by JJ Meyer 14 years ago
279
More like this
For out of state claims, CSA's will need to know how to arrange repairs using the Vendor department. They may information statutes or subrogation.
CSA will need to be aware of states requiring a license. Need to recognize when a state will require a license and to get assitance on those files - Brian
CSA may need to take recorded statements for liability disputes. They will need to be familiar with the recording system. They will also need to be comfortable with the formality of a recorded statement. Thoughts?- from Jenn
Investigation
CSA will need to understand what a proper invest entails
-Proper statement from claimant and insured
-Witness statments
-When to record statement and how (NICE appliaction)
-PR
-Scene invest (google)
-Vehicle photos
CSA needs to recognize exposures
-difference in COMP and COL
-MP and PIP
-PD
-BI
CSA needs to understand triage model
-assign injury claim to injury unit
-assign motorcycle and busses to injury unit
Recognize higher exposures & triages accordingly
Open claim by telephone: Performs all steps of FNOL (above), PLUS:
Obtains any additional required information from othe involved parties
Obtains any additional required information from Claimant
Obtains any additional required information from Insured
Added By Debbie Beard 2/25/10
• Confirm coverage is in order
o If coverage issue - Advise what information needs
to be addressed
o Set clear expectations what is needed to clear
coverage question or confirm no coverage for loss
is available.
• Advise 1st party Coverage’s and time limits
• Advise 3rd party Coverage’s and time limits
• Advise insured if deductible applies or will be waived (be very clear)
o Example: Advise insured that their collision/comp
ded of $500 (or what ever their specific deductible
for this loss is confirmed to be) does apply and is
payable to the shop when the repairs are completed
(they are responsible for the deductible until
confirmed)
• Advise (verbally and in writing) intention to pursue or not to pursue subrogation provided the insured will have a deductible interest outstanding and there is a legal basis for recovery of that money.
• If possible, advise and code liability
o If liability pending set expectations on what is needed to conclude liability
o If PAF advise of liability and send PAF letter
Advise possible rate increase
Give Insured policy services contact number if
additional questions regarding potential rate
increase arise.
• Discuss repair options
o Advise of DRN and non-DRN conditions
o Send assignment to DRN, IA, PDA, Desk Review, or
VIP (NV)
o Advise of repair contact information
o Set detailed expectations and time frames
o Advise and send DRN participation letter (if
applicable)
• Arrange rental (if applicable)
o Advise of rental coverage’s and conditions
o Send assignment to HLE, ERAC or other rental
company
o Advise of rental contact information
o Set detailed expectations and time frames
• Advise and send Acknowledgement Letters
• Advise and send SR-1 if necessary or advise Insured they need to send SR-1
• Set detailed expectations and time frames of next steps
o Of Note: The more detailed expectations that are
set in the beginning the better CSI results you will
have and the potential of less incoming phone calls
you will receive from your customers
• Advise of OA contact information and claim number
• Ask if they have any additional questions or concerns you may help them with at this time.
*If liability decision is pending, set expectations on what is needed to conclude liability
o If PAF advise of liability and send PAF letter
Advise possible rate increase
Give Insured policy services contact number if
additional questions regarding potential rate
increase arise.
*Provided the insured will have a deductible interest outstanding and there is a legal basis for recovery of that money.
