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claims assessment checklist
Initial Claim Review
Verify policyholder information
Ensure all necessary documents are submitted
Check for policy coverage and limits
Identify any red flags or inconsistencies
Assign claim to appropriate adjuster
Investigation and Documentation
Conduct interviews with involved parties
Gather evidence and documentation
Assess damage or loss value
Consult with experts if needed
Document findings and observations
Evaluation and Decision
Review investigation results
Compare claim against policy terms and conditions
Determine liability and extent of coverage
Calculate settlement amount
Prepare and send decision letter to claimant
Settlement and Resolution
Negotiate settlement terms with claimant
Process payment for approved claims
Handle disputes or appeals if any
Close claim file with final documentation
Review feedback for process improvement
