赔案审核英文

汽车保险理赔流程一般分为以下九个步骤：1、出险：出险的意思就是发生了交通事故，不管是车撞车、车撞人或者是其他的交通事故，都可以申请汽车保险的理赔;2、报案：保险公司要求在事故发生的48小时内必须报案，发生事故后立即向公安报警并拨打保险公司的理赔电话，超过48小时没有报案的，保险公司将会拒绝进行理赔;3、现场处理：为了不影响道路交通，有些情况可以选择在标记轮胎的位置后，移动事故车辆，一般都用“T”来标记车辆轮胎的位置;4、提出索赔请求：车主可以在保险公司的勘察员达到事故发生的现场以后提出索赔请求，然后等待勘察员的勘察;5、配合保险公司事故勘察：经过保险公司的勘察员到事故现场进行初步查勘后，判定事故是否属于保险责任范围内，如果属实就进入下一步理赔流程;6、结案：根据损失部位的痕迹及损坏程度，查勘会初步现场定损或直接到修理厂、4s店、定损中心去定损，就完成了结案;7、提交索赔材料：之后车主要按要求向保险公司提交索赔所需的全部材料，然后保险公司审核确认车主所提交的索赔材料的真实性和完备性;8、索赔审核：材料审核通过之后，保险公司进行保险赔款的准确计算和赔案的内部审核工作;9、领取赔款：保险公司依据商定的赔款支付方式和保险合同的约定支付赔款。提交材料：1.车损索赔资料：双车驾驶证行驶证正副页复印件，你的身份证复印件，你的银行卡号，交警责任认定书，对方车维修发票和交强险保单复印件，你的维修发票2.人伤索赔材料：1.伤者身份证复印件正副页，用药清单（盖医院红章），用药发票（该医院红） 门诊病例 住院费用清单（还是盖章） 出院医嘱 如果涉及评残，还有评残鉴定书。

车险理赔流程：

出险-报案-查勘-定损-核价-核损-核赔-支付

1、报案：一般保险公司要求在事发48小时内报案。

(1)出险后，客户向保险公司理赔部门报案；

(2)内勤接报案后，要求客户将出险情况立即填写《业务出险登记表》(电话、传真等报案由内勤代填)；

(3)内勤根据客户提供的保险凭证或保险单号立即查阅保单副本并抄单以及复印保单、保单副本和附表。查阅保费收费情况并由财务人员在保费收据(业务及统计联)复印件上确认签章(特约付款须附上协议书或约定)；

(4)确认保险标的在保险有效期限内或出险前特约交费，要求客户填写《出险立案查询表》，予以立案(如电话、传真等报案，由检验人员负责要求客户填写)，并按报案顺序编写立案号；

(5)发放索赔单证。经立案后向被保险人发放有关索赔单证，并告知索赔手续和方法(电话、传真等报案，由检验人员负责)；

(6)通知检验人员，报告损失情况及出险地点。

以上工作在半个工作日内完成。

2.查勘定损

(1)检验人员在接保险公司内勤通知后1个工作日内完成现场查勘和检验工作(受损标的在外地的检验，可委托当地保险公司在3个工作日内完成)；

(2)要求客户提供有关单证；

(3)指导客户填列有关索赔单证.

3.签收审核索赔单证

(1)营业部、各保险支公司内勤人员审核客户交来的赔案索赔单证，对手续不完备的向客户说明需补交的单证后退回客户，对单证齐全的赔案应在“出险报告(索赔)书"(一式二联)上签收后，将黄色联交还被保险人；

(2)将索陪单证及备存的资料整理后，交产险部核赔科。

4.理算复核

(1)核赔科经办人接到内勤交来的资料后审核，单证手续齐全的在交接本上签收；

(2)所有赔案必须在3个工作日内理算完毕，交核赔科负责人复核。

5.审批

(1)产险部权限内的赔案交主管理赔的经理审批；

(2)超产险部权限的逐级上报。

6.赔付结案

(1)核赔科经办人将已完成审批手续的赔案编号，将赔款收据和计算书交财务划款；

(2)财务对赔付确认后，除陪款收据和计算书红色联外，其余取回。

定损注意事项：

1、车辆维修前需确定损失部位的维修方式。

首先必须告诉大家的是保险公司对于损失部位的定损原则。一般来说，保险公司对车辆损失部件的处理意见以修复为主，即损失部件可以进行修复使用，且修复后不影响该部件的正常使用功能的，应当进行修复处理。如果损失部件无法修复的，可以更换损失部件。

所以，在对车辆损失部件进行定损时，我们首先就要与保险公司和维修单位确定损失部件中，哪些是予以修复的，哪些是予以更换的，避免后期维修中因损失部件维修还是更换而产生争议。

