NIS Navigation & Usage
16 questions
1.
What are the two entry points in NIS and what are they used for?
NIS has two main interfaces:
• WebAgent: policy management (insured person information, financial details, beneficiaries, coverage structure, automated documents, billing, medical exclusions).
• Nordic (NIS Front): case/claim processing, status tracking, prior authorizations (LoG/GoP), care documentation, reporting.
Use WebAgent to view or modify a policy; use Nordic to process a case or a prior authorization.
📚 Training support : NIS Training (Policy) · Sales Training
• WebAgent: policy management (insured person information, financial details, beneficiaries, coverage structure, automated documents, billing, medical exclusions).
• Nordic (NIS Front): case/claim processing, status tracking, prior authorizations (LoG/GoP), care documentation, reporting.
Use WebAgent to view or modify a policy; use Nordic to process a case or a prior authorization.
📚 Training support : NIS Training (Policy) · Sales Training
2.
How do you quickly search for an insured person or a policy in NIS?
In WebAgent, use the "Search" tab. In Nordic, use the search bar at the top of the screen. Information required to identify a file: last name, first name, date of birth, policy number, client code.
📚 Training support : NIS Training (Policy) · NIS Claims Training
📚 Training support : NIS Training (Policy) · NIS Claims Training
3.
How do you quickly identify the actual status of a file in NIS?
There are three distinct statuses to check:
1. The case status (processing phase)
2. The invoice status
3. The payment status
In Nordic, access the case Dashboard to view these three pieces of information. Refer to the 'Claim processing' guide located in the 'Status of a claim' folder on Unisify.
📚 Training support : NIS Claims Training · Sales Training
1. The case status (processing phase)
2. The invoice status
3. The payment status
In Nordic, access the case Dashboard to view these three pieces of information. Refer to the 'Claim processing' guide located in the 'Status of a claim' folder on Unisify.
📚 Training support : NIS Claims Training · Sales Training
4.
How do you ensure traceability of actions performed on a file?
In Nordic, all actions performed on a case are automatically logged in the "Policy Log" section in WebAgent.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
5.
How do you complete an insured person's record with missing information (coverage plan, Social Security number, CFE)?
In WebAgent, access the insured person's record (Policyholder / Insured persons tab). Complete the missing fields once the information has been received from the insured person. If the information relates to a case and is unavailable, set the case to 'Pending External' and contact the insured person.
📚 Training support : NIS Training (Policy)
📚 Training support : NIS Training (Policy)
6.
How do you change an insured person's coverage plan in their personal record?
In WebAgent, access the insured person's record (Policyholder / Insured persons tab), update the 'scheme' field with the information provided, then save.
📚 Training support : NIS Training (Policy)
📚 Training support : NIS Training (Policy)
7.
Why is it important to include NIS links in internal requests?
Including a direct link to the NIS case in internal communications (Teams, email) provides immediate access to the file without manual searching, thereby reducing processing times and attribution errors.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
8.
The insured person is unable to download their insurance certificate -- what should be done?
Check the title (Mr / Mrs / Ms) in the insured person's record on WebAgent. An inconsistency in the title (e.g., MS instead of MRS for a woman, or vice versa for a man) may block the certificate generation. Correct the title and regenerate the document.
9.
How do you handle a configuration bug (e.g., incorrect country of care in NIS)?
Correct the country of care directly in the Nordic case (Step 4 -- Enter the missing information). If the bug is systemic (affecting multiple files on the same contract), open a JIRA ticket and contact your team leader.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
10.
How do you handle a bug affecting multiple insured persons on the same contract? / How do you manage a recurring issue requiring IT escalation?
1. Document the affected cases (case numbers, contract, observed behavior).
2. Open a JIRA ticket with a precise description + screenshots.
3. Contact your team leader to validate the alternative processing approach while awaiting the fix.
Do not process each case individually if a system-level fix is underway.
2. Open a JIRA ticket with a precise description + screenshots.
3. Contact your team leader to validate the alternative processing approach while awaiting the fix.
Do not process each case individually if a system-level fix is underway.
11.
How do you handle a blocking error caused by inconsistent contract dates (start date = end date)?
Analyze the anomaly in WebAgent (Situation information tab -- coverage start and end dates). If the error is confirmed, contact your team leader for correction in the system.
12.
