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Promptness of Claims Settlement (PI9897)

Average number of days elapsed between when an insured incident occurred and when the beneficiary (client of the organization) received the payment or claim denial for all claims settled (or rejected) during the reporting period.
Calculation:
Reporting format
Unit Referenced within Metric Definition
Metric type
Flow
Metric level
Product/Service, Organization
IRIS metric citation
IRIS, 2016. Promptness of Claims Settlement (PI9897). v4.0.

Footnote

Organizations should footnote all assumptions used, as well as the details of claims settlement using a schedule to reflect the detailed timeline breakouts of claims settlement (since acceptable timing can vary by geography). See usage guidance for further information.

Usage Guidance

  • Organizations should note that this metric is calculated using the average of dates from when an insured incident occurs through the date that the beneficiary receives payment or claim denial.
  • Organizations should footnote a schedule outlining the number of claims settled within specified durations and are encouraged to use the breakouts recommended by the Microinsurance Network. The Microinsurance Network recommends that organizations report the number of claims settled within 7 days, 8-30 days, 31-90 days, and more than 90 days. Where applicable, organizations should alter the duration ranges to reflect regional norms.
  • It is not always possible to know how long it takes for a payment to reach a beneficiary (i.e., the benefit received date). In these cases, organizations should estimate using the date in which the claim was paid and footnote these assumptions.
  • For more detail on the ratio, the recommended footnote schedule, and for guidance on interpretation, see the Microinsurance Network's Social Performance Indicators for Microinsurance, p. 19 (http://www.microfact.org/social-performance/).