What Is Claim?
A formal request submitted by an insured or provider to the insurer for payment of covered health services. Claims include documentation such as itemized bills, service dates, and diagnosis codes necessary for processing.
Claim across 2 exams
Claim appears on the following exams. Each defines it in the context candidates are tested on:
- Health Insurance
- A formal request submitted by an insured or provider to the insurer for payment of covered health services. Claims include documentation such as itemized bills, service dates, and diagnosis codes necessary for processing.
- All-Lines Adjuster
- A formal request by a policyholder (or a third party) to an insurer for payment or coverage of a loss that the policy is intended to protect against.