Claims Process

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Claims Process

claims processAn understanding of the claims process as shown in the flow chart is important in the planning of the business. Being the expert in the field of repairs and within the industry you need to be up to speed with the claims process. Given for some customers this may be the first time they have experienced a hailstorm and put in a claim, everything is new for them. Your job is to facilitate the process and perhaps give some guidance and some options. Allow them to make the ultimate decisions but they should be told that if hail damage is on their vehicle, it represents a claim be it now or some time down the track. There is a duty of disclosure for hail damage to be reported to the insurance companies. Hail damage not repaired represents a hail exclusion on insurance policies and voids comprehensive insurance.

Each storm is approached differently by insurance companies depending on the nature of the event, the amount of resources available and the region. Sometimes feedback from previous events and even the media can influence the procedures of a specific event. The Christmas Day Melbourne hailstorm represented a different approach from the insurance companies. The fact that it was in close timing to a previous hailstorm and publicity from the media work was allocated to major PDR companies and panel shops. In this case, it became quickly apparent that liaising with panel shops formed a vital process. The panel shop however controlled the job and the claims process which is why it is not listed in the flow chart. In these circumstance you are answerable to the customer and to a certain extent the panel shop.

Claims Process and the Customer

Customers can come directly from the insurance company, your phone contact number, direct to your shop address after seeing banners or from panel shops. In any case, you need to quickly ascertain what their specific circumstances are, whether they have hail damage, whether they wish to repair or perhaps whether the damage may be conventional or even possibly a write-off (which is for your purposes only – leave the decision to the insurance companies as to the decision for write-offs).

Within the first business day of the hailstorm, customers begin to act and contact their insurance companies. Generally they go through the main contact number or perhaps the hotline set up for that specific event. Some customers may come to your company first. Once you are aware they are going to claim, you need to clearly inform them of the processes. In particular, you need to obtain their claim number at some point.

Given the stress that comes with seeing their vehicle damaged, the long waits on jammed phone lines and the excesses, your role and assurance in this claims process should be one of easing the stress and taking much of the load off them. With the quotation being made quickly, you explain to the customer that the quotation came to specific figure and that you would be forwarding the quotation to the insurance company and they will be contacted. It is imperative that they realise the time frames and delays that could occur out of your control – the submission of the quotation, the processing of the claim, the authorisation and finally the contact to them. Keep them informed of any progress but don’t spam them with phone calls.

Claims process and Insurance

Insurance companies within the first 48 hours usually are able to gain an indication as to the severity of the event based on the number of claims processed within that short period. Normally, once a specific limit of claims (usually 50 or 100 claims) systems in place initiate the opening of mass assessing centres and also the set up of hotlines.

This quickly changes the way work flows into your company. You may wish to ask for an invitation to be involved in the mass assessing and allocations of the vehicles but sometimes this is open only for preferred repairers.

You will note that, unsatisfied customers unwilling to wait for months for repairs will approach or be sent to you. This happens most likely from about a month or two after the event. Occasionally you will also note an increase in customers asking for quotations upon closure of mass assessing centres.

Most importantly, to keep control of customers within the confines of the national preferred repairers, often the customers are told that warranty will not be covered if they go elsewhere. You need to provide assurance that you will provide lifetime warranty for the life of the vehicle with that owner.

Claims Process and the Assessor

An example of an authorisation from Suncorp’s PNet system
 Suncorp_Group_PNET_Mail_Notification

The assessor being the direct contact from the insurance company represents an important component of the clams process for your business. Their role is to receive, process and judge your quotation and make an assessment as to whether to repair the vehicle and to whom it will be allocated. Whether you receive the authorisation for repair depends on the price, past history and of course your dealings with the assessor. You should avoid at all costs upsetting the assessor whether it seems things are fair or how they are dealing with you. They ultimately have the final say on authorisations. If it seems that there are clear evidence of deliberate attempts to divert work away from your company, there are grievance procedures in place to sort out such issues. Be aware that there will be frustrations with work being allocated to preferred repairers. Nothing can be done about this except to try becoming preferred yourself.

Once the vehicle is authorised, you should receive either by email or fax an authorisation notification sheet that lists any conditions for the repair and perhaps some adjustments in the pricing that would or should have been negotiated with you. This then clears the way for you to contact the customer to have the vehicle booked in for the repair.

