The steps that result in an insurance carrier's decision to either pay or deny a claim are known as:
A) allocation.
B) adjudication.
C) determination.
D) justification.

Question

Quizplus · Accepted Answer

Adjudication is the process of reviewing and evaluating a claim to determine if it meets the policy guidelines and should be paid or denied. The process involves reviewing the details of the claim, verifying information, investigating any suspicious activity or errors, and making a decision based on the policy's terms and conditions.

The Steps That Result in an Insurance Carrier's Decision to Either