Lisa
On a newly assigned loss, there is a CC99, what would be an appropriate handling step?
Review Edge to make sure the payment cleared and confirm the Date of Loss
You have been given the diagnosis code S134XXA (ICD-10). What is this injury?
Sprain of ligaments of cervical spine, initial encounter
The date of loss is 1/5/25 and the Application for Motor Vehicle No-Fault Benefits is received on 2/27/25. There is a police report received on 01/07/25 that lists injuries for the Injured Party. What should be submitted in ATLAS and with what recommendation?
PIP Proof of Claim Worksheet and recommend to afford coverage
Relative means a person related to you by blood, marriage or adoption who is a resident of your household. This includes:
A ward or foster child
What information can be used to verify an Insured Driver on an inbound call?
Callers Full Name and Last 4 of SSN
Which of the items listed below is not required for MBR to process a bill?
The Interested Party's Date of Birth
The date of loss is 10/12/2025. When is the last day the Application for Motor Vehicle No-Fault Benefits can be received for it to be submitted timely?
11/11/2025
A new claim is assigned to you and the FNOL Snapshot states that the claim was reported by an unlisted driver. Who needs to be contacted and what needs to be verified?
Named Insured and Permissive Use
Coverage Condition Code 31 is which of the following:
Policy Cancelled on or before loss date
What are CPT codes?
A set of codes describing different kinds of procedures and services performed by physicians and other health care providers
What is the difference between PIP Option A and PIP Option B?
PIP Option B has a $200 deductible
When would we pay interest for a late medical bill?
Both A and B above
What does Basic PIP cover?
Medical treatment, Lost Wages, Replacement Benefits, Death Benefit
Two types of accidents that commonly cause shoulder injuries are:
Side (T-bone) and rotational
Using the above MRI findings, which body part is being reviewed?
Lower Back
.If a GEICO insured is injured while occupying a rental car in NY, who is the primary insurance company for No-Fault?
The rental vehicle's insurance company
Based on the Verification Matrix, what information is needed on an inbound call to verify an Attorney?
Caller’s Name, Name of Company, Name of the IP and Claim Number
You receive all of the documentation needed to process reimbursement for broken prescription eyeglasses worn in the accident. Which reserve line would you pay under?
Basic PIP- Medical Expense
You are assigned a file where the claimant is your sister's friend. According to the Claims Code of Conduct, you should:
Advise your supervisor/manager and request the file be reassigned
What must a PIP adjuster advise everytime a medical provider calls about a claim?
advise GEICO.com/b2b
Our Insured carries PIP Option B coverage on his policy. He is involved in an accident in NY. His brother, Tom, is a passenger who was injured in this accident. Tom resides in California. Does the $200 deductible apply to Tom? Why or Why not?
5 business days
A new loss is assigned to you that has a coverage issue that has not been fully resolved to date. When making contact during the opening, what should you advise them?
Let them know there is a coverage issue investigation pending, and you will keep them updated throughout the investigation.
What information must a PIP adjuster obtain to satisfy the Medicare requirement when an interested party is injured?
First and Last name, Social Security Number, date of birth, gender, CASS verified address, accident related ICD 10 codes and no fault limits.
When a medical provider calls, what must a PIP examiner advise on each phone call?
Advise the geico.com/b2b website