From first notice of loss to final payment, a sequence of steps determines the outcome. The claims process is the structured series of actions an insurer follows to receive, investigate, evaluate, and resolve a claim under a policy.

Typical stages include notice, assignment to an adjuster, coverage verification, loss investigation, reserve setting, negotiation or determination of amount, and payment or denial. Communication with the claimant and documentation at each step are essential. Time limits imposed by policy conditions and unfair-claims-practice regulations shape the timeline.

Efficient processes improve customer experience and control loss adjustment expense. Complex claims may involve experts, subrogation recovery, and litigation management. Insurers continually refine workflows and technology to handle rising claim volumes while maintaining accuracy and compliance.

• Sequence from notice of loss to settlement
• Includes investigation, evaluation, and payment
• Subject to policy and regulatory time frames
• Affects customer satisfaction and expense