---
title: "PD 16: Sample Procedures: Insurance Claims Processing"
description: "Sample Procedures: Insurance Claims Processing"
image: https://blog.bcm-institute.org/hubfs/Implement%20Plan%20Develop.jpg
---
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##### Business Continuity Management
# PD 16: Sample Procedures: Insurance Claims Processing
Before arriving at this plan development phase you would have completed four earlier phases.
These would have enabled you to identify all the resources required to operate the critical business processes and determine the best business continuity strategy to speedily and efficiently recover your business in the event of a crisis.
You are now ready to document a formal BC Plan.
---
[Moh Heng Goh](https://blog.bcm-institute.org/bcm/author/moh-heng-goh) Feb 7, 2025
###### Business Continuity Management Certified Planner-Specialist-Expert
#### 
### Sample Procedures: Insurance Claims Processing
#### 16.1 Critical Business Function
##### WHAT
CS01 - Claims Processing (Less maturity and annuity payments)
#### 16.1.1 Pre-Crisis
##### HOW
- Store Claim Schedules, medical-term dictionary, standard letter templates, policy contracts, and payment vouchers at the offsite office.
- Coordinate with IT to provide backup for the Claims Management System.
#### 16.1.2 Within T+4 hours (RESUMPTION)
##### HOW
- Grab cheques and important system listings (pre-prepared) in the event of an evacuation.
- Require claimants who were informed before the crisis for cheque collection or demanding customers to provide documentary evidence to support their claims.
#### 16.1.3 Within T+4 hours to T+8 hours (RECOVERY)
##### HOW
- Request from claimants who were informed before the crisis for cheque collection to provide documentary evidence to calculate claim amount, .g. Policy Document
- Demand that customers whose payments are due on the day of crisis submit documentary evidence.
- A policy copy will be extracted from the warehouse for cases without documentary evidence.
- Provide manual Cheque Preparation by Finance.
- Require claimants’ signatures on legal documents as valid discharge and declaration.
#### 16.1.4 After T+8 hours (RECOVERY)
##### HOW
- Access E-Claims to identify cases, outgoing cheques and mail lost in the crisis
- Access Claims Tracking system to identify cases (not registered in E-Claims), outgoing cheques and mails lost in crisis
- Re-requisition for cheques lost in the crisis.
- Re-type letters which were lost in the crisis.
- Determine the need to resubmit claims that are in progress.
- Claims processing and payment.
#### 16.1.5 RESTORATION
##### HOW
- Update the system with all data which were manually processed during the crisis.
- Reconcile claims processed manually during a crisis.
- Redirect claim submissions back to the office.
- Liaise with Finance on reconciliation of cheques issued during crisis.
#### Reference
[](https://cta-redirect.hubspot.com/cta/redirect/3893111/3d5d18f0-6660-4115-a6a4-f317614566a0)Goh, M. H. (2021). Implementing Your Business Continuity Plan. Business Continuity Management Planning Series (3rd ed.). Singapore: GMH Pte Ltd.
Extracted from "Chapter 16: Sample Procedures: Insurance Claims Processing"
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