How Insurance Companies Process Claims   

 

   Chapter 1

 [A]  Creation of a Claim

 The Reporting  Process

     1) Reporting to the Agency Which Sold the Business

     2) Reporting  to the Carrier

 

 [B]  Police Verification 

     1) Assignment  for Handling

     2) Resolution  by Fastrack 

     3) Additional  Information  Requested by Correspondence

     4) Additional  Investigation  by Telephone  or Correspondence

     5) Field Investigation - Staff Adjuster  or Independent  Adjuster

 

 

 

 

 

 

 

 

 

 

[C] Checklist : Duties  of the Adjuster

Accomplishing Primary  Duties

1) Interviewing  Parties  Directly  Involved

2) Proper  Identification  of interviewee

3) Establishing Relationship of Parties  directly  Involved

4) Developing Facts  from the prospective of the Interviewee

5) Determining the  Specific Nature of the Injury  or Property  Damages

6) Determining  the Specific Loss Associated  with the Injury  or  Property Damage

7) Developing  Any Ancillary Problems

8) Conducting  an Assessment of the interviewee

9) Developing  Leads

[D] Confirming  And Preserving  Facts

1) Official Records

2) Inspection  of Accidents Site

3) Inspection  of Damaged Property

4) Documenting of Damaged Property

5) Assembling  Medical Documents

6) Interviewing  Witness ( Recorded Statements)

7) Following Up on Developed Leads

 

[E] Performing  Secondary  Duties    

Determining coverage

Evaluating  Exposure

Reserving

       1) Specific Methods of Reserving

       2) Reserve runs

       3) Opening  Reserve from  Loss Notice

       4) Primary  Review

 

[F]  Reporting      

        1) Informing  Superiors of Details

          2) Recommending  Reserves

          3) Suggesting  an Action  Plan 

4) Requesting  Settlement  Authority

5) Preparing  Dart Request   to Disbursal Center

6) Salvage

7) Subrogation  and Contribution

The Negotiation Process 

 

*****Lecture seminar for  this course is 2.5 hours for Continuing Education (CE) This course includes  how claims are assigned within the insurance industry from the start to finish. Adjusters will get a clear understanding  of the bodily injury process. This includes setting up an claim form  reserves as well as  the basic foundation for in preserving evidence lead and first contact with  the claimant  Course study for Professional Designation  requires 7 hours study time.  The test is an open book essay . 

 

This is a great course for professionals  interested in entering the filed of bodily injury claims. At the end of the course the student will receive a professional designation of (ICCBI)  Insurance Claim Consultant/ Bodily Injury.