ULD Investigation
Do we need Carrier Discovery for ULDs if there is no PD involved?
No - if pro rata does not apply (no pd or we're not at fault), we do not need to run CD.
What is our goal for the TL metric 'Report to Close?'
Why do we care about a claim that is near the time of policy inception?
Because the policy may not have been in force and therefore there's no coverage for the loss.
Do you need the LOR prior to transferring a BI feature to ARBI?
What are the 2 required templates in every single claim?
1. Inital Claim Review template
2. Statement of Coverage
Who do we need statements from for ULD investigations?
NI/IO and the ULD
What are 4 main resources for your TL questions?
1. OneNote
2. Salvage website
3. NSU Chat
4. Team chat
What are 3 guaranteed methods of payment?
1. Credit/Debit Card
2. Agent Upload
3. Google pay
4. Paypal
5. Apple pay
What is the difference between URBI, CURBI, and ARBI?
URBI = Unrepp'd BI
CURBI = Complex Unrepp'd BI
ARBI = Atty repp'd BI
What are the steps to address a PIP/UM request when they're not showing on the coverage list for a claim?
1. Search for and upload the signed rejection forms.
2. Write a coverage recommendation and submit the denial request to your supervisor.
3. Once approved, send the pre-written denial, signed rejections, and dec page (if requested) to the attorney.
What are the 3 risks we're looking at in ULD investigations?
1. Permissive use?
2. Should the ULD be on the policy?
3. Is there another insurance carrier that can cover the bill?
What are 4 different things you should consider when looking at a damaged vehicle?
1. DTE
2. Mileage
3. Year of vehicle
4. Airbags deployed?
5. Leaking fluids?
6. How many areas were impacted?
7. Any damage to the wheels?
What are the 4 steps to clearing a Policy Incept cvq?
1. Verify DOL
2. Confirm initial payment cleared.
3. Rule out overlapping insurance.
4. Rule out UPD.
What 2 templates are needed for any UM/UIM transfers?
1. The UMPD/UM Exposure Review template
2. The UM transfer template (depending on the situation, this could be CURBI or the ARBI/LLL UM transfer templates)
What are 2 regulatory letters we sometimes have to send and when?
1. Notice of Repair - the system automatically sends it out to every owner/driver involved in an accident advising them that they have the right to choose any shop they want. If there is no address, we must send these out manually after updating the address.
2. Article 21 - we have to send these to our insured when someone else is at fault for the accident but we cannot pursue them for subrogation. (IE: unknown driver)
What documents do we need to send to the ULD's carrier, and what do we need from them, before we can move forward with PD?
We need to send the ULD's carrier the 2 pro rata letters and our dec page. We need the excess policy language and dec page from the ULD's carrier.
What should you avoid doing if an IV is a potential TL and there is Loan NPO on the policy?
Do not open the Payoff portal ticket!
What are 4 possible DOL verification sources?
1. Confirmation with an independent witness
2. Time stamped video footage of loss
3. Tow bill (From scene and confirmed by vendor)
4. Scene photo metadata
5. Police report (If responded to scene)
6. Bill of Sale (only helpful in certain situations)
When coverage is denied, who handles the denial letters to each party when ARBI is involved?
ARBI handles the verbal and written communication of denial to the insured and to the represented parties. PCS handles the verbal and written communication of denial to any 3rd party that is not represented.
What are the steps to address a Fire Recovery USA bill?
1. Write a coverage recommendation and submit denial request to your supervisor
2. Once approved, verbally inform the customer of incoming letters regarding bill and denial, and advise them to contact us if Fire Recovery USA reaches out to them directly.
3. Send the pre-written denial to Fire Recovery USA.
4. Send the bill, the denial to Fire Recovery USA, and the pre-written explanation letter to our insured.
Who is supposed to take point on PD when we have an ULD?
The carrier that has the bigger limits. However, normal practice is the insurance that has the vehicle.
What is the 'Imperfect Title' process and what are the steps involved?
Imperfect Title process is when a customer has possession of the title but their name is not on it.
1. Ask the customer to get the title into their name. If this is not possible, go to step 2.
2. Contact NSU and ask them to check their database - they will tell you if this customer is barred from getting the title into their name. If they are barred, the Imperfect Title process cannot be done. If they are ok, go to step 3.
3. Contact the listed owner and confirm they sold/transferred the vehicle. If no contact, send the Imperfect Title letter to the listed owner and wait 10 business days.
4. If no response from titled owner, ok to issue payment to the customer MINUS taxes and fees.
As soon as a coverage issue is recognized and we have needs. We send them to the NI, Vehicle Owner, and the Driver.
What are the rules for URBI transfers before and after 24 hours?
Bonus (200pts): Define "Associated Open Property Damage"
Before 24 hours:
1. Injury has been identified and confirmed
2. Entire claim gets transferred to URBI
After 24 hours:
1. Injury has been indentified and confirmed
2. The BI exposure and the Associated Open Property goes to URBI. They will then transfer claim ownership to themselves and handle coverage and liability.
AOPD Defined:
1. Open property being driven by injured party
OR
2. Open property Owned by injured party
What are the first 2 parts of the definition of an Insured Person?
1. You or a Relative that owns, maintains, or uses an auto or trailer.
2. Any person that uses a Covered Auto with the permission of You or Relative.
(Bonus for 250pts: define You, Relative, and Covered auto.
You - NI on the dec page and spouse of NI if they live in the same household or are living separately during a period of separation in contemplation of divorce.
Relative - a household member related by blood, marriage or adoption.
Covered auto - a vehicle on the dec page, an additional auto, replacement auto, or trailer owned by 'you.'