Holistic Claim Review
When do we need to look at diaries in a claim and why?
What Hiya Page would you refer to?
When you enter into a policy (to see what needs to be actioned) and before you leave (to reallocate, move or complete the diary)
Create Diaries (Motor) & Manage Diaries (Motor)
Which step of a Holistic Review covers the following?
The Assistance #
The Referral #
The Complaints #
Trace
Vulnerability
Step 1: The Policy Holder Circumstances
Which step of a Holistic Review covers the following?
The date and time of incident
The incident type
The incident Description
MISC
Step 2 Incident Type
Which step's of a Holistic Review covers the following?
Check the Diary # to read the next steps
Check the Booking #,
Check the TTD #
Check the F5’s
View images/documents
AND
Check the Booking #
Check the AudaNet #
Check the F5’s for assessor/repair updates.
Check the reserves
If Non Drive, identify towing status.
Step 3 and 4 The claim is unfinalised and the claim is settled
Which step of a Holistic Review covers the following?
Check for any outstanding reserves
Check for outstanding Diaries/Images
Check Claims TTDs have been completed
Check excess has been collected where applicable
Step 5 CS Closure
The customer is wanting an update on their claim, the consultant can see the assessor is assigned however it is still within their timeframe.
What would the consultant advise the customer?
What Hiya Page would the consultant refer to?
Advise the customer that the assessor has been allocated on (Date). Advise assessment can take between 1-5 business days depending on the severity of the damages. Once assessment is completed the repairer/assessor will let you know the next steps.
Handle Car Assessment Enquiries Hiya Page
Is it important to be looking at the Brand of insurance that the customer has purchase, why or why not? EG Budget Direct, Qantas ect
It is very important that we are brand aware. Some Brands can have differing PDS wording benefits ect. For Example Oceania not offering NAF Hire Car
The consultant sees the customer has lodged two claims for the same incident
What should the consultant do?
What Hiya Page would the consultant refer to?
Review and close one of the claims as a duplicate
Close a Claim (Motor) Hiya Page
The customers car is not drivable and the consultant identifies the tow has been delayed due to location unknown
What should the consultant do to assist?
What Hiya Page would the consultant refer to?
Update the vehicle location if known, If location of vehicle is unknown set diary for ND PATHING to use their resources and contacts to try and obtain the location
Handle Car Assessment Enquiries Hiya Page
What hiya page would the consultant refer to when reviewing closing the CS?
Close CS (Claim Status) in DISC Hiya Page
The consultant is reviewing a claim that has been lodged online.
What Hiya Page would the consultant refer to?
What letter must be sent at the end of the claim?
What diary would the consultant review completing?
Process Online Claims (Motor) Hiya Page
Send relevant lodgment letter
Complete the New Online (Claim Type) Claim Diary
If a customer has called in and the consultant see's the Referral # has an active entry on it for RAH.
What should the consultant do?
What Hiya Page would the consultant refer to?
Advise the customer the claim is still being reviewed and the team will be in contact when the review is complete. If the claim has been assigned to claim investigations we can review transferring to CIU.
Transfer Call to Claims Investigations Unit (CIU) Hiya Page
The consultant is reviewing a claim and see the incident description is lacking detail and is not a clear description of the accident
What should the consultant do?
What Hiya Page would the consultant refer to?
Update the incident description ensure to usw the framework provided in Hiya where applicable
Handle New Claim Lodgement Enquiry (Motor) Hiya Page
If the consultant see's F5 comments from Audanet would they be important to read when Holistically reviewing a claim, why or why not?
The F5 comments that show within a screen from Audanet would be important to read as they show the communication between the repairer and the assessor. This can be utslised to share information with the customer to provide an accurate update of the claim.
What does COTS stand for?
Confirmation of Transaction Statement (COTS)
What is the purpose of the digital assessment repair booking option?
What Hiya Page should the consultant refer to instead?
To get the customer booked in the right repairer. This process enables the customer to take photos of the car damages and then the assessing team will review the claim and contact the customer to book them in
Book Car Assessment and Repairs Hiya Page
If the customer is requiring an interpreter
What would the consultant need to do on this claim?
What Hiya Page would the consultant refer to?
Ensure the assistance # is completed filling in all the necessary details, including support organisations.
Claims Vulnerable People Guide Hiya Page
If the consultant sees that details from the claim lodgement have been entered incorrectly creating claim delays, what is something the consultant could do to educate another consultant?
What Hiya Page would the consultant refer to?
Lodge Feedback within the Frontline Motor Claims Feedback Form
Motor Claims and Assessing Feedback Forms Hiya Page
If the claim is unfinalised and the booking isnt completed for a non drive car, should the consultant be booking in the customer for repairs. Why or why not?
What Hiya Page would the consultant refer to?
We should be booking a non drive unfinalised claim in for repairs. The reason why is because we dont want to cause any delays to the customer. The Hiya process tells us to book the customer in regardless of the claim status for a non driveable car.
Book Car Assessment and Repairs Hiya Page
Why is it important to close the CS?
To show that all tasks have been actioned
and the claim is completed
It allows for COTS to be triggered
For financial reasons and portfolio/reporting accuracy
What is a Holistic Claim Review and why must consultants complete them?
It is ensuring to consider all aspects of the situation, rather than just focusing on individual elements in isolation.
Our job in Motor Claims is to progress each claim by completing all outstanding tasks to the greatest extent, so customers do not have to call back.
If a customer is expressing dissatisfaction towards a process and the consultant sees the customer has previous complaints within the complaints #, and upon further review, another 2 listed within the comments, what should the consultant do before lodging a new complaint?
What Hiya Page would the consultant refer to?
What are the timeframes for deciding to lodge a new complaint vs reopening a previous complaint?
Open up all of the complaints within Aptean to review the issues and resolutions provided to see if the current complaint has already been lodged as a complaint either resolved or active.
Follow Handle Customer Complaints (Motor) Hiya Page
If the customers issue is already in a previous complaint and it is still within 30 days from the complaint lodged date we are able to reopen this complaint. If outside the 30 day timeframe, we must lodge a new complaint and link the previous complaint.
What are 5 things that a consultant can see within the MISC # that might be relevant when holistically reviewing a customers claim?
Hash's within the MISC Function in Disc:
Damage to the car
Use
Incident location
Location of vehicle
Driver
UW claim questions answers
TP Details
Witness/police details
Safe to drive
Injuries
Prior Repairs
The claim is authorised and the consultant see's an open reserve for Personal Effects
What should the consultant do to action this?
What Hiya Page would the consultant refer to?
Check the F5 comments to see why the reserve was open and what we are awaiting. Check the diaires to see if an image has come through with the proof of PE to be able to review reimbursing the customer
Reimburse Personal Effects (Motor) Hiya Page
Once the CS is closed - If the excess is higher than the total cost of repairs
What would the consultant do for the customer and why?
What Hiya Page would you refer to?
If the total cost of repairs is higher than the excess the consultant would need to refund the difference amount to the customer
Hiya page Refund Claim Excess (Motor) and
Refund Claim Excess (Motor)