What is the best claims process for my agency?

Claims can be tricky! We have identified scripts and processes for your agency to use!

Objective:

To counsel the clients of the agency during their claim and become their advocate when needed.  We know a positive claims experience can generate referrals, whereas a negative claims experience can deter new business. Filing a claim is the only time a client can use the product the agency has provided, and because of this, we need to be sure we are paying attention to clients during this time.

Inbound Claim Call Script:

Caller has called in and gotten to the correct associate.

 First, before we begin are you and all (passengers/family members) ok?

• Are you in a safe location to talk?
• I’m glad you called us, as your insurance agent I want to guide you on the most efficient and effective way to get your claim started. What this means is the carrier is going to need to take an incident report from you. I would hate for you to have to repeat yourself twice. We can help you get that process started but first, can you give a brief overview of what happened so we can get you to the right place?
  • Claim is small and client should be counseled to not report it: Ok, thank you. It looks like your current deductible is $XXX. Based on what you are describing what do you think the cost to repair would be? I’d hate to see you log a claim if the difference was minimal and then you would have a claim on your insurance record.
  • Claim is larger and client needs to report it: The best course of action is for me to connect you with the carrier so they can get your incident report. I’m going to stay on the line with you to make sure you are connected and make the introduction. From there they will take your statement and you will be assigned an adjuster. In a few days, I’ll be calling back to check in with you to make sure everything is moving along. I’m going to place you on a brief hold so we can get the carrier’s claim team on the line.
    • Warm transfer the call to the carrier

We recommend that you do not get involved in what is covered/not covered at this point unless it is obvious (For example - they don’t have rental car reimbursement but they want a rental car) allow the carrier to review the situation and their policy.

When you follow up in a few days and get any feedback then review the carrier’s notes and the policy just to confirm the loss is not covered. If it’s a grey area, escalate the scenario to a team leader.

 Question on if the claim will increase the premium?

The most important thing to consider right now is that you are ok. Your premium will stay exactly the same for the term of this policy. When your renewal comes up in X months we can review your policy and options but the good news is for the time being your premium will stay the same and we can review it at your renewal when we have the information from the carrier.

Claims Process

1. Daily Obtain a list of claims
1. Identify who can email/fax them to us
2. Identify which carriers we need to log in and obtain claims
2. Contact the client to make sure they are ok and let them know if they do not hear from a claims adjuster in 48 hours to contact the agency
3. Send a follow up email so the client has your contact information
4. Set a suspense to follow up in 72 hours
5. Add the contact to a CRM tool to get a claims survey in 30 days

Outbound Call Script on Claims

Script:

Hello, this is NAME from AGENCY NAME. I’m calling because I understand you recently had a claim. We first want to make sure you are ok? Next, have you heard from a claims adjuster yet?

• If no - look at status of the claim in the carrier system, call the company to find out the status. If no adjuster is assigned in 48 hour it needs to be escalated to Ben and Jen
• If yes - great we want to let you know that we are here for you in case you need anything on your claim.

Email Template on a Claim:

Dear NAME;

We are sorry to hear about your recent claim. Rest assured, if you need anything, we are here for you. If you don’t hear from your claims adjuster in the next 48 hours, please call or email me so we can follow up on your behalf. If you need anything, please call us so we can be of assistance.

AGENT

Claims Follow Up

1. Suspense out for 30 days to send the claims follow up

Dear NAME;

It’s our goal to provide you exceptional service on all of your insurance needs. We understand you had a claim recently. While these situations are never pleasant, we want to ensure you are well taken care of by our team as well as your carrier. Would you mind completing this brief survey on your experience?

SURVEY LINK

AGENT NAME