What must claims examiners confirm when reviewing an insurance claim?

When reviewing an insurance claim, claims examiners must confirm that the policy is still in force. This is fundamental because if the policy has lapsed or been canceled, the insurer is not obligated to pay any claims that arise after the policy status has changed. A valid and active policy ensures that the coverage is in place and applicable to the claim being reviewed.

In contrast, while checking if the insured is current on premium payments is important, it is not the primary concern at the initial stage of a claim review, since the primary focus is to establish the active status of the policy. The history of disability of the claimant, while relevant in some contexts, is not a prerequisite for the claim to be validated; it may only come into play depending on the nature of the claim itself. Lastly, although there may be requirements regarding the timeliness of claim submissions, the safeguarding of the policy’s active status is a fundamental step that must be confirmed for the claim to proceed. Ensuring the policy is in force is therefore essential in the claims examination process.