www.loanperformer.com

Table of Contents (Online Help)

Insurance claims

Note that all insurance policy holders have a right to claim for payment/compensation as long as the sickness or accident occurred within the period when the Insurance policy is still valid. It is possible to enter claims on a date after the expiry of the policy. This window allows the user to register the claimant's claim details so as to process Insurance Claim payments.

How to process Insurance claims?

To process Insurance claims you go to Insurance/Claims and a screen like the one below shows up:

• Policy: Choose the policy whose claims you want to enter/ register.
• Select claim: From the drop down, select the claim you want to make adjustments or add against the policy. The claim will only display after selecting the policy.

• Note:
  1. When registering the claim for the first time, there will be no claim yet to pick from this drop-down.
  2. Several claims can be made against the same insurance policy and all of them will appear here in this grid.

• Event occurred on: Enter the date that the event insured happened. It can be the date of falling sick (Disease) or accident.
• Claim placed on: Enter the date the insurance claim is/was placed e.g "15/07/2020"
• Claimant: Enter here the name of the claimant or his/her representative e.g "Jane Gathu"
• Admitted on: Enter the date that the insured was admitted (or when the accident happened) 
• Discharged on: Enter the date that the insured was discharged.
• Claimant phone: Enter here the telephone contact of the claimant e.g "+256-772917898"
• Relation to holder: Incase the person presenting the claims is not the policy holder/owner indicate the relation of that person to the policy holder.
• Client code:The client code of the selected policy will automatically populate here.
• Accident or disease: Select the nature of the Insurance event that occurred to the claimant. It could be an accident or disease suffered. This events will be represented by their Item codes e.g. "200001" as entered under Support files/Accidents and Diseases.
• Add receipt: Once all the above details have been captured click on the Add receipt button and an insurance receipt window pops up as seen below:
• Edit receipt: Click on the Edit receipt button to highlight the receipt and edit it to make changes.
• Save: Click on the Save button to save the receipt. Ensure that the receipt presented is also scanned so that it can be uploaded. The uploaded receipt/file will appear at the envelope shaped field at the right of the screen as seen below.

• Receipt date: Enter here the date indicated on the claim receipt presented by the claimant e.g "15/07/2020"
• Hospital: From the drop down select the heath facility (Hospital or clinic) the receipt is originating from. e.g Hospice. These hospitals or clinics should have been entered under Support files\Hospital and Clinics.
• Receipt number: Enter the receipt number here e.g "00001"
• Amount: Enter here the claim amount indicated in the receipt. This amount is not final as it is subject to verification before it's approval under Insurance/Approve receipts.
• Description: Write down the description that best fits the transaction on the receipt e.g. "Accident claim".
• Upload files: Click this button to upload the receipt. The uploaded receipt/file will appear at the envelope shaped field at the right of the insurance receipt screen below.The folder shown where the receipt is attached is the folder defined at System/Configuration/General path to Insurance files
• Save: Click on the Save button to save the upload or Cancel to determinate the process.

• Click on the Save button to save the uploaded receipt/files. The receipt will appear attached to the insurance policy detail as seen below.

• The details of this claim will also appear both in the fields provided and in the scroll bar in the grid as seen below:
• Any other claim against this policy (POL21000004) will be saved here and will appear under the grid with their cumulative total if not yet paid.

• The system will also prompt the users if they want to preview the Summary claims report with the option to print. The Summary claims report can be printed at this stage.
  

  

  

  

• 

Please note that, for your receipts to be saved, before uploading ensure that you save an image / picture with the recommended extension formats in the Insurance folder you created under System/Configuration/General/Insuranceso that when uploading you will click on that image. Your receipt will be saved. This you will do once. The recommended formats appear once the upload button has been clicked as seen above:

Click on the Save button to save the details of the claim. This details will be available for approval and claim payments.

Related Topics

Contact LPF live support for more information
This service requires an Internet connection.