Number of claims that were submitted to the organization but were rejected during the reporting period.
Number of claims that were submitted to the organization but were rejected during the reporting period.
Organizations should footnote all assumptions used as well as reasons that the claims were rejected. See usage guidance for further information.
This metric should capture the number of claims that have been disqualified for benefit payment (i.e., rejected) for whatever reason.
Examples of reasons for which claims might be rejected, to footnote, include: claims submitted for events that are not covered, claims submitted before the waiting period has lapsed, the insured is no longer covered due to expiration of the coverage period or by attaining maximum eligible age, etc.
January 2020 - IRIS v5.1 Released
No change.
May 2019 - IRIS v5.0 Released
No change.
March 2016 - IRIS v4.0 Released (current version)
Immaterial change. Minor revision to definition language for clarity.
March 2014 - IRIS v3.0 Released
New metric. Claims Rejected (PI3383) developed via the Microinsurance Network.