Claims Operations Overview
🎯 Purpose
Claims Operations governs the end-to-end operational claims process from first notification of loss through settlement support and closure control activities.
Technical claims decisions relating to liability, indemnity, and settlement quantum remain within the delegated authority framework used by claims assessors. This workspace documents the operational processes, routing controls, governance expectations, and service management standards supporting those decisions.
🧭 Operational process chain
Receive and register notification Capture the claim, validate policy linkage, and acknowledge receipt within operational SLA.
Coordinate assessment activity Appoint assessors, monitor milestones, and manage dependency tracking throughout the assessment lifecycle.
Execute settlement operations Process approved settlement activity, payment execution, and recovery referrals in line with delegated authority controls.
Perform post-settlement review Complete closure quality checks, confirm file completeness, and capture data for operational reporting and portfolio analysis.
📊 Service standards and operational controls
Operational activity | Service standard |
|---|---|
FNOL acknowledgement | 4 business hours |
Assessor appointment | 1 working day for property; same day for motor drivable assessment |
Settlement payment execution | Daily payment cycle |
Operational QA review | Risk-based sampling completed monthly |