Insurance claim

An insurance claim is the assertion of a right to payment, reimbursement, defence, repair, or another benefit after an insured event. In Swiss practice, the insured or beneficiary must notify the insurer within the required time, provide relevant documents, and cooperate in clarifying the facts and loss amount. The insurer examines coverage, exclusions, causation, deductibles, and possible breaches of duties. Claims may be accepted, partly paid, reserved, or denied. Disputes often concern the scope of cover, medical or technical evidence, late notification, limitation periods, and interpretation of policy conditions.