mcvonbraun's version from 2015-06-17 21:13

Section 1

Question Answer
What does the file handler have 1 hour to do from the initial assignment?The file handler generally has 1 hour from the time of initial assignment to attempt contact to those parties who have not spoken directly to a GEICO claims rep. (critical) Any attempt made by another CSR is acceptable.
If the report was filed outside of TIP hours, what is exempt?If this is the case, 1 hour attempt is exempt and this category would be rated N/S.
What are the exceptions to the 1 hour attempt?Internet loss reports, on which TIP must be met within 2 hours from the office opening the following day.

Section 2

Question Answer
If the file handler or contact team was unable to make contact within 1 hour, how long do they have to make actual contact?24 hours from the time of initial assignment to make actual contact (critical)
Can a customer be considered contacted by a message left?The customer will be considered contact if a message is left with a person or on an answering machine at their household or place of business.
If actual contact is not made within 24 hours, what should the file handler do? Make aggressive attempts to reach the party.
If aggressive attempts made but no actual contact, how would the category be rated?The category would be rated N/A

Section 3

Question Answer
In what scenario may standard TIP not apply?On claim that would ordinarily meet the RFP qualifications, yet the insured chooses to file under their own GEICO policy rather than pursuing a claim through the adverse carrier. If the insured is able to provide us with adverse carrier information, then TIP with the claimant IP is waived.
What other exception applies to the above scenario?One hour TIP with the adverse carrier is not necessary. However, contact within a reasonable time frame should be made for subro purposes. If the insured is not able to provide us with adverse carrier information, contact within normal TIP guidelines must be made directly with the claimant IP.
If a phone number is not available, what must the file hander do?Attempts to search and locate a contact number should be made and clearly documented.

Section 4

Question Answer
What are the questions the reviewer should ask regarding communication?1. Did we explain all coverage, their rights under the policy, under the state laws, and the claims process to the customer?
2. For long form FNOL, did we advise all parties of liability?
3. Were these liability conversations documented in the file?
What are the three questions related to helmet coverage that must be asked and documented in notes on a motorcycle claim? 1. Was the insured wearing a helmet? If no, document this. If yes, go to question 2.
2. Was the helmet damaged? If no, document this. If yes, go to question 3.
3. Was the helmet coverage available? Explain this to the insured. All must be documented separately.
What are the other questions regarding proper customer service? 1. Did the file handler keep the customer informed of the status of the claim on a regular basis?
2. Was correspondence from the claims handler professional and well written?
How much time does the file handler have to reply to written correspondence which requires a response?A response must be done within 10 days of receipt, and the response must be by phone or in writing. The response must address all concerns outlined in the correspondence.
How must all state mandated letters be sent?In accordance with the specific state requirements
How should all letters required by TCM or Regional Requirements be sent?Timely.
How long does the file handler have to send denial letters? How should they be sent?Denial letters must be accurate and timely within 15 days of the decision and must be in the file.

Section 5

Question Answer
What are the customer service critical errors?1. Failure to keep all informed
2. Failure to acknowledge written correspondence/LOR
3. Failure to advise insured of available coverage.
4. Failure to advise insured (including Named Insured or spouse) of liability (long form only).
5. Failure to send state, regional, or TCM required letters
6. Late or inaccurate denial letters
7. LOU not offered/documented (state specific)
8. Failure to advise the claimant of our liability decision (long form only)
9. Incorrect information given