Is there coverage?
The named insured is driving a vehicle that she has owned for 2 years, but has never been on her policy.
No, you will not be covered. Why? The insured does meet the insuring agreement under part 1 liability to others as an insured person. Exclusion #10 would apply due to the vehicle being owned by you.
What is the section of the 9611 MN policy that covers policy period and territory?
Part VII – General Provisions
ECC stands for?
What is Easy, Caring and Confident
What steps are needed to complete a UDCI investigation?
What is RI from the insd, RI from the ULD, RI from the Agent, Application, AP work up
Whether it is a newly assigned or transferred claim, this should be entered at the beginning of every claim.
What is the Initial Claim Review Template
The named insured is driving a pickup truck owned by his friend, whom he is visiting while on vacation in Hawaii for a week.
Yes, you will be covered. Why? The named insured is driving a vehicle, so the insuring agreement for part 1 liability to others is met due to the insured driving an auto. Primary coverage will follow the vehicle, there is coverage for this loss on that policy. Our policy will be excess and protect our insured.
Cooperate with us; provide any written proof we may reasonably require; and allow us to take recorded statements are all example of what?
Duties in Case of an Accident or Loss
Denial to insured, once approved
EFF no coverage letter to claimant
Call insured and claimant to communicate no coverage
Notify CC
Finalize liability
What pieces of information is needed to run an AP Work Up?
(hint: there are 7. Name 5.)
What is
After working the claim as far as possible on day 1, this is the last thing you should do before moving your diary.
What is enter an updated To Do
The insured’s son, whom is a relative on the insured’s policy, is driving a vehicle that he (the son) bought and registered 60 days earlier, but never added it to the insured’s policy?
No, the son will not be covered. Why? While the son does meet the insuring agreement under part 1 liability to others as an insured person as he is a relative. Exclusion #11 would apply due to the vehicle by owned by a relative.
What are 3 sources that may help identify damages that occurred prior to vehicle coverage being added?
ISO claim reports, VLR/TSO report, Shop estimates, Police reports, Tow Records
What is a reservation of rights letter (ROR), why do we send it, and what is the key item we need to include in the letter?:
Letter that quotes policy language and puts the insured on notice of an investigation
Why: to put the insured on notice of investigation
Key: include all portions of coverage that need to be reviewed.
A regular driver may include a party who utilizes the insured vehicle on a recurring and consistent basis (habitual use of insured vehicle) other than the named insured or resident relative. Examples of this may include... (Hint there are 3)
What is:
If CLRU did not send this, the file owner should be on day 1
What is content submission
The insured and his spouse are the only two listed on our policy. They have one covered auto listed on the policy.
The insured’s friend, Paul, moved into the insured’s house 6 months ago. Paul is unemployed so he allows the insured to use his 1978 Chevy every day to get to work so the insured didn’t have to car pool with his spouse.
No, the insured will not be covered. Why? While the insured does meet the insuring agreement under part 1 liability to others as an insured person, due to driving an auto. Exclusion #10 would apply due to the vehicle being furnished or available for your regular use.
What are 2 documentation examples we can request from the customer on the initial statement to help us confirm a date of loss?
Cell Records, Gas or Meal Receipts, Tow Bill, Pictures from scene
In regards to our customer experience focus as a company, there are five ECC behaviors that guide how to best serve our customers. Name the two that are part of our metrics this year.
What is: Returned Call and Updated Customer
When sending a UDCI ROR, what part of the policy is listed in the ROR letter?
What is general provisions and duty to report changes.
Name the state goal for contacts.
What is 66.9%
Penny and Leonard move in together in Rochester, MN as Leonard gets a job at the Mayo Clinic. They take out a policy as co-insureds on their 2018 Toyota Camry. Penny begins getting acting jobs in Hollywood and fly’s out to California and begins renting a car to get around. After a week renting a car, she determines it is too expensive and she buys a 1992 Ford Taurus to get around in Hollywood. 60 days after purchasing, she is at fault in an accident while on her way to the Cheese Cake Factory.
No, Penny will not be covered. Why? While the insured does meet the insuring agreement under part 1 liability to others as an insured person, due to driving an auto. Exclusion #10 would apply due to the vehicle being owned by an insured.
What are two places you may be able to find video evidence to support the time of loss?
Traffic control cameras, Business surveillance cameras and dash cam footage
Name the the 4 elements of negligence (or negligent tort)
Duties owed, duties breached, proximate cause and damages.
When will we deny for misrep in MN due to UDCI?
What is The insurer (Progressive) would not have written the policy had it known about the unlisted driver at the time of application;
Otherwise UWmemo is sent for driver to be added if deemed a regular driver.
When identifying a material coverage change or new policy on a newly assigned claim; we need to do these two things before calling our insured.
What is DOL pre-work and getting supervisor approval.