What is the threshold blocking DEEP and claims validation (FR & MX) -- who can modify it?
The validation thresholds for DEEP and claims are defined and adjusted by Team Leaders. Contact your team leader for any threshold modification request.
13.
WebAgent does not allow viewing dependents on the policy -- what should be done?
Contact your team leader.
14.
What should be done if the client cannot see their requests in Easy Claim / Easy Claim display bug?
This bug has been identified and escalated. If the issue persists, escalate via a JIRA ticket. Contact your team leader to validate the procedure.
15.
How do you handle a configuration anomaly on a supplementary plan (e.g., VI)?
Open a JIRA ticket to report the anomaly to the technical team. Contact your team leader to validate the course of action while awaiting the fix.
16.
It would be preferable for insured persons not to have access to their ETNA invoices -- how should this request be handled?
Contact your team leader.
Claims Management
35 questions
17.
What are the standard steps for processing a claim settlement in Nordic?
Claim processing follows 8 steps in Nordic:
1. Case Dashboard (insured person identification + policy)
2. View / download the invoice
3. Modify the case
4. Enter the information (provider, coverage, cover cause, date/country of care)
5. Edit the account (amounts, coverages)
6. Additional information
7. Payment processing
8. Case validation
Refer to the 'Claim processing' guide (Session 2 -- NIS).
📚 Training support : NIS Claims Training
1. Case Dashboard (insured person identification + policy)
2. View / download the invoice
3. Modify the case
4. Enter the information (provider, coverage, cover cause, date/country of care)
5. Edit the account (amounts, coverages)
6. Additional information
7. Payment processing
8. Case validation
Refer to the 'Claim processing' guide (Session 2 -- NIS).
📚 Training support : NIS Claims Training
18.
How do you handle an insured person identification error in a settlement?
In WebAgent and Nordic, verify the insured person's identity in Policyholder for WebAgent, and in the client record on Nordic. The mandatory information is: last name, first name, date of birth, policy number. Correct the identification before any validation.
📚 Training support : NIS Training (Policy) · NIS Claims Training
📚 Training support : NIS Training (Policy) · NIS Claims Training
19.
How do you explain the 'Pending External' status of a case to an insured person?
The 'Pending External' status means that processing is awaiting action from the insured person (missing document, additional information). Inform the insured person of the missing item.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
20.
How do you handle a file classified as 'closed without action' that requires reactivation?
Reopen the case in Nordic. Check the action history and available documents. If the supporting documents are now complete, resume standard processing (Steps 3 to 8). Document the reason for reactivation in the case.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
21.
How do you handle a file with multiple active contracts?
In WebAgent, identify the active policies linked to the insured person. Select the applicable contract based on the date and type of care. In Nordic, link the case to the correct contract before processing. Refer to the 'Claim processing' guide (Step 2 -- Policy overview).
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
22.
How do you validate a settlement in a specific currency?
When entering data in Nordic (Step 5 -- Edit the account), verify that the currency matches the contract currency. The system applies conversion rules based on the configuration. If there is any doubt about the applicable currency, contact your team leader.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
23.
How do you correct a settlement when there is an error related to the absence of Social Security coverage?
Check the reimbursement base (BR) configuration in the Nordic case (Step 5). In the absence of Social Security coverage, adjust the calculation according to the applicable contractual rules. Refer to the cover cause and corresponding coverage.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
24.
How do you handle a reconsideration / adjustment request for a settlement after a client dispute?
Reopen or create an adjustment case in Nordic. Re-analyze the documents and coverage rules. If an error is confirmed: correct the settlement and process it. If the initial calculation is correct: explain the contractual rules to the client and close the case.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
25.
How do you process a settlement pending validation?
In Nordic, identify the case in the pending cases list (Dashboard -- filter by status). Open the case and complete the missing steps (Steps 3 to 8 of the standard process). Validate the case once all information is complete.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
26.
How do you optimize the processing of grouped requests (multiple simultaneous settlements)?
Use the Nordic list view (Dashboard -- pending cases "Pending"). Group cases by contract or type of care for batch processing. For bulk processing, coordinate with your team leader on prioritization.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
27.
How do you prioritize an urgent file / manage a backlog of unprocessed requests?
Contact your team leader to define prioritization criteria. Use Nordic filters to sort cases by creation date or status.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
28.
