What do claims administrators do?

What do claims administrators do?


In the event of an occupational accident or occupational disease, the affected worker must inform his employer, who will be obliged to report the accident to the corresponding Administrative Body and refer him to the respective medical center. The concealment of an occupational accident or occupational disease by the employer will be sanctioned by the corresponding supervisory body.

If the employer does not report the occupational accident or occupational disease, the worker must resort to the Administrative Body to which the company is affiliated in order to obtain the corresponding benefits and report the fact to the Labor Inspection (http://www.dt.gob.cl).

In the event that the Administrative Body does not recognize the accident or illness as being of occupational origin, the worker may file a claim with the Superintendence of Social Security, as well as with respect to the benefits granted (http://www.suseso.cl).

What is claims management?

Claims management is the paradox of insurance companies. Neither customers nor insurers want claims to happen, but when they do, they are critical for both parties. … Insurance companies are looking for efficiency and accuracy and to avoid the risk of fraud and/or legal issues with customers.

What is an insurance claim?

A loss is a key element in an insurance contract. It is the occurrence of one of the insured risks, where the Company has the obligation to indemnify, within the limits and with the exclusions agreed upon in the contract. … In a life insurance policy, a loss occurs when the insured person dies.

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What does the directors and officers policy cover?

D&O is a Civil Liability insurance to protect Directors and Administrators. It covers the indemnities for which they are legally liable for damages allegedly caused to third parties in the exercise of their functions, in addition to covering the legal fees for their defense.


Household accidents are all those incidents that occur for different reasons, but that must be solved as soon as possible so that they do not become a major problem. All the breaks, breakdowns or leaks that cause much more serious problems in the structure of a building require a quick solution. However, one of the drawbacks that prevent repairs from being carried out quickly is to determine who is responsible for these repairs, especially within the communities of neighbors. Below, we will explain what to do in the event of a home damage.

The person in charge of the community of neighbors must know that there is a problem. This person will be in charge of communicating it to the owners of the properties and is the one who will make the decision on how to proceed. Of course, in order to do so, he/she will have to follow the rules that the neighbors have in the community.

What is a loss event?

An unforeseen, unintentional act or fact, identifiable at a time and place, originated by a violent, sudden, external and involuntary cause, which produces damage or destruction of things or injuries, incapacity or death to persons.

What is a claim payment?

The payment of claims is an obligation of the insurers, but let’s not forget that the agreement is valid, as long as everyone fulfills their part. Therefore, the insured must take care of five points to fully guarantee the desired protection.

What does D&O insurance cover?

D&O insurance is insurance that protects the assets of a company’s top management against claims from third parties harmed by their decisions, such as employees, shareholders and suppliers. Therefore, it is focused on managers of organizations.

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What is Supply Chain Management?

An occupational accident is any injury sustained by a worker caused by or in connection with work, resulting in disability or death. Therefore, the elements of an accident are an injury; the causal or occasional relationship between the work and the injury, and the disability or death of the injured party.

Accidents occurring on the direct route to or from the place of work. When the accident occurs on the direct route between two workplaces, the accident is considered to be related to the work to which the worker was going.

These are accidents in which the worker’s life is not at risk. When the accident occurs on the direct route between two workplaces, the accident is considered to be related to the work to which the worker was going.

What does the common area policy cover?

Insurance for common areas of horizontal properties covers damages caused by acts of God or natural causes. That is to say, they do not cover deterioration due to use, but rather the events that have occurred. For damages due to use, there are condominium items, which are used for repairs and maintenance.

Where to buy a compliance policy?

Many people wonder where to take out a compliance policy and the answer is simple: in a private insurance company. Insurance companies are the only ones authorized to offer compliance insurance to individuals or companies interested in taking out this type of policy.

What is risk and loss?

risk (risk; peril; hazard) … There must be a possibility of risk; that is to say, the loss whose occurrence is protected by the policy must be “capable of occurring”. Such possibility or probability has two extreme limitations: on the one hand, frequency; on the other, impossibility.

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IESA – Gesinedi – Registration of calls, incidents or claims

In an interview with Mr. Manuel Humberto Gallardo Inzunza, who is a founding partner of the law firm specializing in insurance claims, he pointed out that this is an innovative service with which they seek to partner with insurance agents to attend to the claims of their brokerage portfolio, providing specialized, impartial and sustained attention to clients:

“With this service we add the prestige, commercial, technical and legal capacity of both parties to support policyholders in the event of a claim and to be able to represent them with commitment and without conflict of interest before the insurer. The main objective is to provide the client with complete integral advice, taking care that the terms and conditions of the policy are respected, thus achieving the loyalty of the insured towards the insurance agent.”

“It is a strategic alliance which we formalize with clear rules so that agents can openly tell their clients that they are backed by experts in the attention of claims; with the purpose of strengthening their relationship.”