COVERAGE
An insured borrows their neighbor’s pickup truck to move furniture. While backing out of the driveway, they hit a parked vehicle. The insured’s personal auto policy includes liability coverage, but the borrowed truck is not listed on their policy.
Yes coverage applies
The insured slows down at a stop sign but does not fully stop before entering the intersection and colliding with cross traffic.
✅ The insured for failure to yield right-of-way.
PULL THE CALL!
IV/CV PHOTOS
IV/CV STATEMENTS
DIAGRAM
POLICE REPORT
LOC LETTER
An insured uses their personal vehicle to deliver food through a delivery app after work. While actively delivering an order, they rear-end another vehicle. Their policy does not include any rideshare or delivery endorsement.
Likely denied due to business-use/delivery exclusion.
Two vehicles attempt to merge into the same lane simultaneously during congested traffic and collide side-to-side.
✅ Shared liability is likely due to mutual failure to maintain proper lane awareness.
What department would be responsible for the claim if we identify any aggravating factors?
LV3 - CP1
What is one thing that is not allowed on ANY DIAGRAM
PEOPLE
The insured’s cousin was driving the vehicle at the time of loss, but residency and permissive use are still under investigation.
What is a Reservation of Rights letter?
The insured’s roommate regularly drives the insured vehicle but is not listed on the policy. The roommate causes a lane-change accident while using the vehicle with permission.
Coverage may apply, but depends on permissive use language, household resident requirements, and policy exclusions.
Three vehicles are stopped at a red light. The insured rear-ends Vehicle 2, pushing it into Vehicle 1.
✅ The insured is typically responsible for the chain-reaction collision.
What does evasive action mean?
Any action a driver takes to avoid a collision or lessen its severity.
Adjusters complete the Multi-Loss Checklist when an insured has this many or more claims on their policy.
3 or more
The insured may face exposure because several property damage claims exceed policy limits.
What is an Excess Limits Letter?
An insured causes a stop-sign accident on May 10. Investigation shows the policy canceled for non-payment on May 1, and no reinstatement occurred before the loss.
❌ No coverage applies because the policy was not active on the date of loss
The insured enters an intersection on a yellow light while attempting a left turn. The oncoming driver accelerates to “beat the light” and collides with the insured in the intersection. Witnesses disagree on vehicle speed, but damage shows significant impact force.
Likely shared liability.
This recorded conversation is often critical for determining liability and damages during an investigation.
statement under oath
Adjusters use this estimate platform frequently to evaluate repair costs for damaged vehicles.
CCC
The carrier denied liability to the claimant and now needs to warn the insured they could potentially be sued.
What is a You May Be Served Letter?
A thief steals the insured vehicle and causes a collision with another driver. The insured did not give permission for anyone to use the vehicle.
Coverage may not apply due to stolen vehicle.
The insured approaches a green light and begins driving through the intersection. At the same time, the claimant makes a right turn on red into the same roadway. The insured was traveling 15 mph over the speed limit and strikes the claimant after the turn is completed.
Shared liability is likely.
A vehicle is sitting at a tow yard accumulating fees and is predicted to be a total loss, requiring immediate written notice regarding storage charges.
Storage cut off letter
This skill is critical when explaining coverage denials, liability decisions, or claim delays to upset customers.
EMPATHY
The insured only carries liability coverage but wants the carrier to pay for damage to their own vehicle after an at-fault accident.
What is a Reason for Unpaid Claims Letter?