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When a claim is received , it is first checked whether the claimant is insured by the organization.
If not , the claimant is informed that the claim must be rejected.
Otherwise , the severity of the claim is evaluated.
Based on the outcome ( simple or complex claims ) , relevant forms are sent to the claimant.
Once the forms are returned , they are checked for completeness.
If the forms provide all relevant details , the claim is registered in the Claims Management system , which ends the Claims Notification process.
Otherwise , the claimant is informed to update the forms.
Upon reception of the updated forms , they are checked again . |