🛡️ Life Insurance Claim Intake & Processing
Knowledge Article ID: WL-CLM-001
Business Area: Claims Services
Audience: Customer Service Representatives (CSR)
Last Reviewed: July 2026
Applies To: Life Insurance Death Benefit Claims
🎯 Purpose
To provide Customer Service Representatives with a standardized process for initiating, documenting, and routing life insurance claims while delivering a consistent and compassionate member experience.
📋 Quick Reference
📞 Initial Member Interaction
When a member, beneficiary, or representative contacts WoodmenLife regarding a death claim:
Acknowledge the Situation
Suggested Response:
"I am very sorry for your loss. I will gather the information needed to begin the claims process and ensure the appropriate team receives your request."
✅ Step 1 – Verify Caller Information
Confirm the following:
Member Information
Before discussing policy details:
✔ Verify beneficiary status
✔ Verify legal authorization
✔ Follow all privacy and identity verification requirements
🗂️ Step 2 – Create a Claim Case
Navigation
Customer Service Workspace → Cases → New Case
Populate Required Fields
Case Description
Document:
📄 Step 3 – Collect Required Documentation
The following documents are commonly required:
Required
✅ Claim Form
✅ Certified Death Certificate
✅ Beneficiary Identification
May Be Required
✅ Trust Documentation
✅ Estate Documentation
✅ Court Orders
✅ Additional Claim Forms
Document Handling
🔍 Step 4 – Perform Completeness Review
Before routing the claim, verify:
If Information Is Missing
Set Case Status:
Pending Documentation
Document:
🚀 Step 5 – Submit for Claims Review
When all required information has been received:
Update Case
Verify
✅ All documents attached
✅ Case notes completed
✅ Beneficiary information validated
✅ Contact information recorded
📊 Claim Status Definitions
⚠️ Escalation Guidelines
Escalate immediately if:
Potential Fraud Indicators
💬 Approved Customer Communication
Claim Submitted
"Your claim information has been received and submitted to our Claims team for review. If additional information is needed, a representative will contact you directly."
Pending Documentation
"We have received your request; however, additional documentation is required before processing can continue. Once received, we will move your claim forward for review."
Related Knowledge Articles
Knowledge Article ID: WL-CLM-001
Business Area: Claims Services
Audience: Customer Service Representatives (CSR)
Last Reviewed: July 2026
Applies To: Life Insurance Death Benefit Claims
To provide Customer Service Representatives with a standardized process for initiating, documenting, and routing life insurance claims while delivering a consistent and compassionate member experience.
| Item | Requirement |
| Verify Caller Identity | ✅ Required |
| Verify Beneficiary Authorization | ✅ Required |
| Create Claim Case | ✅ Required |
| Attach Supporting Documents | ✅ Required |
| Route to Claims Queue | ✅ Required |
| Provide Approval Decision | ❌ Not Permitted |
When a member, beneficiary, or representative contacts WoodmenLife regarding a death claim:
Acknowledge the Situation
Suggested Response:
"I am very sorry for your loss. I will gather the information needed to begin the claims process and ensure the appropriate team receives your request."
Confirm the following:
Member Information
- Policy Number
- Insured Member Name
- Date of Birth
- Date of Death (if known)
- Full Name
- Relationship to Insured
- Phone Number
- Email Address
Before discussing policy details:
✔ Verify beneficiary status
✔ Verify legal authorization
✔ Follow all privacy and identity verification requirements
Navigation
Customer Service Workspace → Cases → New Case
Populate Required Fields
| Field | Value |
| Case Type | Insurance Claim |
| Claim Category | Death Benefit |
| Contact | Beneficiary / Representative |
| Policy Number | Applicable Policy |
| Priority | Normal |
| Source | Phone, Email, Portal, Mail |
Document:
- Reason for contact
- Relevant policy information
- Beneficiary information
- Any documentation already submitted
The following documents are commonly required:
Required
✅ Claim Form
✅ Certified Death Certificate
✅ Beneficiary Identification
May Be Required
✅ Trust Documentation
✅ Estate Documentation
✅ Court Orders
✅ Additional Claim Forms
- Upload all documents to the case.
- Verify attachments are legible.
- Confirm document type is accurately identified.
- Update document status.
Before routing the claim, verify:
| Verification Check | Complete |
| Policy Located | ☐ |
| Beneficiary Verified | ☐ |
| Claim Form Received | ☐ |
| Death Certificate Received | ☐ |
| Documents Attached | ☐ |
| Notes Documented | ☐ |
Set Case Status:
Pending Documentation
Document:
- Missing items
- Date requested
- Follow-up commitments
When all required information has been received:
Update Case
| Field | Value |
| Status | Submitted |
| Queue | Claims Processing |
| Ownership | Claims Department |
✅ All documents attached
✅ Case notes completed
✅ Beneficiary information validated
✅ Contact information recorded
| Status | Meaning |
| Received | Claim reported |
| Pending Documentation | Additional information required |
| Submitted | Sent to Claims Team |
| Under Review | Claims evaluation in progress |
| Approved | Claim approved |
| Closed | Claim completed |
Escalate immediately if:
Potential Fraud Indicators
- Identity discrepancies
- Suspicious documentation
- Unauthorized requests
- Estate disputes
- Power of Attorney concerns
- Multiple conflicting beneficiaries
- Coverage disputes
- Contestability questions
- Unusual benefit requests
Claim Submitted
"Your claim information has been received and submitted to our Claims team for review. If additional information is needed, a representative will contact you directly."
Pending Documentation
"We have received your request; however, additional documentation is required before processing can continue. Once received, we will move your claim forward for review."
- Beneficiary Change Requests
- Policy Information Updates
- Member Verification Procedures
- Document Submission Guidelines
- Claim Status Inquiry Procedures