The Five Claims Milestones

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1 The Five Claims Milestones Every claim filed by one of our customers moves through what we call the five claims milestones. Some move quickly, with only a brief stopover at each step; others may take days or weeks. But whatever the time frame, the basic process is the same. MILESTONE #1 Assignment Whether you reported your claim to your agent, called HelpPoint Claim Services, or your policy brand phone line, your claim was assigned to a HelpPoint Claim Services professional, who will guide you through the claims process and work with a team of specialized claim professionals to manage your claim. During that process, you may work with: n Your agent the professional who sold you your insurance policy, who can answer questions about that policy and any endorsements, and about your deductible, but will not adjust your claim. n Your claims professional, who will guide you through the claims process inspecting your property or vehicle if necessary, determining and investigating covered damages, and helping you better understand your policy and its endorsements. n A contractor or vehicle repair facility, whom you will select to arrange for repairs to your property or vehicle. (We do not perform repairs, nor do we select or provide a contractor or vehicle repair facility for you.) n Other specialists, whose services you may need for example, a structural engineer, repair facility, medical professional, etc. MILESTONE #2 Initial Contact In this phase, your claims professional contacts you about your claim. This is when your claims professional will: n Obtain initial information about your loss. n Discuss your policy coverage and any applicable endorsements. n Explain how your claim will be handled. n Suggest ways to prevent further damage for example, by putting a tarp over a damaged roof or a broken vehicle window. (You are responsible for maintaining and protecting your property. If it is damaged, you must take appropriate action to protect it from further damage until you have it repaired.) n Schedule an in-person appointment, if one is needed to adjust your claim. MILESTONE #3 Evaluation If an inspection of your property or vehicle is needed, your claims professional will conduct that inspection to determine whether your loss is covered gathering all the facts about your loss, investigating and documenting damage or injury, interviewing witnesses or other involved individuals, taking photos and samples, and formally evaluating your claim. It is our objective to evaluate coverage, complete our estimate if the loss is covered, and deliver a payment during our first visit. If we can t, we ll explain why. And if we do, we stand ready to re-inspect your property or vehicle and provide a supplemental payment if you, a contractor, vendor or auto repair facility later identifies additional damages that are covered by your policy. During this visit, your HelpPoint Claim Services professional may discuss some terms and programs you may not be aware of. This pamphlet explains them in more detail.

2 MILESTONE #4 Resolution We ll work with you to resolve your claim fairly. In many cases, your claims professional will issue a payment based on the estimate for repairs at the end of the initial inspection. If your claim is complex, it may take a bit longer. Payment for medical bills will be made according to the coverage being used under the policy and your state s laws. If you have questions about your claim payment, please review the Frequently Asked Questions section of this pamphlet and if your question isn t answered there, please do not hesitate to contact your claims professional. And remember cashing a check does not waive any rights you have under the terms of your policy. If your damages are not covered, in part or in whole, by your policy, we will provide a letter explaining what damage is not covered and identifying the portion of your policy that applies to that coverage denial MILESTONE #5 Claim Closed When we resolve your claim according to the terms of your policy, we close the claim. You still may have some questions at that point. Once again, check the FAQs in this pamphlet and if you have a question that we haven t answered there, call your claims professional. You also can view the five Claims Milestones and Claims FAQs at Farmers.com, and learn more about the process of handling your claim on a Foremost-branded policy by visiting Foremost.com. Notes:

3 Notes:

4 Actual Cash Value (ACV) vs. Replacement Cost Value (RCV) When we evaluate your claim and identify covered property that was damaged and needs to be repaired or replaced, your policy terms determine whether the repair or replacement will be covered for actual cash value (ACV) or replacement cost value (RCV). In general, actual cash value (ACV) of damaged property is its replacement cost less depreciation (the difference between what your property was worth new versus used ). That depreciation amount is subtracted from the replacement cost value (RCV), to determine its ACV. Replacement cost value (RCV) is the full cost to repair or replace damaged property with property of like kind and quality. If your policy covers repair or replacement at ACV, we pay you the depreciated amount, less your deductible. If your policy covers repair or replacement at RCV, we pay the ACV of the damaged property until you actually repair or replace it; in most cases, you can then claim the depreciation that was deducted. Certain restrictions may apply, including a specific time limit on the RCV claim. Note: This is not a policy document. Please read the actual policy documents for your state for important details on coverages, exclusions, limits, conditions and terms. Not all products and discounts are available in every state. If you have any questions about ACV or RCV, please contact your HelpPoint Claim Services claims professional. Your Estimate Once your claims professional completes your loss estimate, they will review it with you before issuing payment. The first page includes our contact information and your claim number. That number is the unique identifier for this claim; we use it to quickly locate your information. The estimate of the cost to repair covered damage is organized by room, area or item, and includes individual line items that indicate what will need to be repaired or replaced to bring your property or vehicle back to its pre-loss condition. It also includes a summary page, with an overview of all items included in the estimate. The estimate you receive from your HelpPoint Claim Services professional is just that: an estimate. A number of issues may contribute to differences between our estimate and your contractor s or vehicle repair facility s. If there are differences, don t panic: just contact your claims professional, who will probably ask you to send them a copy of the contractor s or vehicle repair facility s estimate for review. They ll then discuss it with your contractor or vehicle repair service, and may then reinspect your property or vehicle to resolve any differences. If you are reporting property damage that makes it reasonably likely that you will need the services of a general contractor to manage, supervise and coordinate repairs, we may include an amount for general contractor overhead and profit if we expect you to incur that cost. When you contract for property restoration services, feel free to discuss that work with your claims professional and your contractor to ensure that all damages are properly inspected. We will work with you to quickly resolve any issues so your contractor can proceed with the repairs for you. If you have any questions about your estimate, please contact your HelpPoint Claim Services claims professional.