How do you verify that a file is properly closed in all systems?
After validation in Nordic, check the three statuses:
1. Case status: closed
2. Invoice status: validated
3. Payment status: paid or in progress
Refer to the 'Claim processing' guide and the Unisify 'Status of a claim' section.
📚 Training support : NIS Claims Training · Sales Training
1. Case status: closed
2. Invoice status: validated
3. Payment status: paid or in progress
Refer to the 'Claim processing' guide and the Unisify 'Status of a claim' section.
📚 Training support : NIS Claims Training · Sales Training
29.
How do you handle a client request with multiple settlements on different dates?
Process each settlement by linking it to the contract applicable on the date of care. If the care spans two contractual years, create a separate case for each contract.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
30.
What should be done when an insured person has two active contracts generating duplicate settlements?
Contact your team leader.
31.
How do you handle a widespread duplicate settlement issue on a contract?
Analyze the entire contract in WebAgent to identify the root cause of the faulty configuration. Open a JIRA ticket if the issue is systemic. Contact your team leader before any processing.
32.
How do you handle a doctor / provider that is miscategorized in NIS?
In Nordic (Step 4 -- Enter the missing information), correct the provider type by selecting the appropriate category. Verify that the coverage and cover cause are properly aligned with the corrected provider type.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
33.
How do you analyze a denial with no visible reason in the system?
Check the case history, statuses, and coverage / cover cause configuration in Nordic. Also check medical exclusions in WebAgent. If no reason can be identified, contact your team leader.
📚 Training support : NIS Training (Policy) · NIS Claims Training
📚 Training support : NIS Training (Policy) · NIS Claims Training
34.
How do you process a settlement with a country of care anomaly?
Correct the country of care in the Nordic case (Step 4). Verify that the applicable coverage matches the corrected country. Recalculate the reimbursement if necessary.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
35.
How do you process a validated settlement where payment has not been made?
Distinguish between the three statuses (case / invoice / payment) in Nordic. If the case is validated but the payment has not been triggered, contact your team leader for accounting action.
📚 Training support : Sales Training
📚 Training support : Sales Training
36.
How do you handle a request that has already been reimbursed on another case (duplicate reimbursement)?
Check the payment history in Nordic to confirm the duplicate. Identify the already-reimbursed case. Contact your team leader for the accounting adjustment procedure for the overpayment.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
37.
How do you process a voided (cancelled) case that the insured person has reopened?
In Nordic, check the voided case status and the history of cancellation reasons. Explain the reason for the void to the insured person. If the void was made in error, contact your team leader to proceed with reopening.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
38.
How do you process a file pending internal validation (pending internal)?
Identify the internal decision-maker responsible for validation. Follow up via Teams with the NIS case link attached. Contact your team leader if the validation deadline has been exceeded.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
39.
How do you process a file requiring a change of linked contract?
In Nordic, change the case's contract linkage to the correct one (policy number + product). Recalculate the applicable coverages after correction. Contact your team leader if the change impacts payments already made.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
40.
How do you process a reimbursement that incorrectly includes the Social Security portion?
Check the reimbursement base configuration (BR + supplement). Correct the calculation in the Nordic case by making an adjustment. Contact your team leader for validation before any reversal.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
41.
How do you check the number of sessions reimbursed vs. remaining?
In Nordic, analyze the reimbursement history for the relevant type of care. Check the limitations configured in the coverage (Step 5 -- Limitation overview). Refer to the 'Claim processing' guide.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
42.
How do you process a file after receiving additional documents sent by the insured person?
Open the case in Nordic. Add the received documents and resume the standard process (Steps 3 to 8).
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
43.
How do you handle a reimbursement that is not at 100% despite supplementary coverage?
In WebAgent, verify that the supplementary plan is active and correctly configured. Check the applicable contractual caps. If the supplementary plan is active but has not been triggered, contact your team leader.
📚 Training support : NIS Claims Training · Business France Training
📚 Training support : NIS Claims Training · Business France Training
44.
How do you analyze a reimbursement that is lower than the client's expectations?
Check the contractual coverages (coverage, cap, any applicable penalty) in WebAgent and Nordic. Explain the calculation applied according to the contract. If a discrepancy is a confirmed error, create an adjustment case.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
45.
How do you process a file involving multiple teams (operations, accounting, IT)?
