Video Demos

Video Demos

Review the following videos to help solidify what you've learned throughout this course. These are videos of real claims and recorded by Pet Specialists.

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Demo - RIP Approval Claim

This video is a great example of settling an RIP claim (deceased pet) that is approved with some exclusions. RIP claims take a little extra special handling since the policyholder is already under a lot of stress and grief.

Demo - Complication of a Pre-Existing Condtion Denial Claim

This video is a great example of settling a claim related to a complication of a pre-existing condition. This is a denial, but with a twist (the complication), which requires a slightly different macro. You can also see how to enter multiple different exclusions into the macro. Lastly, you can also see what happens when settling the claim when it's fully denied in the Item Review & Payment task.

Click Here!Cian vs. OG Policy

Demo - Dental Illness Denial Claim

This is a great example of a policy that doesn't have the Dental Illness add-on, so all of the charges were grouped together (as seen in the Item Review & Payment task). So it's a straightforward denial explaining that dental illnesses aren't eligible for coverage under the A&I policy.

Demo - Partial Approval/Denial Claim

This claim is approved, but has some exclusions and is in a state that requires specific wording (California).

Demo - Lack of Information (LOI) Closure

This is an example of a claim that is being closed due to lack of information. That means it is neither approved or denied, just being closed for the time being due to how long it's been opened and the fact that we didn't receive key information necessary for the claim. These require some different messaging (macros), so definitely take the time to watch this through.

Demo - Pre-Existing Claim Denial

This is a straightforward Cian policy denial due to the condition being pre-existing.

Demo - Multiple Condtion Claim Denial

This is a great example of a claim denial but with two denied medical conditions and how to format the denial letter to address both conditions.

Demo - Duplicate & Preventative Claim

This is a preventative claim appoal but it also contains some duplicate claim items. This is a great example of handling a preventative claim and what to do if we're denying a claim because it's a duplicate.

The CLX Pet Specialist was able to determine that the pet had a Cian policy right away... How? The easiest/quickest way to differentiate between an OG policy and Cian policy is the waiting periods. In this case, the CLX Pet Specialist saw that the pet had an orthopedic waiting period, which means they have the Cian policy. However, if the pet has a renewal, the orthopedic waiting period won't be on the Squeezed Version page, so you can either:

1. Search for the waiting period (command F "waiting"). If they have an orthopedic waiting period, they have the Cian policy. If they don't, it's the OG policy (screenshot example of searching waiting period in a renewed Cian policy).
2. Or look at the "What's Not Covered" section. Cian policy will have bullet points, the OG policy will not.

OG Policy

Cian Policy

Cian Policy