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Scenario #4 - Lucy
Lemonade
Created on September 4, 2025
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Transcript
Scenario #4
Lucy
Start
TL;DR + Claim Media
Both Lucy and Grover have been scratching consistently on their ears and shoulders and chewing at their feet.
Claim Lifecycle
Next
Claim Overview
- Policy Information:
- Policy Started On: 3/4/2025
- Illness Eligible From: 3/18/2025
- Orthopedic Coverage Eligible From: 4/3/2025
- Policy Type: Cian, Vet Visit Fee add-on, Prev+ add-on
- Claim Information:
- Claim Filed On: 3/25/2025
- Occurrence Date Per PH: 3/23/2025
- Vet Visit Date Per PH: 3/24/2025
- Claimed Condition: Skin Allergies
- MRR?:
- MRR is not completed at this time
- Pre-Existing Conditions?:
- No pre-existing conditions had been identified at the time the claim was filed
Next
Invoice
The submitted invoice is below (client information intentionally omitted, vet information omitted for space):
Invoice looks altered because it was cut from 2 pages to 1 for training purposes. So don't worry about possible misrepresentation! :)
How would you proceed with this claim with the information provided to you? Do we need additional medical records? Why or why not? Discuss before proceeding to the following page!
Next
Claim Investigation Determination
Click on the image below to see how a Claim Advocate would proceed with this claim!
Do we need additional medical records?
Do we need an MRR?
Defend your reasoning!
End