Use Teams to coordinate with the relevant teams, attaching the NIS case link. Document the pending actions for each team in the Nordic case. Contact your team leader for priority arbitration if necessary.
46.
How do you handle third-party payment invoices in the United States? Who is responsible?
Contact your team leader for the responsible team and the applicable process.
47.
How do you process a file requiring multiple adjustments (several settlements)?
Create the corresponding adjustment cases in Nordic. Document each correction individually. Contact your team leader for validation before any bulk processing.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
48.
How do you process a large volume of settlements related to a specific contract?
Contact your team leader for the responsible team and the applicable process.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
49.
How do you process a contract cancellation request that impacts operations?
Refer to the adjustment process (Void/Refund). Contact your team leader for validation.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
50.
How do you handle a client request requiring multiple internal approvals?
Contact your team leader to organize the approval workflow. Document the steps in the Nordic case.
51.
What should be done when a provider appears as "UNKNOWN" in NIS and the creation request has not been submitted?
If the case has already been approved, the Network team can no longer intervene, as they do not have the necessary permissions to modify an approved case. In this situation, go back to the prior authorization and add the correct provider directly using the link provided by the team.
Guarantees, Structure & Coverage Rules
19 questions
52.
How do you correctly apply contract-specific penalties (e.g., 50% vs. 20%)?
Check the contractual rules in WebAgent (Policy Structure tab). The penalty rate is defined in the contract terms and configured in NIS. Verify consistency between the rate applied in Nordic and the contractual terms. If in doubt, contact your team leader.
📚 Training support : NIS Training (Policy) · Sales Training
📚 Training support : NIS Training (Policy) · Sales Training
53.
How do you handle contractual exceptions (e.g., no penalty on dental implants)?
Check the specific contract clauses in Nordic (Structure tab). Apply the client-specific rules during processing in Nordic (Step 5 -- coverage & cover cause). If in doubt, contact your team leader.
📚 Training support : NIS Training (Policy)
📚 Training support : NIS Training (Policy)
54.
What types of glasses are reimbursable (prescription / comfort / blue light filter)? Are sunglasses covered in case of photophobia?
Only prescription glasses with a medical prescription are covered under standard optical coverages. Comfort glasses and blue light filter glasses are generally not reimbursable. For sunglasses coverage in the case of photophobia, contact your team leader (specific medical and contractual analysis required).
55.
How do you process care provided before the contract start date but related to a VIE assignment?
For VIE assignments, exceptional acceptance may apply according to specific VIE rules. Check the coverage period in WebAgent and the specific contract clauses. Any exception must be validated by your team leader.
📚 Training support : Business France Training
📚 Training support : Business France Training
56.
How do you process care provided during a VIE assignment (consultation, physiotherapy, medical certificate)?
Check the structure in Nordic. For care during a VIE assignment: use the coverage adapted to the country of assignment. Direct insurance, assistance, or specific service requests to the dedicated teams (see the 'Routing by request type' slide -- Business France Training).
📚 Training support : Business France Training
📚 Training support : Business France Training
57.
What is the validity period of a prior authorization? How do you handle care provided beyond the deadline?
The validity period of a prior authorization is 6 months from the date of issuance. Any care provided beyond this period cannot be covered under this authorization. Apply a coverage denial, inform the insured person, and document the reason in the Nordic case.
58.
How do you process a penalty dispute?
Check whether the prior authorization was obtained within the required timeframe. If the penalty was applied in error: correct it in Nordic (Step 5). If the penalty is contractually justified: explain the applicable rules to the client. For disputed cases, contact your team leader.
📚 Training support : NIS Training (Policy)
📚 Training support : NIS Training (Policy)
59.
How do you apply the Business France 2026 dental coverages (care outside France)?
For dental care outside France under a BF 2026 contract, apply the new structure:
• Base: 80%
• Option 1: 90%
• Option 2: 100%
Annual cap: EUR 200,000 or EUR 300,000 depending on the zone (+ reinforcement cap if subscribed). Check the subscribed option in WebAgent (Policy Structure / Coverage). Refer to the 'Business France' guide (Session 3).
📚 Training support : Business France Training
• Base: 80%
• Option 1: 90%
• Option 2: 100%
Annual cap: EUR 200,000 or EUR 300,000 depending on the zone (+ reinforcement cap if subscribed). Check the subscribed option in WebAgent (Policy Structure / Coverage). Refer to the 'Business France' guide (Session 3).
