Claims decisions

Coverage verification

Coverage verification is confirming that a policy actually covers a reported loss: the right policy in force at the loss date, the correct endorsements applied, and no exclusion that bars the claim, before it proceeds.

It is rarely one checkbox. Coverage turns on the policy as it stood at the loss date, on mid-term endorsements that moved the terms, and on exclusions that almost apply. All of it is easy to miss under time pressure.

Why it matters

Getting coverage wrong is expensive either way. Pay a claim that is not covered, or wrongly deny one that is. It is the first gate every claim passes through.

In Mysa

Mysa runs coverage as part of the SOP on every claim, the policy at the loss date, the endorsement that moved the deductible, the exclusion that almost applies, and flags anything off.

See it on Mysa