closed claim

closed claim

(klōzd klām)
A claim whose processing has been completed, including review of any appeals.
References in periodicals archive ?
Second, nationwide and long-term analyses conducted in collaboration with malpractice insurers are needed to further improve the quality of closed claim analyses.
Review a representative sample of open and closed claim files;
The Obstetrics Closed Claim Study identified a number of "underlying vulnerabilities" that place patients at risk and increase liability for clinicians.
Vickie Kilgore, research director of the Insurance Research Council briefed the attendees on IRC's latest closed claim study of 37,000 auto insurance claims.
The principal source of these data is the Florida Medical Malpractice Closed Claim Report obtained from the Florida Department of Financial Services.
Among the models that will advance are: the Military Sales Practices model regulation; amendments to the Viatical Settlements model act; the Medical Malpractice Closed Claim Reporting model law; changes to the Long Term Care Insurance model act, which includes producer training requirements; and the Uniform Health Carrier External Review model act.
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.
It is interesting to note, however, that results obtained from analyses including the open claims are generally comparable to those for the closed claim sample (see Pozzebon 1993).
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.
The holistic review of a closed claim file for feedback to an individual adjuster is the most common type of assessment.
Bobrow allegedly reopened closed claim files and inserted the new names in an attempt to avoid suspicions.