📚 Training support : Business France Training
60.
How do you classify a dental procedure?
Check the exact nature of the procedure on the invoice and prescription: an Inlay is an intracoronal restoration, an Inlay-Core is a prosthetic element. Apply the coverage and cap corresponding to the correct classification. If in doubt, contact your team leader.
61.
How do you handle an antimalarial treatment?
Check in the contract whether antimalarial treatments are covered (certain VIE / international contracts specifically include them). Contact your team leader for any case not clearly covered.
62.
What should be done in case of an incorrectly applied coverage?
In Nordic, identify the incorrectly applied coverage. Modify the case (Step 3 -- Modify a case) to apply the correct coverage and cover cause. Recalculate the amount and validate.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
63.
How do you handle a specific coverage with a particular cap (e.g., VVIF)?
Check the specific cap in WebAgent (Policy Structure / Coverage). Apply this cap during processing in Nordic (Step 5). Contact your team leader for coverages not documented in NIS.
📚 Training support : NIS Training (Policy)
📚 Training support : NIS Training (Policy)
64.
How do you handle a doubt about the classification of a medication (e.g., antibiotic)? Can a medication initially denied be reimbursed after medical reassessment?
Analyze the molecule and therapeutic class of the medication. Check whether this medication appears on the reference list covered by the contract. If the medical reassessment confirms coverage, create an adjustment case in Nordic and proceed with reimbursement, documenting the medical justification. If in doubt, contact your team leader.
65.
How do you handle a supplementary plan that is not triggered automatically?
In WebAgent, verify that the supplementary plan is properly configured and active (Calculation tab). Contact your team leader for configuration correction.
📚 Training support : Business France Training
📚 Training support : Business France Training
66.
How do you process a multi-year file (care spanning 2 contracts / 2 different years)?
Identify the active contracts for each year in WebAgent. Allocate the settlements between the corresponding contracts (contract N for year N care, contract N+1 for year N+1). Create a separate case for each contract in Nordic.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
67.
How do you explain the reimbursement process involving Social Security to the client?
The reimbursement is calculated on the Social Security Reimbursement Base (BR), to which the supplementary portion is added according to the subscribed contract. The total reimbursement cannot exceed the actual expenses incurred by the insured person.
68.
There is no specific coverage for provider fees -- how should this be handled?
Contact your team leader.
69.
How do you process a request with up-to-date CFE entitlements?
In the insured person's record, verify that CFE entitlements are properly registered and valid. If entitlements are confirmed, process the file by applying the standard international coverage rules.
📚 Training support : NIS Training (Policy)
📚 Training support : NIS Training (Policy)
70.
What should be done when modifying a coverage amount triggers an automatic date change in NIS?
When modifying a coverage amount (especially after an initial amount of 0), certain dates may be automatically updated in NIS:
- The coverage date may be changed (e.g., reset to a default date);
- The admission and exit dates may also be reset to the current date.
It is therefore essential to verify and, if necessary, manually correct all dates after modifying the amount, to avoid any errors during file validation.
- The coverage date may be changed (e.g., reset to a default date);
- The admission and exit dates may also be reset to the current date.
It is therefore essential to verify and, if necessary, manually correct all dates after modifying the amount, to avoid any errors during file validation.
Supporting Documents Processing
11 questions
71.
How do you verify consistency between the invoice, prescription, and receipt?
Check that the date, nature of care, and amount are consistent across the three documents. The prescription must correspond exactly to the care invoiced. In case of inconsistency, set the case to 'Pending External' and request compliant documents from the insured person.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
72.
How do you process a request pending a detailed invoice or proof of payment?
Set the case to 'Pending External' status in Nordic. Send a request to the insured person specifying the required information (procedures, dates, practitioner, unit amounts, proof of payment). Follow up if no response is received within the allotted time.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
73.
What should be done when an insured person does not provide the requested documents?
Complete the "Missing Information" field in Nordic during case processing. Contact your team leader if the insured person disputes the document request.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
74.
How do you handle a non-detailed invoice (e.g., from certain foreign countries)? Can processing proceed without a detailed invoice?
