Coverage
A type of loss, such as when a wildfire burns the vehicle, a falling tree branch, or flash flood
What is 'act of nature"
Policyholder Cranston drove his 2003 Pontiac Aztec over a sharp rock in the middle of the desert, damaging the undercarriage. There is no damage to the rock. He carries the following coverages:
Property Damage 25k
Bodily Injury 30/60
UPD 2500
UMBI/UIMBI 30/60
This is our next step for handling the claim
What is 'Set RPO?'
with no applicable first party coverage, there are no further steps
The claimant is uninsured, but GEICO wants to pursue them directly for subrogation. This information needs to be on file to pursue the claimant directly
What is the claimant's valid address?
The page in ATLAS where we update the negligence percentage
What is 'Claim Details?'
Flo is a busy woman who doesn't have time to handle the claim personally. This type of contact, such as a personal assistant or extended family member, could have Flo's permission to speak to us/handle the claim on her behalf.
What is Related Contact?
Much like a warranty on the new vehicle, this coverage provides repair cost related to the vehicles breakdown.
Mechanical Breakdown Insurance (MBI)
Claimant Doug reports his car was struck while stopped in front of the hotel. This is what we mark for liability during the FNOL
What is "fault unknown, liability investigatin pending?"
Policyholder Marvin rear-ended claimant Limu. After receiving a subrogation demand from Liberty Biberty and assigning the demand to SRT, this is what we can do with Limu's Property Damage Exposure?
what is nothing?
(we need to wait for SRT to complete their review and issue payment)
Claimant General (first name The) was rear-ended by policyholder Caveman (first name The). After accepting liability, the is when to update the paycode for The General's Property Damage Exposure
What is 'immediately?'
Claimant Shaquille tells us he has an appointment with his podiatrist tomorrow. This is how we update the claim in ATLAS
what is 'update Shaquille as Injured and Treating'?
bonus points:
assign to Casualty for BI claim
The type of coverage needed when I accidentally put diesel in my gas tank
What is "Comprehensive?"
Limu and Gary both claim they had a green light when they entered the intersection. We have policyholder Gary's statement, but not Limu's. This is what we should mark for liability
what is "fault unknown, liability investigation pending?"
Policyholder Gary was rear-ended by Claimant Limu while stopped at a red light. Limu was driving a vehicle owned by Doug. This is the responsible party under the Recoveries Tab in ATLAS
What is Doug?
Liability is resolved at 100% on the insured. There are no coverage issues. This paycode can be set for the claimant even if we are unable to reach them on the phone
What is Inspect and Pay? (Good Paycode)
"Hi, yes I'm calling from Weenie Hut General Hospital with regards to our patient Mr. Squarepants. I understand he's insured with you for the accident on the 15th?" This is how we respond to inquiry calls from Medical Providers
What is 'direct them to the b2b site?'
The type of coverage concern where we need to obtain PORS and CANS
What are Fatal Coverage Conditions? (cc31/34/55)
ie, policyholder lost coverage 2 months prior but they are disputing the cancellation
Claimant Limu turned right on red while policyholder Marvin was traveling straight on a green light. Marvin and Gary collide. This is the duty Limu breached.
What is "yield right of way?"
other acceptable answers: respect control of intersection, obey traffic code, maintain proper lookout
Erie Insurance sends a demand for $1,000. SRT reviews the demand and determines the following amounts are reasonable:
$700 for repairs, parts and labor
$50 for two days in a rental car
Assuming we have accepted full liability with no coverage issues, this is our next step?
What is issue a check to Erie for the approved amounts using the appropriate reserve lines?
(700 under PD, 50 under LOU)
While the Physical Damage Adjuster will make the official call as to whether the customer's vehicle is a total loss or not, this is something we can advise while scheduling the inspection
multiple correct answers. have customer:
remove personal belongings, license plate
authorize GEICO to tow the vehicle
rental car available right away (if they have coverage)
The Personal Injury loss type is used to describe these types of claims, where no claim for vehicle damage is presented.
What are "Personal Injury" losses, such as when policyholder is injured as a pedestrian or as a passenger in someone else's vehicle?
The term we use to describe a situation where a policyholder might have multiple active policies at the time of loss. For example, Jason Momoa's new GEICO policy started on the 1st but his old State Farm policy doesn't cancel until the 6th, and his accident is on the 3rd.
What is concurrent insurance?
When working CIQ, this is the step just before entering the evaluated liability
what is 'view recommendations?'
Claimant Mayhem is found 75% at fault in a merging loss with policyholder Maxwell (we are 25% responsible). The resulting impact pushed Maxwell's car into claimant Flo's vehicle. In a several only liability state, this is how much Flo can expect to recover from Maxwell
What is 25%?
"Where is my money!" Claimant calls in to ask the status of her payment. You check the Financials tab and see "Electronic Notification Failed." This is what we advise our caller.
What is "our attempts to send electronic payment didn't work, so the check is in the mail"?
This is the reason we issue two-party checks under first party claims when policyholder has not yet paid off their car
What is 'we protect the lienholder's interest?'
(fraud/scam prevention is also technically correct but can come across as accusatory when advising ph)