closed claim

closed claim

(klōzd klām)
A claim whose processing has been completed, including review of any appeals.
References in periodicals archive ?
Review a representative sample of open and closed claim files;
However, as we started working with Telesis in claims testing, we noticed that the way they configured their automation testing tool, that active and closed claim data conversion could be a real possibility.
While anecdotal evidence provides support for this assumption, it cannot be explicitly verified since general damages claimed are not reported in the closed claim data.
Based on data contained in the Physician Insurers Association of America Data Sharing Project, which contains information on more than 192,000 closed claims and suits, the average indemnity and allocated loss-adjustment expense payment per closed claim is between 15% and 20% higher for bariatric compared with general surgeons.
The general objectives of the claim audit includes: assessing the efficiency and effectiveness of the TPAs; reviewing a reasonable sample of open and closed claim files; evaluating the TPAs, adjusters experience, competence, and staffing levels; obtaining suggestions for improvement in claims handling, reserving, expense control, loss mitigation and reporting; ensuring that all provisions of the contract for the TPAs services are met and compliance with the NYLB-TPA Claims Handling Procedures.
Within the first 90 days after Superstorm Sandy, Wright Flood closed or advanced payment to nearly 70% of its 20,000 claimants; while the flood industry was generally criticized for a closed claim rate that reportedly reached just 30%.
In this manner, you can systematically recognize similar claims characteristics earlier in the life of a claim, using historical, closed claim data.
Within the first 90 days after Superstorm Sandy, Wright Flood closed or advanced payment to nearly 70% of claimants, while the flood industry was generally criticized for a closed claim rate that reportedly reached just 30%, as seen in the WSJ Metro Section.
The group's reserves appear to have stabilized in years 2005-2007 as evidenced by its reported favorable reserve development emanating largely from closed claim files.
This report also references data collected in previous IRC closed claim studies.
A closed claim review of cases with severe shoulder dystocia performed using this screening tool indicated that a sizable portion of cases could be predicted with a relatively small increase in the rate of cesarean.