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DON’T FREAK OUT 

DON’T FREAK OUT 

DON’T FREAK OUT 
February 02
10:39 2022

DON’T FREAK OUT 

Understanding the 3 key stages of the claims reporting process can boost customer satisfaction and retention

By Chris Hale


While your clients may purchase insurance hoping they never need it, they certainly have high expectations once something happens. The thought of filing a claim is likely very intimidating for them, however, they may feel better about starting a claim if they know what comes next and realize they are not going at it alone. To give insureds confidence in the event of a claim, agents should educate them on the three critical stages of the reporting process, including their obligations to them as their agent.

Pre-work: Organize documentation and collect evidence

The first step may seem obvious, but you might be surprised at how many insureds rush straight to reporting the claim without assembling any necessary evidence or even remembering their agent exists for this very purpose.

The importance of honest and complete information is extremely relevant given the principle of Uberrimae fidei, Latin for “in utmost good faith,” which is the foundation for all insurance policies, since they presume full disclosure of all pertinent facts on the part of both contracting parties. This includes everything from police reports to surveillance video or witness names to receipts of items purchased to mitigate further loss. Once a loss occurs, it’s important that insureds take reasonable steps to mitigate, control and resolve known damages, and to not make any changes to items, such as vehicles, products, machinery, pipes, and parts, that the insurance carrier will need to inspect.

If the insured has no control over the object(s), including the scene of an accident, it’s highly encouraged that they take plenty of photos. This will assist with any potential subrogation investigation that the carrier undertakes. If surveillance video in or around the area where the incident occurred is available, insureds must act quickly to submit a request to that entity to preserve the video and request copies. Companies are quick to record over and/or delete video footage after a short period of time if no request is received.

At the end of the day, the more documentation and evidence an insured can provide, the more you, the agent, can help them.

Go time: Notify claims professionals

Once the insured has provided you with necessary documentation and evidence, the onus is on the agent to file the actual claim. It’s standard practice with most bound insurance policies for there to be a claim-reporting instructions document that outlines how the agent can report a claim. Too often, claims are misreported, which delays the process further, so it’s absolutely a client retention tool to know the process for each carrier representing your clients.

In most cases, email is the preferred method to report a claim. Photos and videos are appropriate to send, but agents should be cognizant of file size as the recipient (i.e., adjuster or carrier) may have limitations on what they are able to receive. It may be best to send any large documents in a separate email or consider waiting to send them directly to the adjuster once one is assigned.

Keep in mind, it’s often best practice to share thoughts or opinions (such as who was at fault) about the incident over the phone with the adjuster rather than sending in an email or within the loss notice. The reasoning for this is, when you put something in writing, it becomes discoverable and potentially admissible if the claim ends up in litigation.

The best claim is a closed claim and

cooperating with the investigation and

providing the carrier/third-party administrator

with as much information as possible

will help achieve the best outcome possible.

Post-submission: Ongoing management and follow-ups

 Reporting a claim may be one of the most pivotal moments in the process, but your job is not done. Agents are responsible for making sure each party involved is working together harmoniously.

Once an adjuster is assigned, the adjuster will call for your help with the handling of the claim. It’s nearly impossible to cover all the necessary details in one single phone call or email, so adjusters and claimants will often have to go back and forth—and back and forth and back again—to cover all the necessary ground.

If additional paperwork is received on a claim, such as lawsuit papers or correspondence from an attorney, these need to be provided to the adjuster as quickly as possible.

In property claims, if a “Proof of Loss” form is needed prior to payment, agents need to advise clients not to ignore it, as it’s not meant to be a release. Insureds should get the form back to the adjuster as soon as possible, so that the claim moves forward. Remember, claims being open for too long could fall into renewal periods and that can put the account at risk.

The best claim is a closed claim and cooperating with the investigation and providing the carrier/third party administrator with as much information as possible will help achieve the best outcome possible.

As any seasoned insurance agent knows, making a claim is the biggest pain point for insureds, yet simultaneously the biggest opportunity for you to win lifelong clients. Ultimately, your clients need to buy into and believe in the process—and trust you as their champion—for it to succeed.

 The author

Chris Hale is the director at Care Providers Insurance Services (CPS), a program built by NSM Insurance Group, a leading provider of specialty insurance programs. For more than 25 years, CPS has focused exclusively on partnering with agents to serve nonprofit and social service organizations across the United States with specialized and comprehensive insurance programs. To learn more, visit cpsinsure.com or contact Chris at cmhale@nsminc.com

About Author

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Rough Notes Editor

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