Coverage Questions
What should you do if the insured disputes the use of non OEM parts
Explain/provide the SF Promise and advise if they prefer parts other than those included on the estimate, they should notify the repairer. Should the use of those other parts increase the repair cost, they will be expected to pay the difference.
OEM disputes should not be reassigned to Property
If a loss is reported by the insured and liability is unclear, is a QFC needed for the insured?
NO
Photo estimate is not eligible in which two states?
Rhode Island and Massachusetts.
How do you update a TIN for a Repair Facility?
Add the participant from ECS, Use the Maintain Additional SPI and update the TIN, then complete the TIN/TPAR Update Template and send to CSA.
Where are all the places in a claim that you can look to see if a police report was filed
CSS or additional details tab
What would describe a vehicle as a Temporary Substitute Car?
Replaces your car for a short time while your car is out of use due to its: breakdown, repair, servicing damage, or theft;
and
Neither you nor the person operating it, own or have it registered
To ensure you are completing a quality first contact with the Name insured or Claimant what should you do?
Use the QFC Template, and QFC Call Driver
When determining the correct inspection option for the Named insured or Claimant, what should you do?
Use the IOT
What template do you use to setup a double insured claim?
453
How do you update the DOL?
Policy request, update the DOL and click search
When completing the coverage analysis, what needs to be determined?
Whether coverage exists for the loss
Potential questions of coverage
Potential reasons to escalate the file
Potential jurisdictional policy differences that may apply
Potential for low limits and excess exposure
After completing liability, you determine that the Name insured is at fault and the claimant was injured. What should you do with the claim?
What location must be used in the IOT to ensure the assignment is correct?
The current location of the vehicle
Whose claim do you access when completing a Double Insured Recovery
Both the insured and claimant insured
Use Double Insured Button on the 200 COL Details page and complete the double insured payment
From Not-At Fault Insured Claim:
Confirm Subrogation is open
Update Subrogation Participant Details page is updated with At Fault Insured information
Access Financials - Double Insured Recovery Task - Reassign to CSA Unit
Complete File Note Template 360 with recovery type of Subrogation
Create CSA – Activity Double Insured Recovery Task and paste file note template 360 into Additional Notes and send to CSA Unit.
Other than name, what personal information on the claimant participant page are you required to ask for?
DOB
What are 2 things you must you do to determine if UPD applies
Check for U/U1 on the policy coverage strip
Run UPD tool
What do you do if liability is tentative, and we are not able to reach the Claimant driver after 3rd attempt?
Establish liability based upon investigation to date
Name 3 vehicles SF considers exotic
Alfa Romeo Lamborghini
Aston Martin Lotus
Audi R8 Maserati
Bentley Maybach
Bugatti McLaren
Ferrari Panoz
Fisker Rolls-Royce
When can a CSA revert a Double Insured Recovery
If Double Insured payment was made in error/incorrectly, CSA Unit can revert (void) the payment if not posted already
If subrogation was open but subrogation doesn’t apply and we are needing to close the claim, what do you have to do?
Access the subrogation screens, click on subrogation participant details---third screen and change the status to close.
Identify these letters on a policy strip B, C, D, G, H, L, P, R1
B- Property Damage, C-Medical Payments Coverage, D- Comprehensive, G- Collision, H-Emergency Road Service, L- Comprehensive and Collision for Recreational Vehicle Policies, P-Personal Injury Protection, R1-Rental Reimbursement
How many days should you set the default calendar for Vermont claims
Calendars should be set for 20 days or less
What are all the ways EA assignments are handled
Snapsheet
Directly with the NPS that are in-network through open shop
What do you have to include when recording handwritten drafts when the draft copy is unavailable?
Draft number
Date payment issued
Payee
Amount of draft
Draft Coding (example: 500-1) including any special instructions for split coding
Alias of issuer or alias of claim associate with draft authority if draft was issued by an agent or State Farm attorney
What should you do if Verint shows “chip: scheduled tasks” but there are no more tasks in queue?
Work from the CHIP unscheduled task queue.