Statement of Claim

In the context of Extended Health and Dental Care Insurance, a "Statement of Claim" is a document provided by the insurance company to the policyholder after reviewing and processing a submitted health or dental claim. This statement outlines the details of the claim, including the services or treatments received, the amount billed, the portion covered by the insurance, any deductibles or co-payments applied, and the total reimbursement amount paid to the policyholder or service provider.

Key aspects of a Statement of Claim include:

1. Claim Details: Lists the services or treatments for which the claim was submitted.
2. Coverage Explanation: Specifies what amounts are covered by the insurance policy, including any limitations or exclusions.
3. Cost Breakdown: Provides a detailed breakdown of the total charges, insurance payment, deductible amounts, and any remaining balance owed by the policyholder.
4. Payment Summary: Shows the total reimbursement amount and the recipient, whether the policyholder or the healthcare provider.

The Statement of Claim serves as an important record for the policyholder to understand their insurance coverage and any out-of-pocket costs associated with their healthcare or dental services