Simple claims
T/F: Pregnancy, childbirth, miscarriage, abortion or any complications are ALL covered under HIB
FALSE
In CI exclusion, The contraction of the Critical Illness is within or prior to the Elimination Period - this is the same for both Indiv and group
Trop I
Troponin I
turn around time for disbursement
2 days
Turnaround time for Appeal / Requests for Reconsideration / Holding period for pending claims
30 days
the maximum day HIB could be covered
1000 days
in HIB, is organ donor confinement covered for both Individual life and Group?
YTD Top QC scorer for Living team
Karyn
A third party vendor engaged by Manulife Philippines to conduct investigation when deemed necessary upon adjudicator’s assessment
External Investigator
In Healthplus, The Company will pay the expenses incurred for prescription drugs prescribed by the Insured’s attending Physician while confined in a Hospital for each day of the Insured’s Hospital Confinement as a result of Injury or Sickness.
Prescription Drug Benefit
The rider counterpart of Group - AMR benefit to individual policies
Maccimax
AMI
top error driver for death
bank account details
Approves claims that are beyond the authority of the Claims approvers.
Claims Committee
The Most common pregnancy complication filed to us.
This also means pregnancy in which implantation of a fertilized ovum occurs outside the uterine cavity.
Ectopic Pregnancy
What is the main difference between TDW and TPD
TPD - provides lumpsum benefit
SLE
Systemic Lupus Erythematosus
Approver of disbursement if claim batch is beyond 50M
This refers to the act of canceling or voiding an insurance policy from its inception, as if it never existed. This typically occurs when an insurer discovers that the policyholder has misrepresented or omitted critical information during the application process, which would have affected the insurer's decision to issue the policy or the terms of the policy.
Policy rescission
Under what FB surgical procedure does CESAREAN SECTION belong to?
Operation on Uterus
Creatine kinase-MB
Direct POC with finance
the process of changing the policy status upon receiving claim death notification. Usually done in CAS
Death Claim Tagging