5 Frequently Asked Questions (FAQs) Once I receive my settlement check, what happens next? You may now begin to have repairs done to your property or vehicle. You can do them yourself or hire the professional of your choice. HelpPoint Claim Services does not hire contractors, auto repair facilities, or other professionals to complete your repairs, or assign medical providers for liability claims. We will pay you for the estimated amount of damages, but you are responsible for hiring, managing and paying your contractor, vehicle repair facility or other professional. You may want to ask friends and neighbors for referrals to qualified contractors or auto repair professionals who are experienced in the types of repairs needed. We may provide a list of independent contractors or Farmers-inspected Circle of Dependability vehicle repair facilities who indicate they work in your area, but you still must enter directly into a repair agreement with the contractor or vehicle repair facility you choose; we do not do so and we will not direct or manage their activities, although your claims representative will be happy to meet with you and your contractor to ensure that all damages are properly inspected and estimated. When selecting a contractor or vehicle repair facility, you may want to consider: n Are they local? n Are they licensed, bonded and insured? n Do they provide a workmanship warranty? How did HelpPoint Claim Services arrive at the figures in the estimate? We use estimating software to determine repair and replacement cost for damages. Often, the same software tools are used by contractors or auto repair facilities, applying prices that are regularly updated with input from software company customers, to maintain fair and reasonable charges for your area. What happens if my contractor s or vehicle repair facility s estimate is higher than your claims professional s estimate? Our estimate includes all damages seen at the time of our inspection. If your contractor s or vehicle repair facility s estimate is higher than ours, please contact your claims professional to resolve the differences. Please make sure that your contractor s or vehicle repair facility s estimate includes: n Square footage of area being replaced (for property claims). n Unit price of materials and labor. n Brand and model of materials to be used. If your contractor or vehicle repair facility identified additional damages that were not included in our original estimate, your claims professional may need to re-inspect the damages.

6 Why is my mortgage company listed on my property claim settlement check, or my lienholder on an auto claim settlement check? If required under the terms of your policy, your check includes the name of your mortgage company or auto lienholder. Since these companies procedures for endorsing such payments may differ, we suggest you contact your mortgage company s or auto lienholder s customer service department to ask about processing the check before you make any commitments for repairs. Before mailing a check to your mortgage company, contact them to find out if they want you to endorse it. What if someone else is responsible for the damage? Under the terms of your policy, we have the right to pursue reimbursement of covered losses from a responsible party. We may request your cooperation in obtaining documentation, such as a plumber s report, information about the responsible party s auto insurance coverage, a lease agreement, a police report, a witness statement, the part that failed, or other items. It is imperative that you provide the requested materials as soon as possible so we can process your claim in a timely manner. Depending on your state s laws, you could receive reimbursement for all or a portion of your deductible. Will my premiums go up because of my claim? It is possible that a loss may affect your premium. We encourage you to meet with your agent to review your policy. I have replacement cost coverage on my Homeowners policy. How do I recover the depreciation withheld in my settlement? If you have replacement cost coverage, you must show that repair or replacement has been completed before we can pay any recoverable depreciation. You may provide: n A signed contract. n Cancelled checks; credit card statements. n Receipts or paid invoices or other verifiable documentation. n Cash payment recorded with dates, amounts, names, addresses and telephone numbers. How do I deliver documents to you? For claims on Farmers, 21st Century and Bristol West-branded policies, you may mail documentation to P.O. Box , Oklahoma City, OK ; fax to (877) ; or to For claims on Foremost-branded policies, you may mail documentation to P.O. Box 2739, Grand Rapids, MI 49501; fax to (877) ; or to You do not have to include the name of your claims professional, but it is extremely important that you put your claim number on each document you submit.

7 What if I want to upgrade my property? Insurance provides for repair or replacement of damaged property with like kind and quality materials. If you choose to upgrade those materials to a better quality, you are responsible for any cost greater than the cost to replace that property with an item of like kind and quality. The only upgrades that may be covered under your property policy are those required by building codes, ordinances or laws, if your policy provides for such coverage. What can I do to help speed up the process? One thing you can do to help your claims professional is to create a detailed list of damaged or lost property, either before their inspection or while they re estimating the damages. And, on injury claims, you can help by providing medical records and billings as quickly as possible. What are endorsements? Endorsements are amendments added to a policy, which either add or reduce coverage under your policy. Your claims professional can explain how any endorsements on your policy affect your claim. If you have any other questions about your claim, please contact your HelpPoint Claim Services claims professional. Notes:

8 Questions:

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