Injury Jeopardy

Verbal Release

100

Sally is ready to settle her BI today, Gens is $2,665.25, and meds incurred $4,558.00, would this be eligible for a Verbal Release? 

No, exceed the eligible amount for a verbal release of $2,500.00

200

Lupita is ready to settle her BI today, has $1,500.00 gens  and missed some LOE for $300.00, and wants to seek Chiro txt for the next 30 days for $1,500.00, is this a quick verbal release? 

No, due to open meds this does not qualified for a verbal release

300

Amy, Tom's legal guardian is ready to settle Tom's BI claim. Tom went to PCP once, had some Xrays done and no other plan for future treatment. Can we go over a verbal release with Amy?

Yes.

Da Basics

100

Please name 3 General damage factors

Pages - General Damage Factors (sharepoint.com) 

200

What's the maximum amount of LOE that we can pay without proper documentation?  

$500.00

300

Name a step you would utilize in the "During" provider negotiation phase?

1. Talk to the right person
2. Build Rapport
3. Ensure you have all the bills to date
4. Go through adjustments one category at a time
5. Gain agreement prior to moving onto the next section
6. Maintain rapport
7. Summarize your agreements at the end of the call
8. Obtain a written agreement for the injured party, if needed

Just for Fun

100

On this event, we partner with vendors in the area to donate a vehicle to a veteran.

Keys to Progress

200

As Breswki once said " Ultimately we are here to ___ and to ___ our insured " 

A) Pay and Help 

B) Dance and Party with 

C) Close features and protect

C

300

Name the rep : JVCINCO

**CINCO MEANS 5 IN SPANISH**

Da Director

Resources

100

Where can you confirm a law suit has been file?

Superior and Supreme court links in the Arizona State specific link

200

Once a settlement is agreed upon, that requires a written release, how can you locate the appropriate release? 

URBI - under Settlement

AZ State -  under Internal

300

Subrogation - How many days do we have to file a claim for a Government Entity?

180 days

Mics

100

When an possible excess is identified, you would send excess letter(s) to:

A) Claimant and Provider

B) Claimant and Adverse Carrier

C) All all potential insureds 

C

200

Name a qualification for Negligent Infliction of Emotional Distress ?

• Witness injury to closely related person.
• Suffer mental anguish manifested as physical injury.
• Be within the zone of danger so as to be subject to unreasonable risk of bodily harm. 

300

Common BIE - what qualifies for Other Economic Losses (OELs) ?

• OELs are special damages which are owed to the injured party but are not included in medical or wage specials (for example: child care, household help, missed event)
• Rationale for considering, or not considering, OELs in the evaluation