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Created by Laverne Dahlin, Winnipeg Branch Presented by Stan Bodal, Claims Training Schedule Of Loss Workshop.

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Presentation on theme: "Created by Laverne Dahlin, Winnipeg Branch Presented by Stan Bodal, Claims Training Schedule Of Loss Workshop."— Presentation transcript:

1 Created by Laverne Dahlin, Winnipeg Branch Presented by Stan Bodal, Claims Training Schedule Of Loss Workshop

2 Agenda Schedule of Loss Forms Workshop Importance of schedule of loss forms Obtaining appropriate information Claims Advisor versus Field Rep handling Examiner handling of Schedule of Loss Verifying Schedule of Loss Handling Proof of Purchase Summary - investigate, evaluate, negotiate & settle claim Questions & Answers Page 2

3 Why Are Schedule of Loss Forms Important? Page 3

4 Why SOL is Important Can be used to obtain appropriate information regarding description, purchase price, age and replacement cost for items lost or damaged. Page 4

5 Why SOL is Important Provides a column to calculate actual cash value so you can provide a cash advance as expediently as possible with supporting documentation on file. Page 5

6 Why SOL is Important Provides details on proof of ownership. Insured will need to provide original receipts, canceled cheques, credit card receipts or statements, manuals and photographs. Page 6

7 Claims Advisor Vs Field Rep When the claims advisor is handling content losses, the claims advisor must complete the schedule of loss obtaining all appropriate information listed on the SOL. Use of an electronic form will assist in taking down the details over the phone. Initial contact with the insured is within within times specified under various protocols, ei. Water damage requires 2 hours Page 7

8 Claims Advisor Vs Field Rep Claims advisor is to take a recorded statement by telephone with as much detail as possible on what was lost or damaged for reserving purposes Request police report for B & E claims comparing it to the statement that was taken (if required) Page 8

9 Claims Advisor Vs Field Rep Claims advisor is to question claimant if there are discrepancies. Should there be any red flags claims advisor to discuss claim with supervisor or manager to determine if claims investigation is to be involved. Page 9

10 Claims Advisor Vs Field Rep If insured has a few items left to replace and this is what is preventing you from settling the claim then offer to pay slightly more then the ACV and close the file. If the number of items makes the task challenging to complete by telephone, a critical path letter is forwarded to the insured with the SOL forms. CA to follow-up every 30 days. Page 10

11 A field adjuster (employed or contracted with supervisors or managers approval) can be dispatched to assist claims advisor with task assignment to complete the SOL, conduct site investigation, etc. When the forms are returned, the claims advisor should verify pricing through Avivas preferred vendors to obtain the best possible price. Claims Advisor Vs Field Rep Page 11

12 Claims Advisor Vs Field Rep Obtain an Authorization at the time of the interview to reserve Avivas right to secure purchasing information. Page 12

13 Claims Advisor Vs Field Rep Claims advisor to request photos of exterior premises from contractor. Page 13

14 Claims Advisor Vs Field Rep Field reps are to contact insured within the time frame specified in the protocols and to make appointment to attend site within company protocols; Water 2 hours, 24 hours for site investigation. Obtain a n Authorizationa t the time of the interview to reserve Avivas right to secure purchasing information. Page 14

15 Claims Advisor Vs Field Rep Field reps to conduct site investigation, take relevant photographs (including exterior photos) provide SOL forms referring the insured to self- explanatory instructions, take a recorded statement to detail as much of the loss as possible for reserving purposes, do critical path letters and follow-up with insured every 30 days. Page 15

16 Claims Advisor Vs Field Rep Verify the SOL items through our preferred vendors to obtain the best pricing. Question any discrepancies, refer any red flags to supervisor or manager to determine if claims investigation to be involved. Page 16

17 Examiner Handling Of The SOL Contributions by Steve Dryer National Analyst Page 17

18 Global vs Line By Line Depreciation Some Independents prefer to depreciate Globally but Line by Line Depreciation is the preferred method. Advise Independents not to transfer schedules to Excel spread sheets when they receive them on Aviva forms. Page 18

19 Spot Checks Use a tape and calculator to make sure that the math is correct. Ensure that the Independent has spot checked at least some of the items on the schedules to ensure that they are reasonable and accurate. Spot check if preferred vendors have been used to price the items. Page 19

20 Spot Checks Ensure that the Independent has secured independent quotes on higher end items such as jewellery. Some times you can calculate the ACV with the information on file and not wait for the Independent to do this for you. Page 20

21 Obtaining Appropriate Information All SOLs require execution by a Commissioner of Oaths. An adjuster can use judgment when requesting the commissioning of SOL forms that are under $5,000. A commissioned SOL and Proof of Loss is required for all claims that become questionable. Page 21

22 Obtaining Appropriate Information It is important to explain to the insured that not receiving the required information on the SOL forms there will be delays in the handling of the claim. Insured should be advised to number proof of ownership documents to correspond with SOL items. Page 22

23 If insured requires receipts returned they are to be stamped with appropriate stamp, initialed, copied and returned. Keep receipts in numerical order at the back of the SOL forms. They can be bound with a cover sheet showing RC #1, RC #2, etc. Insured to match the replacement cost receipts to SOL page and item number. Obtaining Appropriate Information Page 23

24 Verifying SOL Insured submits SOL forms with columns 1-8 completed. (see example on the course page) If not completed properly arrange a meeting to discuss what needs to be done. Assist as much as possible to limit delays. Process replacement cost receipts in red ink. This will be the copy you return to the insured with your critical path letter. Be sure to make copy for your file. Page 24

25 Verifying SOL Insured should submit replacement cost receipts to correspond with the page and item number; ie: if claiming at page 2, item 1 – item 24 shirts; Request one receipt for 24 shirts. Alternatively, it can be listed in groups of 4 or 5 if insured is shopping over a period of time. This may avoid confusion by using only one line on the SOL to track what items are outstanding. Page 25

26 Verifying SOL Do ACV calculation by using depreciation guidelines located in claims procedure manual (example can be found on course page) bulletin 3.7. Each item needs to be depreciated in accordance with its age. Page 26

27 Verifying SOL Do adding machine tape to calculate the Actual Cash Value and Replacement Cost amounts for each SOL page and affix the adding tape on the SOL form. You can fold over the SOL forms to 11 inches, affix the tape to the back of the SOL form. This will make the calculations readily noticeable. Page 27

28 You will calculate all the SOL page totals to grand total the ACV and R/C amounts. This can be affixed to the initial submission appropriately marked RC #1, ACV #1. You will continue to do this for each submission. You will only need to photocopy the pages where amounts are calculated. Verifying SOL Page 28

29 Step 1: Investigate Claims Advisors and Field Adjusters are to compare the INVESTIGATION information to what is being claimed on the SOL confirming that the claim is appropriate, eg proof of ownership, like kind and quality, items repaired. Page 29

30 Step 2: Evaluate Claims Advisors and Field Adjusters are to EVALUATE all replacement cost values through independent sources, utilizing preferred vendor pricing where applicable, eg.; WCC, Birks, ICC Page 30

31 Step 3 & 4: Negotiate & Settle When the Claims Advisors and Field Adjusters are completely satisfied that the SOL has been properly completed, commissioned, scrutinized with appropriate documentation on file and the mathematic calculations are verified the claim can be NEGOTIATED and SETTLED. Page 31

32 thank you for your participation Page 32

33 & Questions Answers Contact your immediate supervisor or Page 33


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