Claim professionals face many unique and diverse challenges when determining whether a claim is payable and to whom such claim shall be paid. The claim professional’s role and expertise is critical since one may unknowingly pay invalid claims on policies that were improperly issued, or even where fraud was involved in the application, unless one basic requirement of the life insurance contract is validated – the presence of insurable interest.
The treatment of cancer is undergoing a major period of research and development with new treatments being introduced on a regular basis. Many of these are very expensive, with the cost of some new drugs running into tens of thousands of dollars. Cancer is highly emotive, with patients eager to benefit from the latest medical advances. It is therefore important that health underwriters and claims assessors have knowledge of these treatments.
This article introduces some types of treatment being used to combat cancer today. In future articles we will more fully explore each treatment type.
Managing claims involving deaths outside of the United States is a unique challenge for insurers and the claim professional. Foreign deaths are often more complex, and the risk of fraud is much greater than domestic death claims. This requires the collection and analysis of information that may not be necessary for other claims. One tool that can be used to assist in the collection of information necessary to analyze a foreign death is the Foreign Death Questionnaire.
This article will attempt to address such questions as: Who are homicide’s victims and offenders? Why is the U.S. murder rate several times higher than that of other wealthy countries? Why are fewer homicide cases being solved? What significant factors correlate closely with murder rates? And what impact does homicide have on life insurance claims?
Currently, suicide stands as the 13th leading cause of death worldwide, responsible for nearly 1 million fatalities annually. RGA’s Global Research and Development team’s analysis of suicide rates before and after the 2008 financial crisis uses population data from Canada, Australia, the UK and the U.S., as well as insured data from RGA’s extensive database.
This paper presents the results of the research, as well as information about treatment of suicide claims in these markets.
This article will explore and discuss the immediate issues that need to be considered in a life insurer’s claims department, as well as give a practical guide to developing a partnership and support model for the management of subjective claims.
A photo of a young man enjoying himself snowboarding is posted online on a social networking site. Nothing unusual in that – hundreds of thousands of photos are shared in this way every day. The difference here is, this man is currently receiving disability benefits under an Income Protection (IP) policy, claiming that, following an accident at work, he suffers widespread musculoskeletal pain causing significant functional limitation.