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Property and Casualty - CK

 

Property and Casualty

What is Property and Casualty insurance?

It is a insurnace that help to protect you and the property you own. Property insurance helps cover stuff you own like your home or your car.

Types of P&C insurance

Homeowners insurance

Renters insurance

Car insurance

Pet insurance

Natural disaster insurance,

 

Detailed explanation of types of P&C insurance

Homeowners insurance can help pay to repair damage to your home or your personal property like fire, lightning, windstorms, hail, smoke, theft, That’s the “property” part of homeowners coverage

 

Renters insurance protects you and your personal property against covered perils, much like homeowners insurance. A key difference, however, is that because renters don’t own the places where they live, their property coverage doesn’t include their physical dwelling itself—that’s covered by landlord insurance

 

Car insurance can cover physical damage to your car along with your liability in case your actions cause bodily injury or property damage to someone else.

 

 

Pet insurance helps cover your furry friends’ vet bills.

 

Flood insurance, which isn’t included with standard homeowners or renters policies, provides coverage for when your home or personal property are damaged or destroyed by floods. If you live in a flood-prone area, you’ll want to purchase a separate flood insurance policy.

 

Earthquake insurance reimburses you for damaged caused by earthquakes. Insurance policy already covers losses caused by fires, explosions, theft, and other named perils in the aftermath of an earthquake.

Patient responsibility or out of pocket expenses

The amount which patient needs to pay from their pocket

Deductible: PR1  Fixed annual amount paid by secondary insurance or patient before he can take benefits from the insurance company.  Or

It is an amount which patient needs to pay before insurance starts to pay

 

Co-insurance: PR2- A specified percentage amount paid by secondary insurance or patient.  80:20

 

Co-payment: PR3 Small dollar amount paid by secondary insurance or patient on every visit

 

 

 

What is Insurance Underwriting

It is the process through which insurance company determine the actual loss and after that they will price it

 

What is Insurance Claim

It is a formal request from the insured for reimbursement against the losses under your insurance Policy

 

What is Insurnace

Insurance is an agreement with a company in which we pay them in a regular amount of money So that they agree to pay at the time of any mishappening

 

 

What is Settlement

Mutual understanding between insured and insurer.

 

 

 

Who is Adjuster

It is the person who settle the claim for the insured

 

Natural Disaster Insurnace

It is only covered for the person who pays high premium

 

What is Premium

It is a amount which need to paid by the policy holder before getting benefit from insurance, monthly , qualtery, half yearly, yearly

 

 

Who is Insured

who has purchased the policy

 

Who is Insurer

insurnace company who pays money to the provider or insured

 

What is insurance Coverage

Insurance Coverage that covers the risk and liability or loss of a person that arise due to any mishappening  and it is covered by insurance company

 

Annuity

It is a Private company sponsored plan in which Person has to pay the premium for a Given period of time and he can get the benefit(money) after the maturity and it paid in ceratin interval of time with Interest by the insurance company. For Eg. LIC

RISK

Risk measures the uncertainty that an investor is willing to take to realize a gain from an investment

 Differnce between agent and broker

Broker can help clients buy and sell property, negotiate sales prices, and sign contracts

An insurance broker represents you as the client whereas an Insurance Agent represents the company they are employed by as their client, and you become the customer.

 

 

Type of annuity

Fixed Annuity- your money earns interest at rates set by the insurance company

Variable Annuity: the insurance company invests your money in stocks, bonds or other investments you choose.

 

What is Subrogation-imp

Subrogation' is referred as the process of seeking reimbursement from the responsible party for a claim that they had already paid. For example, you have an accident where your car gets damaged, and you have car insurance, the insurance company will pay you the money. But the insurance company comes to know that the accident occur due to other party fault, now they will claim the money from the other party this is known as 'subrogation'.

 

What is indeminity Plan

Indemnity' term in the insurance is used to cover the loss or damage claimed by another person. For example, the owner of the gym has indemnity insurance to compensate it customers in case of injury or accident and to avoid the financial loss due to a lawsuit.

 

 

 

 

What is Double Indeminity Plan

'Double Indemnity' or murder. This type of policy is provided by some insurance companies, where according to their policy they are liable to pay double the face amount in case of death by accidental means does not cover suicide, and death caused by gross negligence of the insured person. For example, John is taken into surgery to have his appendix removed. Following the surgery, John develops a high fever and other symptoms which have the nursing staff concerned. Upon examination, it is determined that the surgeon accidentally left a surgical sponge inside his abdomen, which requires a second surgery for removal. John’s surgeon has acted negligently by failing to ensure all of the sponges were accounted for before ending the first surgery. While this is upsetting, it is something that occasionally occurs.

