When a claim is received , it is first checked whether the claimant is insured by the organization . If not , the claimant is informed that the claim must be rejected . Otherwise , the severity of the claim is evaluated . Based on the outcome ( simple or complex claims ) , relevant forms are sent to the claimant . Once the forms are returned , they are checked for completeness . If the forms provide all relevant details , the claim is registered in the Claims Management system , which ends the Claims Notification process . Otherwise , the claimant is informed to update the forms . Upon reception of the updated forms , they are checked again .