PDR and the Claims Process

Your role in the claims process as the business in PDR repair is to provide advice in regards to the repair process, quotation submissions, and to facilitate communication between the assessor, you and the customer. Generally steps in the claims process are as follows:

  • – contact and liaising with the client
  • – generate a quotation
  • – submit the quotation to the insurance company or independent assessor or agent
  • – liaise with the assessor as to the progress and time required for any decision in regards to authorisation
  • – receive any authorisation paper work
  • – book the vehicle for repair
  • – once repaired and ready to pick-up the vehicle, collect the excess
  • invoice the insurance companies less the excess complete with any documentation if required

Depending on the circumstances, you may or may not require the customer to book for a quotation. However, occasionally when there are assessing centre sessions ongoing, often the insurance companies lock out opposing insurance clients and only allow their own customers within that specified time frame. In that case, you (or your secretary) may organise another appropriate booking date. If you are lucky to have a second workshop, you may divert the customers to that workshop and someone else on hand to assess and quote the vehicle.

In the initial process of contact to the insurance companies, you may require to go through their general number or hotline. Given you are at some point going to be contact them again, you may ask for a direct line to the assessing centre, or directly the allocated assessor. Doing this will keep you out of those tedious phone calls.

Mass assessing centres

If you are fortunate enough to score a deal with the insurance companies and get a mass assessing invitation – be it at your premises or at one of theirs, you require to be vigilant and organised. You are competing against your own competitors in the industry and must try to expedite the process and avoid any issues. Quotations in these circumstances require to be reasonable and completed within the allocated time frame negotiated or advised by the assessor. They would have ample experience in this area.

In some cases, you will have vehicles being assessed one at a time between more than one repairer. In this case you need to have in place either another estimator with you or some system to rapidly assess and quote the vehicle. If you take on too much, you may find that the vehicle is too much work and will slow you down. Take on what you can cope with work-wise but also bear in mind there are pressures placed on you by the insurance companies if you take on all the light jobs. It simply is a balance between the two.

In some assessing centres, companies ask customers to attend on a specific day or weekend a mass assessing of several thousand vehicles in one paddock for instance. In this case you require a team of estimators to quick quote as many vehicles as possible in a tender process again bearing in mind what you can repair within your workspace.

In all cases, keep in mind that the conditions for the repair process. Some insurance companies have time limitations for all work to be completed and this can place an incredible strain on resources. It has been mentioned that one company even had rotating shifts for its technicians on a six day basis to keep up with the repair and probably time frames.

Management on these days are crucial – you likely don’t get a second chance. You need to manage the day well and keep up with any documents you require for the jobs as insurance companies and the assessors have an incredible work load.

If the insurance company has asked for assessing centre to be set up in your premises, provide them with whatever resources they require including printers, fax, internet, tables and chairs as well as refreshments. You take care of them, they are more likely going to respect you. Once again, keep up with whatever is required in terms of the documents for each vehicle and also the booking of the customers.

Bookings of customers

It is essential to plan well the booking process particularly with the initial rush of vehicles. Proper management of your work as well as the available space for repairers within the premises including parking on and off the premises is crucial to the management of the booking process.

Repair process

Although the repair process and procedures are discussed in separate modules, maintaining the status of the paperwork with the authorisation documentation is part of the interim of the claims process. During repairs, you may wish to place on the seat inside the vehicle the paperwork associated with that vehicle. There has to be an organised and streamlined system in place. Obviously, when repairing the vehicle, invoicing is essential as it helps track what vehicles have been repaired – whether the invoicing is an online software system such as Pnet or a simple invoice book. A signature on the invoice is a receipt or a contract that the customer or client has accepted the repair and should pay.

In terms of the customers, it is best not to repair the customers’ vehicles in front of themselves. Having the car pulled apart – lining hanging down, lights taken out, dust off the vehicle and so forth is not something owners want to see. Would you like to see someone who is having an operation or see them afterwards? Customers will usually not understand the process of PDR and why parts need to be taken off and that it will be put back together properly. It is best for customers to see the end product – shiny and clean and fully repaired! Less questions are asked this way. Furthermore, it could also get insurance involved where it was never necessary. Last of all, PDR technicians usually do not want to be dealing with customers and do not want to let them see them working and asking questions. PDR technicians are not the best when it comes human relations!