Claims Follow-up for General Insurance Agencies
A claim is the moment a client judges the agency. This module gives each claim one record, so staff can say what was sent, who replied and what is still outstanding.
One record per claim
A claim opens from the policy, so the insurer, number and client are already attached. The entry then grows as the claim moves.
Motor and health claims differ
A motor claim usually involves a garage, a surveyor and a repair estimate. A health claim involves a hospital, a TPA and a cashless or reimbursement route. The record carries the fields for each, and the stages are named the way the agency speaks of them.
Who uses it
Claims staff own the list and see which claims need a call today. The owner reads open claims by age. Servicing staff answer a client’s question without asking the claims desk. Nobody has to hunt through a phone.
What it does not do
It does not decide, approve or pay a claim. Those steps belong to the insurer. The system records what the agency did and what the insurer replied. How long an insurer takes is not predicted or promised here.
Frequently asked questions
Can a claim be opened straight from a policy?
Yes. The claim picks up the insurer, policy number and client from the entry, so staff do not retype them.
Does it track cashless hospital approvals?
It records the approval request, the reply and the amount noted, as entered by staff. The approval itself is given by the insurer or TPA.
Can the client see the claim status?
Not by default. Staff can share an update over WhatsApp. A client view would be built as its own piece of work, should the agency want it.
What if the insurer rejects the claim?
The outcome and the reason given are recorded, along with any representation the agency made on the client’s behalf.
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