Claim Adjudication

Claims Specialists

The Claims space is heavily regulated by state and federal statutes which require that only licensed professionals handle the actual processing of Claims. Boost manages the claims process with fully licensed claims specialists that offer a full suite of Claims capabilities. These specialists handle the intake, processing, adjudication and payment of Claims. They also deal with any customer communication directly during Claim processing.

Claims Adjudication

The process of taking a claim from FNOL to settlement can be simple or require many steps depending on the Product and nature of the claim. Something like a cyber security breach might involve deeper investigation than something like a dog getting the sniffles. Boost manages all processing including validation to prevent fraud, whether or not the claim should be covered under the policy and communicating with the insured for any follow ups.

Claims Settlement

The final step of adjudication is the settlement of a Claim. Settlement can happen a couple of ways.

Full SettlementThe Claim was accepted and the amount paid to the Customer is equal to the reported value of the loss.
Partial SettlementThe Claim was accepted but will not be completely covered by the payment. This could be the result of a limit or Policy term, OR could be the result of an agreement reached between the Customer and the insurance provider.
Claim DeniedThe Claim was denied and the insurance will not pay out. Denials are generally the result of a Claim being outside of any Coverage under the Policy.

Once a settlement decision has been made the Customer will be notified of the outcome and a check mailed out to their preferred address.


What’s Next