2、确定车辆维修费用金额。

在车辆维修中，维修费用的高低也是比较常见的争议之一。保险公司对于车辆维修费用一般是按照维修单位的资质等级来核定的。对于更换的损失部件则是按照配件市场区域价格进行报价。

但是，部分维修单位可能因为配件进货渠道等原因造成配件价格高出保险公司报价，或者其他原因造成维修工时费用较高。在这种情况下，我们应该在保险公司定损人员、修理厂接待人员三方都在的时候，共同协商好修理总费用。

3、定损和维修尽可能在同一地点。

除了做到以上两点以外，还必须要注意的是定损地点与维修地点要尽可能在同一家维修单位。因为如果您的车是在4S店定损，也确认好了维修项目以及维修金额。事后您又到社会修理厂去维修，且按照4S店定损金额支付维修费用，那么您就有可能要承担损失了。因为，保险公司对于4S店与社会维修厂的定损价格标准是不一样的，保险公司是按照实际修理厂标准确认维修金额标准。

参考资料：

百度百科-车险理赔流程

应该是 :保险公司 出险报案、(查勘定损)、理赔管理应用程序流转系统

First, the principle of settlement of claims My company has been dealing with process followed heavy contracts, the principle of keeping promises to fulfill "prompt, timely, accurate and reasonable" settlement of the 16-character one. Without violating the law and under the premise of the insurance provisions, as far as possible to meet the reasonable demands of customers, and fairly deal with claims issues. Second, the loss adjuster working experience 1, dealing with high-risk projects in the experience of loss High-risk high amount of investment projects, technical sophistication, risk concentration, the accident occurred after the loss of reasons, the responsibility defined, and its choice of compensation methods require higher skill levels and more abundant working experience, over the years, I have against the company and to train a group of employees with the quality of the above. 2, dealing with large losses experience Floods, fires, typhoons and other disasters and accidents often lead to large enterprises within the framework of damage, but the loss of a single reason for the loss in varying degrees, I deal with the company in similar accidents, the standard in the determination of claims, the claims focus and training, emergency response procedures for the settlement of claims prepaid compensation, and other aspects of a complete set of operating procedures. 3, quickly raise large sums of compensation ability and experience Unified corporate, authorized management mode of operation, I made the company can do a chessboard, in a huge indemnity, we can rapidly mobilize funds for payments, such as the 1998 Yangtze River floods, my company in a short time, to raise 1.5 billion yuan - to my local branch. 4, and domestic and foreign experts, adjusting the experience of co-operation To ensure reasonable, accurate, my company started earlier and industry experts to deal with, I established a company's own technology expert network; for convergence and the international insurance market, we achieved in the country and has business licenses international adjusters have also established good relations of cooperation. Such as: 1, Qualcomm criteria Technology Services Limited (SGS - CSTC Standards Technical Services Ltd); 2, Mr. Fallon international settlement Group (Mclarens Toplis group.) 3, the public guessing too An insurance company 4, Ocean Insurance Appraisal Company 5, Dalian Zhengda Insurance Appraisal Ltd. Third, claims procedures 1,report The event of a disaster or accident, the insured shall immediately notify our company, calls 95518. Reporting methods can be oral or written. I made a report to the company, will be detailed records of insurance policies, insurance other,subject, the accident occurred time, place, why, etc., belonging to quickly determine whether the accident and timely insurance Tongzhi insured, the insurance people at the same time request to be furnished " no notices "registration file. 2, site survey: My company for your company provides 24-hour reporting service, received a report quickly to the scene of the incident after a survey to verify time, place, after, causes, extent and the amount of losses to the insured to the rescue. The total loss in 300,000 yuan within selected incidents accreditation body, and selected 1-2 experts to attend work if losses over 300,000 yuan, according to international practice, the two sides jointly commissioned designated domestic or after the China Insurance Regulatory Commission approved insurance estimated losses for the public to identify. 3, approved compensation losses and prepayments My insurance company based on the terms set insurance liability, according to the agreed terms of the insurance contract and the extent of damage to property and loss of the losses amount to determine the number of compensation, once the amount of loss by mutual recognition, in the insurers to provide all of claim document, in Dalian branch competence (5 million yuan the following or its equivalent in foreign currency), I will be in seven working days to pay compensation if the company authority over Dalian, as reported to head office approval, I will be in 30 working days pay reparations. The responsibility belongs to the large insurance compensation, the amount of time it is difficult to determine if I can amount of the company's 30 to 50 percent, the first part of the compensation paid in advance to help your company promptly resume production. The loss amounted to a final, I will be the required time limit for payment of the remaining compensation.