Out-of-Contract Life Claims Settlements Audit Report

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Auditing Compliance and Accuracy in Life Claims Settlements

This sample audit report reviews the out-of-contract life claims settlement process at a company.

Key findings and respective recommendations include: developing and documenting the meaning of an out-of-contract life claim settlement and the approval criteria used to assess an out-of-contract life claim settlement request; amending the current out-of-contract life claim settlement request process so that all requests must first be subjected to the claims appeals process prior to consideration as an out-of-contract life claims settlement request; and maintaining a detailed log for all out-of-contract life claim settlement requests received (both approved and denied). Key information to be included in this log should be defined and consistently captured, establishing an out-of-contract approval process which includes an appropriate segregation of duties and periodic independent review/oversight over approved and denied requests, and documenting the accounting and financial reporting approach used for out-of-contract life claim settlement payments. The documented guidance should include referencing of any impacting statutory accounting and compliance standards.

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