Regulatory Alerts2021-01-23 | 24037Added · Updated
Claims Guideline for Insurers
Insurers, brokerages, and agencies must establish, document, and implement claims management policies and procedures approved by their Boards of Directors to ensure fair, prompt, and efficient settlement of claims. The guideline mandates specific operational timelines, including acknowledging claim receipt within four business days, forwarding completed forms to insurers within three business days, and effecting payment within three business days of settlement agreement. It further requires insurers to maintain detailed claim files, utilize appropriate reserving methods such as case or triangulation estimates, and establish internal controls and complaint resolution procedures to monitor compliance and handle disputes.