 

Insurance cycle

 submission, processing, adjudication, and payment/denial.

 

 

Insurnace name-Allstate, StateFarm group, USAA group,Liberty Mutual

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Profile

 

 

 

Underwriter

In this process new policy has been designed

In order to design new policy basic details are required like-

Name , DOB, SSN, Address

So we have to enter all the details which was given in the data after adding all the data we have to bill the claim to the insurance for processing .so my task was to chk the data and enter all the thing manually without any error and sometime we have to open the records like patient card, DL and many more things to enter in the software.

Software name--Invision

 

KCC recovery Process

In my previous organisation I was working as a analyst and I was working in KCC recovery process , so we get allocation on daily basis from the client under that insured name  and contact number car number and claim number was listed so we have to search the account with the claim# in the software called EFR, so after opening that software we have to check the how much amount needs to be paid and how much amount we have received from Insurance after checking if we found that payment is made correctly then we have to forward the case to client and if amount is overpaid so in that case we have to create a case and sent the overpayment amount back to the insurance company and if there is underpayment then we have to recover that amount from insurance.

And on daily basis I have to work on 50-60 cases per day

 

 

 

 

 

FNOL ( First Notification Of Loss)

In my previous organisation I was working as a analyst and I was working in FNOL process, first of all let me tell u about what is FNOL ( When ever the loss occurs ,the insured or the representative such as employee ,broker, agent inform the insurer( insurance company) about the incident so this is known as FNOL.

This is the first step of a claim process and my job was to review the loss notification received and need to generate a claim number and we have check any duplicate notification about that loss if found than no payment will be made and we have to route that claim to our dedicated department.

If there is a fresh claim we will capture the relevant details and we will generate a claim number ,after generating a claim number we will sent that case to dedicated department so that the can contact the adjuster for the payment.

 

 

 

 

 

 

 

 

Payment Support process

In my previous organisation I was working as a analyst and I was working in Payment Support process related to claims,

So on daily basis we are supposed to get invoices in my bucket, we have to review the claim by opening the invoice in our software called CareB after opening I have to check every details related to that claim and if everything iis ok the we have to issue a payment, and while issuing a payment we have to make enteries and after entery it goes to concered department for approval after approval of that case it goes to payment department wo make the payment.

Our daily target was 40-50 cases per day

 

 

 

 

 

 

 

FCC Process/

In my previous organisation I was working as a analyst and I was working in FCC process so we got allocation through email and after getting the allocation

We have to open a claim through account number

 

And need to sent First Notification of  loss to the insurance Company                     

Need to chk Date of injury and date of incident

After that need to submit the Claim

And after submitting it goes to adjuster

Who verify all the loss occurred

After verifying Adjuster will process the claim and make the payment

And after payment if insurer is not satisfied with the payment made by the adjuster he can file a complaint in labour court.

 

 

 

 

 

 

Underwriting process

Software-Vision and Adapt

In my previous organisation I was working as an executive in underwriting process and about my work we got allocation on daily basis through email or we got PDF so after getting the allocation we have to open the account# in software called Vision and I have to design a new policy of the insured so we have to add date of birth, address ,social security number, policy ID, and we have to update the policy and after updating the policy we also help the customer in upgradation of the policy or changing the policies. So that's all about my work, my main work is to design a new policy.

 

Design a new policy

Help customer in changing the policy

Help customer in upgradation in there policy

 

SSN-It is a 9 digit number which is used to track the earning of US citizens ( govt)

 

 

 

 

Name

Living in

Schooling

College

Familiy

Workexperince

I want to join Genpact for better carrer and better future

In my previous organisation I was working as an executive in underwriting process and about my work we got allocation on daily basis through email or we got PDF and after getiing allocation I have open the account in the software Called Vision and design a new policy , so to design an new policy we need coupe of information like name, DOB, Address, SSN, so after getting there delatils we have to design a policy and after creating the policy we have to forward the case to verification team , and we also help the customer in upgrading the policy and help the customer in chaning the policy and my main work is to design a new policy.

 

Nomrally  120

And 1 case krne 5-7

 

 

 

 

 

 

 

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