Claim Status

Below is the list of claim statuses along with the entity capable of updating the claim to particular statuses.

Status

Definition

PIC

INITIATED

Claim has been created but will not be processed until the required data are submitted by the Insured.

Insured

DATA_SUBMITTED

Claim data (forms, and files) has been filled and submitted by the Insured.

Insured

EXPIRED

Insured has not completed all of the necessary claim data within agreed time frame based on the insurance product terms.

Insured

DATA_ON_REVIEW

Claim has been successfully submitted by the Insured and is under review by Cermati Claim Team.

Cermati/Insured

DATA_COMPLETE

Claim has been reviewed by Cermati and proceeded to the Insurer for further analysis and confirmation.

Cermati/Insured

DATA_INCOMPLETE

Submitted claim has been reviewed by Cermati Claim Team but requires additional documents to proceed further.

Cermati

APPROVED

Claim has been reviewed and approved by the Insurer.

Insurer

REJECTED

Claim has been reviewed and rejected by the Insurer.

Insurer

ADDITIONAL_DATA

Claim has been reviewed by Insurer but requires additional documents to proceed further.

Insurer

REIMBURSEMENT_TRANSFERRED

Final status. Claim has been paid by the Insurer to the Insured.

Insurer

CANCELLED

Claim has been cancelled by the Insured. Cancelled claims will not be processed any further.

Insured

PIC

Definition

Insured

Customer(s) or organization whose name(s) is under the policy issuance and/or covered by the insurance.

Insurer

Insurance Company that underwrites the insurance product (insurance risks).

Cermati

Cermati internal team (e.g. Claim Analyst, etc).