Prepare a clear, proportionate request

This guide helps claims handlers explain what information would help answer an outstanding claim question, why it matters, and how to hand off submission safely. The worked example uses Northstar Mutual, a fictional insurer, and illustrates communication—not coverage, eligibility, or evidence policy.

Printed documents and folders on a desk

Start with the question you need to answer

Ask for information that is relevant to the specific unresolved point.

Before drafting a request, state the claim question in plain language. Check the approved guidance that applies to the claim and request only information that helps address that question. Explain the purpose of each requested item, and use the approved secure-submission route for the customer and claim context.

Example: If the unresolved question is which household item is being discussed, a focused request might ask the customer to identify the item and, if appropriate under applicable guidance, provide a description or image. Do not imply that this example is universally required or sufficient.

Make the request understandable and proportionate

Illustrative wording only. Confirm evidence criteria in the approved guidance for the specific claim.

Worked example: identifying a damaged household item
Claim question
Focused request:
Which household item is the customer referring to?
Unclear or overbroad request:
What else can you send us?
Illustrative evidence category
Focused request:
A description or image that helps identify the item, if appropriate under the applicable guidance.
Unclear or overbroad request:
A broad bundle of unrelated records without explaining why they are needed.
Plain-language explanation
Focused request:
“This would help us understand which item your claim refers to. Please use the approved submission route we have confirmed for your claim.”
Unclear or overbroad request:
“Send all supporting documents.”

Offer a workable communication alternative

Ask what would help the customer understand or respond; follow approved handling processes.

Discuss
Ask about the communication need

Use a neutral question, such as: “Would another format or way of communicating make this request easier to use?” Do not assume what adjustment a customer needs.

  • Let the customer describe a format or communication preference.
  • Record the preference only through the organization’s approved process.
Coordinate
Check the handling implications

If an alternative may affect how information is received, stored, or assessed, consult the designated trained role before agreeing the arrangement.

  • Explain any next step in plain language.
  • Use the approved claims or information-handling escalation route when uncertain.

Prepare and hand off the request

Use the applicable approved process for the claim and customer context.

  1. 1

    Name the unresolved claim question

    Write one clear sentence describing what still needs to be understood.
  2. 2

    Check the applicable guidance

    Consult the authorized source for the claim type, product, location, and role before deciding what information to request.
  3. 3

    Explain each requested item

    Request only information relevant to the question, and state in plain language how it may help.
  4. 4

    Discuss accessible alternatives

    Ask whether a different format or communication adjustment would help, then follow the approved process and consult a trained role when handling implications are unclear.
  5. 5

    Confirm the approved submission route

    Direct the customer only to a channel approved for this claim and customer context. Do not request sensitive claim material through an unapproved channel.
  6. 6

    Record the request and handoff

    Document the request, the customer’s stated preference when applicable, and any escalation using the organization’s approved process.

When the route or requirement is unclear

Pause before asking the customer to send sensitive claim material. Check the authorized claim guidance or contact the designated claims or information-handling support role. If a customer cannot use the confirmed submission route, explain that you will check the approved alternative and follow the organization’s handoff process; do not promise an unverified channel or outcome.

Ownership and upkeep: Financial Services Operations owns this fictional guide. Send a correction through the established operations help route, identifying the claim guidance or submission-channel information that appears outdated. Keep customer claim material in its authorized system.