FNOL
What do we need to confirm 1st when taking a call/claim ?
- who is calling ? Insd or relationship to insd?
- Main Contact
- Confirm Address, Email and phone # and amend parties involved
How to input TP details on GW when setting up a claim ?
- Add veh --> TP
- Amend all possible details including insurance info (other carriage involvement)
What Exposures do we open for APD if insd is at Fault ? and what Exposures do we open if insd is not at fault and all TP info confirmed for an Ontario MVA ?
- If At Fault : LOU and COLL/All Perils exposures
- If Not at fault and TP details confirmed DCPD - LOU and VEH Exposures
What are the body shops that Qualifies a claim for AE ?
- Assured
- Carstar
- Fix Auto / Pro Color
- CSN
- CCS
- Speedy Collision
What if Insd already paid their Deductible to the Body Shop and the Ded has been waived after confirming TP info and Liability ?
- Confirm insd's address
- Issue Cheque as ded reimbursement to Insd
- Send confirmation Email to insd.
Policy cannot be found or it is a Binder. What is the procedure ?
- Set up claim as unverified
- Take full FNOL and amend all details
- Cannot Confirm coverage, open Exposure or set up services
- Send to B/O to follow up with UW for policy retrieve/Sync
What if TP is a pedestrian or Cyclist hit by insd ?
- Take all possible info on TP and amend on file
- List any injuries
- Open Both AB and BI to be on safe side for investigation. (If the TP as own insurance attached or covered thru their direct family member - Then Our BI will Respond / If TP does not have any insurance attached, then our AB will Respond)
If Exposures already opened as Coll /All Perils and LOU on a claim and we later receive confirmation of all TP info and TP is at fault in an Ontario or NS MVA, what do we need to do ?
1. Review/Change exposure to DCPD - LOU and VEH
2. If liability and ded status confirmed :
- Update insd
- Update B/S (audatex comments)
What do we need to do if Insd is already in an Enterprise Rental (arrange by Body Shop for example) and no services is created yet on GW ?
- Create a services to the same Enteprise location
- In notes to Vendor - advise to match ticket to Existing reservation for auto billing
- Communicate with Enterprise in-House Rep and provide claim # so they can do necessary to match the ticket.
What if insd has been charged by police for Impaired Driving ?
- Take complete FNOL and details of loss
- WOP
- UW alert
- Do not confirm coverage
- Assign claim to B/O for Possible Denial
Can we discuss coverage and next steps with a listed driver or any unlisted person related to insd ? If yes, when ?
- Only if Full Authorization is provided by named Insd and noted on file
- If no Authorization, we can only take loss details (as anyone can report a claim) and contact will be required with named Insd to discuss coverage and next steps.
What if our insd damaged a TP property (Fence, Wall etc...) ? Can Claim be AE ?
- We need to list the TP property damages on GW
- Gather info on TP and the property ( Address, owner/contact info - insurance if provided )
- We can open Third party Property damage exposure once the property damages are already listed
- Claim cannot be AE and needs to be sent to B/O as the will potentially have to cover TP property damages or receive Subro from TP property insurer. (If TP not claiming for any property damages, claim can be AE)
What do we need to amend on the PD Exposure Coll/All Perils or DCPD - Veh once created ?
- Ded amount
- Paid or Waive
(Audit will review for points - Exposure wont close when closing claim)
What Services do we need to created if Veh is a Total loss , ETA Red and non Drivable ?
- Copart for Veh pick up / Confirm Veh location (Arrange for veh release from tow yard and authorized tow bill - Advise in to remove plates and personal belongings)
- Set up E-app for veh appraisal at copart yard : Service ---> Auto ---> Repairs Shop ---> Other(Include Copart Lot # and notes to Vendor)
If Insd does not have Collision Coverage and is at Fault. do we need an exposure on claim ? or can we close claim without Exposure ?
- For UW purposes, an Exposure needs to be opened
- Exposure will also be required if sending At fault/no coverage by Mail (onbase)
- Exposure will also be required is sending At fault/no coverage by email so CI can upload the letter to the file.
- What Exposure do we open ? All region - TP property damage
If a Police Report / ACC # is provided, what do we do ?
- Amend the police info in required filed on GW
- With ACC # we can verify Croms portal to gather all info and statements/diagram of incident from insd and tp to help adjust claim.
What are the possible ways to Negate BI if our insd is at Fault in an accident ?
- Call TP insurer and confirm if claim reported and confirm details , ask if any injuries reported
- Send TP report to TP insurer asking for response on their claims info
- Call TP Directly to confirm details if TP phone # provided
What Exposure do we open for NS or ON MVA if liability if 50/50
Once all TP details confirmed, open both COLL/All perils & LOU + DCPD - LOU and VEH
What is the difference between ETP repairs shop and TRF network ?
- ETP Repair shop - Electronic Transfer Process - a means of electronically communicating with shops who are not part of our preferred network/banner shop program, however, can be selected as part of our appraisal process. ETP shops do not charge a fee for completing estimates for us and therefore utilizing these shops is a benefits and saves on cost and time instead of utilizing a field appraiser. ETP shops can also be located within AudaTarget or GWCC. We do not use ETP shops for PBE as we do not have an official partnership with these shops.
- TRF is a network of banner shops or Trusted Repair Facility shops that we work in partnership with to prepare estimates and repair damages. They do not charge a fee for completing estimates and can be utilized for PBE if the customer chooses a contactless appraisal option and does not want to go into the shop to have vehicle appraised.
What is the main thing to do when you get an inquiry call on an existing claim ?
- Make Sure you Review all the previous notes to understand what has already been done and what is required next on the file
- If Required insd/caller can be put on hold to review everything
- Always think for moving the claim forward and complete all processes and assign claim correctly is required
Name 5 types of claims we can AE !
1. Alberta - Comp or SVA- If going to RGR (Assured, Fix Auto, CSN, Carstar)
2. Alberta - hit and Run, no TP info if going to RGR
3. Any ON - MVA going to RGR
4. Any ON - Comp or SVA going to RGR
5. NS claim as DCPD province and going to RGR
What do we need as information from TP ?
•TP vehicle info: year/make/model, plate#, color
•TP vehicle damages
•Driver/Owner info: driver’s license#, contact info
•Passenger / Injuries
•Insurance company & policy information
When to Open AB ? When to Open BI ?
**For AB :
- Anyone in our vehicle is injured (driver or passengers) or taken away by ambulance
- Fatality in our vehicle
- Third Party is a cyclist
- Third Party is a Pedestrian
- Insured/dependents injured as pedestrian, or passenger in other vehicle (ON)
**For BI :
- Occupants in TP vehicle
(Insured partially or fully at-fault)
- Passengers in our vehicle
(Insured partially or fully at-fault)
- Fatality or Life Threatening injury in any vehicle.
- Third Party is a Cyclist.
- Third Party is a Pedestrian.
- When in doubt reach out - Consult BI
What needs to be mentioned in Notes to Vendor when Creating service to a B/S ?
Audatex PBE accepted & Audatarget link sent Y or N:
Loss Description:
Damage Description:
Vehicle Drivable Y or N:
Towing Y or N:
Estimated Drop Off Date:
Current Vehicle Location:
Colour and Odometer Reading:
Deductible Status:
Insured to Pay Taxes:
43R/PS+/Waiver of Depreciation:
Arranged Copart for vehicle pickup Y or N:
Copart Lot Stock Number:
Explain Car Seat Replacement Procedure !
Review new Car Seat replacement SOP