authentication & Disclosure
This must be completed before discussing or updating any claim information.
What is call authentication?
QA expects proactive identification and addition of all involved parties on the claim.
What is participant identification?
This should occur promptly to move the claim forward.
What is initial insured or claimant contact?
Date of loss and accident facts must be verified and kept current under this requirement.
What are key loss facts?
All vehicle and property damage to be captured accurately.
What are asset damages?
Collision vs. comprehensive and deductibles must be disclosed accurately in this step.
What is coverage disclosure?
Failing to verify identity before updating address, phone, or email leads to this quality defect.
What is updating claim information without proper authentication?
Drivers, owners, and passengers fall under this key participant group.
Who are insured or claimant participants?
Using calls, texts, emails, and letters supports QA expectations for this.
What are sufficient contact attempts?
This must be discussed on collision losses and documented accurately.
This must be discussed on collision losses and documented accurately.
This must be offered when coverage applies and repairs are sought.
What is a Method of Inspection (MOI)?
Opening the correct first‑ or third‑party exposure prevents this error
What is improper coverage exposure?
This occurs when customer information is shared with an unauthorized participant.
What is incorrect PII/PHI release?
Body shops, witnesses, TPCs, and attorneys belong to this category of participants.
Who are other involved parties?
QA flags this when follow‑ups are promised but not completed.
What is insufficient subsequent contact?
Updating liability before the investigation is complete causes this QA error.
What is premature liability decision?
Failing to explain how inspections or supplements work leads to this defect.
What is not setting proper damage handling expectations?
Payee, method, and amount mistakes fall under this QA category.
What are payment processing errors?
This disclosure must be provided when placing an outbound call.
What is outbound call disclosure?
Failing to assign accurate roles and associations results in this common root cause.
What is incorrect role and association selection?
Passengers may require outreach based on claim handling guidelines under this requirement.
What is participant contact review?
Express claims transferred incorrectly result in this segmentation defect.
What is improper claim segmentation?
Rental needs for insureds and claimants must be identified here.
What is alternate transportation need?
Claims closed too early can disrupt this part of the lifecycle.
What is claim resolution?
Agent, insured, and non‑insured participants all require this to be handled correctly but differently.
What is participant authentication?
Police reports and search tools should be leveraged to avoid this miss.
What is failing to identify all applicable participants?
Failing to reach agents, witnesses, or vendors creates delays because required participant contact was not completed.
What is Contact & Timeliness?
UMPD claims are especially sensitive to errors in this area.
What is liability handling?
Explaining car class, limits, and LOU requirements satisfies this expectation.
What are rental or LOU expectations?
Accurate summaries, tasks, and state scripts support this standard.
What is proper file documentation?