What does a claims manual typically include?

A claims manual is an essential document that outlines the policies, procedures, and standards necessary for effective claims management within an insurance organization. It serves as a comprehensive guide for claims handlers, providing them with the necessary frameworks to process claims efficiently and consistently.

The inclusion of policies ensures that claims are handled in accordance with regulatory requirements and company standards, leading to fair treatment of policyholders. Procedures detail the step-by-step processes that claims handlers should follow, which helps in standardizing responses to claims and reducing errors. Finally, established standards set expectations for the quality of service and the timeliness of responses, which are critical for customer satisfaction and regulatory compliance.

While customer feedback forms and surveys, detailed descriptions of insured entities, and technical specifications of insurance products are all important aspects of an insurance business, they do not specifically pertain to the operational guidelines and frameworks provided in a claims manual. Therefore, focusing on policies, procedures, and standards directly addresses the core function of the claims manual in managing claims effectively.