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Claims

Give clients better support when they need it most

Track every claim, document, follow-up and settlement amount from intimation to closure.

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app.agentdesk.co.in / claims / CL-2209Sample data
Health reimbursementClaim CL-2209 · Fatima Shaikh
Claimed₹1,85,000
Approved₹1,62,000
Deducted₹23,000
SettledPending
  1. IntimatedPolicy and insurer filled in
  2. Documents PendingDischarge summary received
  3. FiledSubmitted to TPA
  4. Under ReviewNext follow-up on 18 Oct
  5. Approved
  6. Settled

Start a claim quickly

Choose the client and, when available, select their policy. AgentDesk brings in the policy number and insurer automatically. You can also record a claim for a policy that is not already in the system.

app.agentdesk.co.in / claims / newSample data
New claimPolicy details filled in
ClientFatima Shaikh
PolicyHealth floater ▾
InsurerFilled from policy
Policy numberFilled from policy
Claim typeHealth reimbursement ▾
Claimed amount₹1,85,000

Policy not in AgentDesk yet? You can still record the claim.

Cover common claim situations

Track health cashless and reimbursement claims, critical illness, accident, death, maturity, survival benefit, motor damage, third party, theft, property, travel and other claims.

  • Health cashless
  • Health reimbursement
  • Critical illness
  • Accident
  • Death
  • Maturity
  • Survival benefit
  • Motor damage
  • Third party
  • Theft
  • Property
  • Travel
  • Other

Follow every stage

Move a claim through Intimated, Documents Pending, Filed, Under Review, Query Raised, Approved, Partially Settled, Settled, Rejected or Withdrawn. Open claims keep their follow-up dates visible.

  1. Intimated
  2. Documents Pending
  3. Filed
  4. Under Review
  5. Query Raised
  6. Approved
  7. Partially Settled
  8. Settled
  9. Rejected
  10. Withdrawn

Keep settlement figures clear

Record claimed, approved, settled and deducted amounts, along with the settlement date, payment mode, reference and reasons for deductions or rejection.

app.agentdesk.co.in / claims / CL-2209 / settlementSample data
SettlementHealth reimbursement
Claimed₹1,85,000
Approved₹1,62,000
Settled₹1,62,000
Deducted₹23,000
Settlement date24 OctNEFT · Ref ending 7781
Deduction reason₹23,000Room rent above eligible limit · Non-medical items

Do not lose track of documents

Maintain the pending-document list and the next follow-up date. These actions also appear in the client’s upcoming work.

app.agentdesk.co.in / claims / CL-2231 / documentsSample data
Pending documentsMotor damage · Karan Shah
  • Claim formReceived
  • Driving licenceReceived
  • Repair estimatePending
  • FIR copyNot needed
Next follow-up18 OctCall garage for estimate

Review claim service

Use reports for the claims register, open-claim ageing and settlement ratio by insurer or TPA. This gives management a clear picture of open work and outcomes.

app.agentdesk.co.in / reports / open claims ageingSample data
Open claims ageingBy days since intimation
0–15 days11
16–30 days7
31–60 days4
Over 60 days2

Settlement ratio by insurer or TPA

Insurer A94%
Insurer B88%
TPA C79%

Related pages

Policies and Renewals For Insurance Agents Reports Customers and Families

Keep every claim moving towards closure

Give the team a clear process and the client a better service experience.

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