Claims

A claim is a term with several meanings depending on the context, but in legal and related professional settings, it generally refers to the following:

Legal Definition

A claim is a set of operative facts that create a right enforceable in court. In legal terminology, it is often synonymous with a "cause of action." For example, when someone files a lawsuit, they must state a valid claim—meaning they must present facts that, if proven, would entitle them to relief from the court. If a lawsuit does not state a valid claim, it may be dismissed for failure to state a claim upon which relief can be granted.

Insurance and Healthcare

• Insurance Claim: A formal request made by a policyholder to an insurance company for payment or coverage after a covered incident, such as an accident, illness, or property damage.
• Healthcare Claim: A bill of medical codes that healthcare providers submit to payors (such as insurance companies, Medicare, or Medicaid) to receive payment for services rendered to patients. These claims include details about diagnoses, procedures, and costs.

General Usage

Outside of legal and professional contexts, a claim can mean asserting a right to something, such as property or benefits, or stating that something is true. For example, someone might claim ownership of an object or claim a deduction on their taxes.

Academic Writing

In academic writing, a claim is a statement that presents an idea or argument. Claims are used to build and support the overall thesis or argument of a paper, often appearing in topic sentences and thesis statements.

Summary Table

Context	Definition of Claim
Legal	Set of facts creating a right enforceable in court; synonymous with cause of action
Insurance	Request for payment or coverage under an insurance policy
Healthcare	Bill of medical codes submitted for payment of medical services
General	Assertion of a right or statement of truth
Academic	Statement presenting an idea or argument