As a general rule, a detailed invoice (procedures, dates, practitioner, amounts) is mandatory. Exceptions are reviewed on a case-by-case basis depending on the country of issuance and the type of care. For specific cases (countries where detailed invoicing is not standard), contact your team leader.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
75.
What should be done when a document has been provided but the file remains pending?
In Nordic, verify that the document is properly attached to the case. If the document is present and compliant, resume standard processing. If the case remains blocked despite a complete file, contact your team leader.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
76.
How do you process an undated medical prescription? Can a reimbursement be made without a date of care?
An undated prescription is non-compliant: request a dated prescription from the insured person and set the case to 'Pending External'.
The date of care is mandatory to validate a reimbursement (it determines the applicable contract). Without a date of care, block the reimbursement and request a document specifying this date.
📚 Training support : NIS Claims Training
The date of care is mandatory to validate a reimbursement (it determines the applicable contract). Without a date of care, block the reimbursement and request a document specifying this date.
📚 Training support : NIS Claims Training
77.
How do you process a request where the invoice was incorrectly deemed insufficiently detailed?
Verify the level of detail required for the type of procedure concerned. If the invoice does indeed contain all the necessary information, reopen the case. Correct the case status.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
78.
How do you process multiple invoices for the same procedure (multi-invoicing)?
Verify that the invoices correspond to distinct procedures and not to double billing. If the multi-invoicing is legitimate (e.g., professional fees + pharmacy): create a separate account per invoice in Nordic. If it is a duplicate: process only the valid invoice and document the reason.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
79.
How do you process a proof of payment added after the initial request?
Reopen the case from the 'Pending External' status. Add the received proof of payment to the case documents. Resume standard processing and document the date of receipt.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
80.
How do you process a mandatory medical certificate (e.g., VIE departure)?
Verify that the certificate covers the relevant period and care. Validate the document's compliance (date, signature, nature of care) before processing. Contact your team leader if the certificate presents any anomalies.
📚 Training support : Business France Training
📚 Training support : Business France Training
81.
How do you handle a request where it is impossible to obtain additional documents (constraints in certain countries)?
Analyze the case on a case-by-case basis according to the constraints of the country concerned. Contact your team leader for a decision on potential exceptional coverage.
Finance
11 questions
82.
What is the difference between NIS payment proof and bank accounting proof?
• NIS payment proof: confirms that the payment has been validated in the NIS system. It does not necessarily include the bank transfer number.
• Bank accounting proof: issued by the bank, it contains the transfer number (bank reference). For requests for documentation including the transfer number, contact the accounting team through your team leader.
• Bank accounting proof: issued by the bank, it contains the transfer number (bank reference). For requests for documentation including the transfer number, contact the accounting team through your team leader.
83.
What should be done in case of a global payment rejection (accounting incident)?
Report the incident immediately to your team leader. The accounting team will proceed with re-submitting the payments after identifying the cause of the rejection.
84.
How do you handle an insured person who claims not to have received a payment despite a 'paid' status in NIS?
In Nordic, check the payment status and transaction references. If the payment is confirmed on the NIS side, invite the insured person to check with their bank using the available references. If the issue persists, escalate to the accounting team through your team leader.
📚 Training support : Sales Training
📚 Training support : Sales Training
85.
How do you handle bank details (RIB) not registered on Easy Claim?
Contact the insured person so they can register their bank details on Easy Claim. Process the payment once the bank details have been validated in the system.
86.
How do you process an EasyPay Card request?
Follow up with the insured person if the request is incomplete, then process according to the standard EasyPay Card rules. Contact your team leader for specific cases not covered by the standard process.
87.
How do you handle a discrepancy between the reimbursed amount and the expected amount?
Check the coverages and calculation in Nordic (coverage, cover cause, limitation). If additional supporting documents are needed, request them from the insured person. If the discrepancy is due to a calculation error, create an adjustment. Contact your team leader for significant discrepancies.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
88.
How do you handle reimbursements not visible on the client side despite processing? / Cases where funds have not yet been received?
Check the financial flows in Nordic (payment status). If the payment has been processed on the NIS side but not received by the client, verify the registered bank details and escalate to the accounting team through your team leader.
📚 Training support : Sales Training
📚 Training support : Sales Training
89.
How do you process a file requiring intervention from the accounting department?
