Coverage / Subro
Liability determinations must include what specific detail?
What is the percentage of negligence for each party?
Initial contact with all parties should generally be attempted within this number of business hours.
What is eight business hours?
This plan must be updated whenever steps change and should include all remaining actions needed to bring the file to conclusion.
What is the Action Plan?
This is the team that must be notified immediately when a claim adjuster notices possible fraud indicators.
Who is the SIU team?
These should reflect the reasonable cost to repair covered damage.
What are estimates?
When subrogation potential is confirmed, this letter must be sent.
What is the Notice of Surbo?
Before adjusting a claim, the claim professional must confirm this is in force.
What is the insurance policy?
After making a liability decision, the file must show the percentages of negligence for each party, the contributing factors, and an update to these fields in Claims Center.
What are the Fault Code and Percentages?
When referring a claim to SIU, what type of information must be provided?
What is specific information about the suspected fraudulent activity?
Property damage claims must be paid within ______ days of receiving documentation.
What is 5 days?
This document must be sent as soon as a potential coverage issue is identified.
What is the Reservation of Rights letter?
After 10 business days with no contact, this letter is required.
What is the Duties Letter?
These are the type of questions claims adjusters use to gather as much information as possible about the loss?
What are open-ended questions?
A thorough investigation may include collecting these types of items for documentation.
What are statements, photos, diagrams, & police reports?
Payments over $2500.00 must include what party when applicable?
What is the Lienholder?
How many days after sending the ROR should a denial be considered if unresolved?
What is 10 business days?
Adjusters must make reasonable efforts to locate parties using available sources, including the agent, a police report, or ______.
What is an ISO search?
This fault code should be used if the adverse party is unknown in an UMPD claim.
What is No Fault?
This section of the claim file must reflect all efforts and relevant information, including clear labels and specific descriptions for uploaded documents.
What is claim file documentation?
Photos in the claim file help with documenting damage and increase the probability of this type of recovery.
What is Subrogation?
If all contact attempts fail, what type of ROR is appropriate?
What is the Non-Cooperation ROR?
Name the two ways the ROR must be sent.
What is certified and regular mail?
When pursing subrogation, what must be obtained from the adverse party?
What is contact information & carrier information if applicable?
Any unfavorable risk discovered during claim investigation—such as unlisted drivers, garaging discrepancies, or late reporting—should result in one of these being submitted.
What is an Underwriting Advisory?
A vehicle suspected to be a total loss should be moved promptly using what methodology?
What is Etow?