DESTINI BANGSAKU (LEGAL DISCOURSE)

    1)Faster Claims Processing: AI-powered systems can swiftly evaluate and process vast amounts of data, allowing faster claims processing. Customers will benefit from faster claim settlements, increasing customer satisfaction and retention rates. 2)Fraud Detection: AI systems can be trained to spot trends and anomalies in claims data, making it easier to detect fraudulent claims. This guarantees that valid claims are processed quickly, while fraudulent claims are highlighted for further examination, limiting potential losses for insurance companies. 3)Risk Assessment: AI can help with risk assessment and determining appropriate insurance rates for customers based on their specific circumstances. This tailored approach to risk assessment has the potential to result in more equitable pricing for customers and a better knowledge of the overall risk profile for insurance companies. 4)Chatbots and client Service: AI-powered chatbots can manage client enquiries and help them throu...

The handler of the claim, therefore, has to know whether the event or circumstances regarding the claim is covered. The following questions need to be answered: a) Are the circumstances regarding the claim covered in the policy? b) For a third-party claim, is the Insured legally liable? c) Is there any legal principle which may affect the claim? Once notice has been received, the claims handler should ask himself the following questions: a) Is the policy in question still in force? b) Is the insured item the same as that in the insurance policy? c) Is the event a covered risk/peril? d) Was there an undue delay in the notification? 

An insurance claim is an actual application(demand) for benefit from one's insurance company on the happening of the insured event.  It includes a claim by a third party against the insured whose liability is covered by the insurance company  The person or company that will receive financial compensation or its equivalent benefits from the Insurer is known as a 'claimant’. The are various circumstances and issues that may arise in any claim situation.  Some reasons why a claim is denied: (a) the insurance policy has lapsed. (b) the insurance policy does not include the benefit. (c) claim falls under the exclusions ( i