Contact the accounting team via Teams. Provide the case number, contract number, and the amount in question. Contact your team leader for urgent interventions.
90.
How do you correct a disbursement error after validation? / How do you handle a payment deletion followed by invoice recreation?
Contact your team leader for validation before any payment cancellation.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
91.
Unable to track a payment with 'Payment in Transfer' status -- what should be done?
Contact your team leader. Tracking payments with this status requires action from the accounting team.
92.
Overpayment identified on an EasyPay Card -- how to proceed?
Contact your team leader. The procedure for refunding an overpayment to Social Security must be validated internally before any action is taken.
Request Follow-up & Coordination
17 questions
93.
How do you handle a request sent through the wrong channel or to the wrong team?
Redirect the request to the appropriate channel or team. Inform the sender of the correct contact to use in the future. Document the redirection in the Nordic case if applicable.
94.
How do you correct a recipient error in Teams / internal group?
Correct immediately by resending to the correct recipient. Document if the request was sent to an unauthorized third party. Raise awareness within the team about proper routing practices.
95.
How do you handle an insured person who refuses to identify themselves when requesting information?
Identification is mandatory before any processing. Inform the insured person that without complete identification (last name, first name, date of birth, policy number), their request cannot be processed.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
96.
How do you ensure follow-up after processing to inform the client?
After closing the case in Nordic, inform the insured person of the processing outcome (reimbursement completed, document sent, etc.). Use the client's preferred communication channel.
97.
How do you process a request submitted through an intermediary?
Coordinate with the third party (broker or HR department) to obtain the necessary information. Document the intermediary in the Nordic case. Direct to the appropriate contact if the request has been misrouted.
Routing reminder: insurance/assistance/services -> dedicated teams; contractual questions -> APRIL account manager; HR questions -> the company's HR department.
📚 Training support : Business France Training
Routing reminder: insurance/assistance/services -> dedicated teams; contractual questions -> APRIL account manager; HR questions -> the company's HR department.
📚 Training support : Business France Training
98.
How do you handle redundant requests for documents already accessible online?
Inform the insured person of the available digital tools (Easy Claim, policyholder portal) and the documents accessible online.
📚 Training support : Sales Training
📚 Training support : Sales Training
99.
How do you manage internal communication regarding file progress / post-processing follow-up (internal feedback)?
Use Teams to communicate on file progress. Systematically include the NIS case link in communications. Confirm the processing once the case is closed. Use the correct groups/channels by team to avoid attribution errors.
100.
How do you improve the quality of requests sent to the processing teams?
Systematically include in each internal request:
• The direct NIS link to the case
• The contract number
• The file context
• The actions already taken
A complete request reduces back-and-forth and speeds up processing.
• The direct NIS link to the case
• The contract number
• The file context
• The actions already taken
A complete request reduces back-and-forth and speeds up processing.
101.
How do you manage cross-team communication (BKK / Paris / Nordic)?
Use Teams, specifying the target team and attaching the NIS case link. For issues requiring cross-team escalation, contact your team leader.
102.
How do you communicate the details of completed reimbursements to the client?
Compile the payment history from Nordic. Send a detailed explanation to the client (dates, amounts, references for each reimbursement) via the appropriate communication channel.
📚 Training support : NIS Claims Training
📚 Training support : NIS Claims Training
103.
How do you handle an insured person who refuses to comply with contractual requirements?
Remind the insured person of the contractual terms they subscribed to. If the refusal persists, contact your team leader for arbitration.
104.
How do you handle an urgent callback request from a broker?
Prioritize the file in Nordic. Inform the broker of the processing outcome as promptly as possible. Contact your team leader if the request requires internal approval.
105.
How do you handle a client requesting an urgent certificate in a foreign language?
Contact your team leader. Issuing a certificate in a foreign language may require specific approval.
106.
How do you handle an internal disagreement on the completeness of a file?
Contact your team leader for internal arbitration.
107.
How do you handle an operational blockage caused by the absence of a key person / a managerial decision?
Contact your team leader to identify a substitute or validate the decision to unblock the situation.
108.
How do you process a file requiring specific authorization (restricted access)?
Contact your team leader to designate the person authorized to process the file.
109.
How do you handle requests related to AETNA (e.g., access to settlements, insured person inquiries)?
Contact your team leader. The issue has been escalated to the IT team.