Coverage
The following can be used to verify what information for a claim?:
A third party witness
a police report
a tow bill, and
telematics data from GEICO's DriveEasy program
What is Date of Loss?
In ATLAS Claim Summary Tab, who is typically listed first?
Who is Our Insured (Owner)?
While working CIQ, you can use the "Guidance" link under each breach to learn more about what it is, which can help you determine if it applies/whether it was breached/by whom. List some possible breaches in a typical intersection loss. (multiple correct answers)
what is:
- maintain proper lookout
- obey traffic code
- yield right of way
- respect control of intersection
- maintain safe vehicle
- etc
"I don't want to be recorded, I already did all that with my own insurance company," Claimant Shaquille tells you while making First Contact. This is how we can get their statement.
What is 'Take a Verbal Interview without recording them?'
(never take a recording without their consent, even if you are speaking on a line that "may be monitored and recorded for quality and training purposes")
These are example of interested parties that could be marked as Negligence Free Party (NFP) in ClaimIQ (multiple correct answers)
what is:
- passenger
- owner who wasn't driving
- witness
- pedestrian
- cyclist
What is needed to resolve a CC99?
What is verify payment (By reviewing EDGE), and verify date of loss (tow bill, police report, telematics data)?
While working a "document upload" activity in the claim, you see the document is labeled as having a time limit demand. However, once you open and inspect the document, it's actually an information exchange report from the police. This is our handling process.
What is:
-rename the document
-update the information on file according to the document
-notate the file and move on
ClaimIQ will determine a fair range of liability for each party based on these factors.
What are the breached duties and proximate cause?
(These can be marked as low, medium, and high for each driver, with one breach marked high as the proximate cause)
Policyholder Maxwell was involved in a merging style loss where both parties are disputing liability. Maxwell may have been driving for Uber at the time of the accident. This is the number of phone calls we need to have with Maxwell to secure both their coverage and liability recorded interviews
What is one?
both RIs can be done on one call, even as you take separate recordings
This letter notifies interested parties about our ongoing coverage investigation. It maps out to policyholder exactly what we need from them in order to resolve coverage.
What is a Reservation of Rights?
This person is the best trainer within GEICO
Who is Jen?
Which tab in ATLAS do you assign a demand to the Subrogation Review Team (SRT)?
What is "Demand Summary Tab"?
Policyholder Martin loans his vehicle to his friend Maxwell, who is then involved in an accident with Claimant Doug, who was driving a limousine owned by Claimant Limu. This is who we mark as CBP
Who is Maxwell?
"There's no way you can say I'm at fault!" Claimant Mayhem disagrees with your liability decision. This is how you would handle the call. (Facts of Loss provided)
FoL: cmt merged into ph due to cmt lane closing
ph poi: pass qtr panel
cmt poi: dvr fender
What is 'have a detailed discussion with the customer about how we determined liability?'
*this may include elements such as reviewing evidence, duties, and breaches while following the 'pattern of agreement'
Defined in the policy as 'In, upon, entering into or alighting from the vehicle.'
what is 'occupying?'
For which of the following coverage condition codes would a UE119 be needed?
What is CC50: Named driver exclusion?
Once a liability decision has been reached, we really ought to notify all parties involved immediately. By law, this is the number of days we have to send out those letters.
What is 15 days?
In the ClaimIQ Record Exchange these are the steps needed to mark that we accept liability when we are 100% at-fault. (need all four elements)
1. select "Offer"
2. enter today's date
3. enter "100%"
4. check the "Accepted" box
(also be familiar with how this is works when we do not accept liability)
You get off the phone with Attorney Phoenix Wright, who represents our insured, Caveman (first name The). The attorney tells us his client was rear-ended by claimant Mayhem, insured by Allstate. Attorney Wright's client is now in intensive care with multiple fractured ribs and fractured hip. In addition to getting Allstate's disposition, we need this important information from the Adverse Carrier
What are their Bodily Injury coverage limits?
(With severe injuries there is a possibility we will need to utilize UM/UIM coverage)
Policyholder The Caveman and Claimant Mayhem are involved in a head-on collision. We investigate and determine both parties are 50% at fault. The road they were driving on was in a state the follows 'contributory' negligence law. Mayhem's insurance, Allstate sends us a demand for $15,000 in property damage. This is how much we pay for Mayhem's damages.
What is 0%?
(In a contributory state, you must be 0% liable to be able to recover)
If a coverage investigation concludes that the policy was cancelled prior to the date of loss. Which type of letter would be sent to the insured?
Bonus: How many days do you have to send this letter?
What is "Denial of Coverage?"
Bonus: 15 days
These are examples of violations of what Act:
Denying resolution of their medical claim until a settlement on their property claim is reached.
Advising the customer, they must use a GEICO approved body shop for repairs to their vehicle.
What are the Fair Claims Settlement Practices?
What does the ‘view recommendations’ button in ClaimIQ do?
What is "it provides you with a recommended range for liability based off the duty breaches you updated for the parties involved"?
Claimant Cantrelle is involved in an intersection loss with our insured, Gary, who was driving a rental car at the time of the accident (ATLAS identifies a cc37 for unlisted vehicle). There is a dispute about who ran their stop sign. This is the number of recorded statements we need to resolve the entire claim.
What is 3?
(coverage and liability RI for ph Gary, plus liability RI for cmt Cantrelle)
ATLAS will do _______ when the following conditions are met:
Payment issued to the insured or an estimate is in the claim if the inspection type is an Auto Repair Xpress.
Adverse carrier has accepted liability.
Adverse carrier is a member of Arbitration Forums.
All adverse carrier contact information is secured in ATLAS, including their claim number.
Adverse carrier has not issued payment to the insured.
What is automatically advance insured's deductible?