Service
Claims application file audit
A line-by-line financial review of claim applications as they sit in the processing file: figures, policy wording, and supporting papers.
Ask about this reviewThis is the core engagement. We take a defined batch of insurance claim applications — motor, medical, property, or liability — and test whether the amounts proposed for payment follow the policy, the evidence, and the processing rules the handler was meant to apply.
Each file is treated as a financial record, not a workflow ticket. We recast the claim computation, match invoices and medical bills to the heads of loss, and note where deductibles, betterment, salvage, or contribution have been missed or applied twice.
The output is a file-level working paper plus a batch summary: agreed amounts, questioned amounts, and items that cannot be concluded without further papers from the claimant or the handler.
On the engagement
- Sampling plan agreed before the first file is opened
- Recalculation of settlement figures against policy limits and excesses
- Cross-check of invoices, repair estimates, and medical invoices to the application
- Exception log with a recommended next action per file