The workflow is for the following product:
Cattle Death claims due to Accident, Disease and Operation.
The workflow assumes that claims will be given access to :
- Premium Register for Coverage verification.
- Soft copies of all policies issued with hard copy of the Veterinary Surgeons Certificate.
- List of all insured cattle with date of commencement, Tag number, age, Sum Insured
oversight of all claims handling, customer service issues, HDFC ERGO- interface
issues will be the responsibility of the Claims Manager.
Workflow for Cattle Claims(explanation)
- Claim Notification- Customer gives immediate notification to Regional/Branch Office.
Coverage Verification is done by the branch office and the claim is registered through
- Physical Verification- PM Examination of Carcass is compulsory. The same will be
coordinated by the region/branch.
- Documentation – Branch office does the processing of the claim through filenet
and sends it for approval to H.O though filenet (for reserve approval and loss approval).
If documentation is incomplete regional/branch Office sends out reminder.
- Pay/not to pay –Documents are checked for admissibility of loss. Cross checked
with policy conditions. If claim is payable, the claim is approved by H.O.
If claim is not payable, Claims Manager must give his sign-off for repudiation mentioning
the reasons for the same. The denial of the claim to be approved by H.O through
filenet. Claim Manager has to inform claimant immediately of claim repudiation in
writing, with reason.
" All claims are subject to approval by Surveyor appointed by HDFC ERGO GIC LTD