1. CSR/Claims Representative receives notification from customer of loss.
2. CSR/Claims Representative creates appropriate ACORD claims form from customer's data base and then enters additional claims data. (Should be done whether or not coverage exists)
3. CSR/Claims Representative reviews customer's electronic file to ascertain if coverage exists.
4. If CSR/Claims Representative can verify that coverage exists, and is within the agency's authority, CSR/Claims Representative issues claims draft and records in draft log (Go to step 11)
5. If CSR/Claims Representative can not verify that coverage exists, or the claim is not within the agency's authority, CSR/Claims Representative forwards claims ACORD form to the company.
6. CSR/Claims Representative enters appropriate data into electronic claims log or note pad.
7. CSR/Claims Representative sends one of the following letters to customer:
Type of Loss:
Other Party:
Date of Loss:
Dear :
Thank you for your report of loss. We are giving it our immediate attention.
In order to expedite the settlement of your loss, please send us a list of the items lost or damaged, their approximate age, the cost to replace them, and the amount you paid originally, if known.
Since claims service is our most important service to you, please let us know if you have any questions or are not completely satisfied with the handling of your claim.
Sincerely,
Dear :
Thank you for your report of loss. It is being given our prompt attention.
Please note the following:
The loss you called in to our office today has been referred to your insurance company. Enclosed is a copy of the report. Please make any necessary changes; sign, date, and return to our office in the enclosed self-addressed envelope.
Since claims service is our most important responsibility to you, please let us know if you have any questions or if your loss is not being handled to your complete satisfaction.
Sincerely,
Claims Supervisor
Enclosure
Type of Loss:
Other Party:
Date of Loss:
Dear :
Thank you for your report of loss. It is being given our prompt attention.
At your request, we are retaining this loss for our records only.
Claims service is our most important responsibility to you. Please let us know if you have any questions or if your loss is not being handled to your complete satisfaction.
Sincerely,
Type of Loss:
Other Party:
Date of Loss:
Dear :
Thank you for your report of loss. It is being given our immediate attention.
Please send our office any correspondence you receive from the other party or their representatives. Also, be sure to refer the other party to our office.
Since claims service is our most important service to you, please let us know if you have any questions or are not completely satisfied with the handling of your claim.
Sincerely,
Type of Loss:
Other Party:
Date of Loss:
Dear :
Thank you for your report of loss. It is being given our immediate attention.
The driver of every motor vehicle involved in an accident that results in damage to property in excess of or in bodily injury or death must file a report of injury or damage with the Department of Motor Vehicles within 15 days after the accident. Enclosed is an SR-1 Form. Fully complete, sign, and return the form to our office. A self-addressed envelope is enclosed for your convenience.
Since claims service is our most important service to you, please let us know if you have any questions or are not completely satisfied with the handling of your claim.
Sincerely,
Dear :
I am sorry you have experienced a loss. Since claims service is our most important responsibility to you, please keep us informed if your loss is not handled to your complete satisfaction.
If you have not heard from an adjustor in a few days, please advise our office so that we may follow up on your behalf. My Customer Service Hours are 9:00 a.m. to 12:00 p.m. and 1:00 p.m. to 5:00 p.m. Monday through Friday.
Your Lienholder may require an inspection of any damaged property. We suggest you call them immediately to expedite the settlement of your claim. In the event your property is mortgaged to a bank, mortgage company, etc., any settlement may be payable to you and your Lienholder. You both must endorse the check before it can be cashed.
Should you have any questions or problems, please contact me personally.
Sincerely,
8. CSR/Claims Representative sets up a suspense to follow up if the claim is not handled in a specific period of time. (If the agency's automation system has an electronic claims log showing open and closed losses, it should be reviewed weekly to follow up on open losses)
9. If claim check or denial has not been received in a predetermined period of time, send follow up letter.
10. When claims check is received from the company send the check to customer along with Cover Letter (CLAIMFRM.PL).
11. CSR/Claims Representative updates customer's electronic claims file.
12. CSR/Claims Representative deletes any unnecessary follow up dates.
13. If customer returns claims letter, file in Insurance Company file to review with Company Representative on a regular basis. (Also if there are criticisms of agency's handling of claims, refer to agency principal)