InsureIT adl bir sigorta irketinde maluliyet sigortas talepl.pdf

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InsureIT adl bir sigorta irketinde maluliyet sigortas taleplerini ele almak iin aadaki sreci dikkate alyoruz. Bir talep alndnda, bir kdemsiz hasar yetkilisi nce sigorta bilgi sistemine talep ayrntlarn girer ve temel bir kontrol gerekletirir. Daha sonra talep, rapor edilen engelliliin derinlemesine bir deerlendirmesini yapan ve aylk denek hakkn tahmin eden (yani, davacnn ne kadar aylk tazminata hak kazand ve hangi sre iin) bir kdemli hasar memuruna tanr. Ksa sreli sakatlk yardmlar sz konusu olduunda, kdemli hasar yetkilisi daha fazla belge gerektirmeden fayda deerlendirmesini yapabilir ve sonucu mteriye e-posta veya posta yoluyla bildirir. Uzun sreli ( aydan fazla) engellilik talepleri durumunda, kdemli hasar yetkilisi, yardm haklarn deerlendirmek iin tam bir tbbi rapor talep eder. Salk raporu alma sreci aada aklanmtr. Kdemli talep yneticisi tbbi raporu aldktan sonra, yardm hakkn deerlendirebilir. Kdemli talep ileyicisi daha sonra mteriyi deerlendirmenin sonucu ve varsa aylk haklar konusunda bilgilendirir. Karar sigorta bilgi sistemine kaydedilir. Bir talebin bir yetkilendirmeye yol amas durumunda, bir finans grevlisi ilk hak sahiplii demesini manuel olarak tetikler ve sonraki aylar iin aylk yetkilendirmeyi planlar. Bir salk raporu gerektiinde, kk bir hasar ileyicisi mteriyle iletiime geerek (telefon veya e-posta yoluyla) talebinin deerlendirildiini bildirir ve mteriden InsureIT'e kendilerinden tbbi rapor talep etme yetkisi veren imzal bir form gndermesini ister. salk salaycs. Yetki alndktan sonra, kk hasarlar ileyicisi (posta yoluyla) sigortacnn yetkilendirme yazs ile birlikte salk kuruluuna tbbi raporlar iin bir talep gnderir. Hastaneler, InsureIT'e posta yoluyla veya baz durumlarda e-posta yoluyla yant verir. Soru: Yukardaki srete hangi admlar deer katar?(oktan Semeli) A. Temel kontrol gerekletirin B. Salk kuruluundan salk raporu talep edin C. Avantaj haklarn deerlendirin D. Sonucu mteriye bildir E. doktor raporu bekle.

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It had been seven weeks since her surgery and Marlene was One function of the lymphatic system is to help return still feeling the effects of the lumpectomy, axillary dissection interstitial fluid to the venous circulation. Removal of lym(removal of armpit lymph nodes), and radiation therapy. When phatic tissues, such as the lymph nodes that were excised the doctor had told her she had breast cancer, Marlene's world during Marlene's lumpectomy, can compromise fluid drainage. was turned upside down; she was only 57 years old, healthy In Marlene's case, inadequate drainage of her upper limb is proand active. Her initial shock and numbness had given way ducing tissue swelling, also referred to as edema. to a determination to "beat this thing," The doctor had said As she reached into the tepid dishwater, Marlene felt a dull the prognosis was encouraging. Several lymph nodes were buming pain. A sharp knife at the bottom of the dishpan had removed from Marlene's armpit at the time of the lumpectomy opened a gash between her thumb and forefinger. "Francis!" to determine if the cancer present in the bean-sized lump had she called out to her husband. Francis came rushing in. spread to the lymphatic system and potentially to the rest of "Marlene, what's wrong?" he asked. her body. Thankfully it had not. She was tired and disoriented _ "I cut myself. Is it bad?" after the radiation treatments; even now she was only begin-_ Francis took her hand. "It's not too deep. May need a few ning to recover. She felt good enough this evening to wash stitches, though. Let's clean it up and get something on it, then the dishes herself, rather than having her husband do them. We'll go to the urgent care center." The surgery that removed her axillary nodes had left Marlene "If it's not that bad, let's just put a bandage on it. I am so with a nagging pinching sensation in her armpit and numb tired of doctors and nurses and hospitals," replied Marlene. areas of skin near the scar, but overall she felt satisfied with Francis carefully washed the wound and placed a clean the result. The swelling in her arm and hand did bother her, cotton pad over it. "Your hand seems so swollen, Marlene," he however. She didn't think much about the swelling at first, as remarked. the surgeon indicated it might occur if lymphatic vessels were Three days later, Marlene noticed that the swelling was injured during surgery. It had started several days ago, but over worse, and red streaks extended from her hand up her forearm. the last few days her swollen arm and hand had really become She gently lifted the bandage. Pus oozed from the wound, and bothersome. its margins (edges) were red and inflamed. She reached into her.

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