice.
12. Once settlement is accepted, we ensure fast disbursement of claim amount.
13. We keep your pending claims status posted by sending MIS reports to you periodically.