ILLINOIS CLAIMS PROCEDURES

Transcription

1 CLAIMS PROCEDURES 1635 WEST NATIONAL AVENUE, MILWAUKEE, WI 53204

2 BADGER MUTUAL INSURANCE COMPANY INDEX LOSS REPORTING... 1 CLAIMS PROCESSING... 2 AGENT AUTHORITY... 2 AUTO INSPECTIONS... 2 DIRECT REPAIR PROGRAM... 3 LOSS PAYMENTS... 3 STOP PAYMENT REQUESTS /07

3 BADGER MUTUAL INSURANCE COMPANY ILLINOIS CONTACT INFORMATION Phone (414) Toll Free (800) FAX (414) After Hours (866) Alliance Claims Solution LOSS REPORTING We encourage policyholders to make new claim reports by telephone. The opportunity for claim representatives to speak to the policyholder at the initial reporting stage produces tremendous effi ciency in the claim handling process. Our agency partners should report routine losses to the Claims Department either by fax or . Claims involving serious injuries/death, extensive property damage claims or other extenuating circumstances requiring emergency response may be telephone reported by the agency. Do not mail notices which have already been sent via fax or . This will help us avoid setting up a duplicate claim. Agencies should fax reports of loss to the number above. Policyholders may report new claims after hours, weekend, and on holiday to our After Hours number shown above. This After Hours number is monitored by Alliance Claims Solutions. Losses reported to the Alliance number are immediately ed to Badger Mutual claim staff and contact is made with the policyholder no later than the following business day. For emergencies, Alliance Claims Solutions is instructed to contact Badger Mutual claim staff members any hour of the day requesting an immediate contact with the policyholder. When faxing, please fully complete the ACORD loss notice, obtaining as much information as possible from the insured or third party. Items that expedite claim processing include: policy number and insured's information date of loss telephone numbers including cell phone extent of damage [amount of estimate(s) if known] contact person name, address and telephone number of other party (for liability claims) 1 11/07

4 BADGER MUTUAL INSURANCE COMPANY CLAIMS PROCESSING A claim representative is assigned the same day Badger Mutual receives the loss. A Receipt of Loss Report (Exhibit A), which indicates the claim number and the name of the claims representative, is mailed to the agent and the insured. Our standard is contact with the policyholder within 24 hours of Badger Mutual s receipt of the loss assignment. In the event an independent adjustment fi rm is retained to provide assistance, the policyholder will be contacted and an inspection will be scheduled within 48 hours of the assignment. AGENT AUTHORITY A. PROPERTY Should a policyholder suffer a serious loss when the Home Offi ce is closed, agents should report the claim to our after hours service, Alliance Claims Solution. A Badger representative will be contacted with the loss information and will contact the policyholder to provide further direction. B. AUTO Agents may authorize replacement of glass and such other measures as are necessary to protect the auto from further damage, such as towing to a safe facility. If auto glass is repaired rather than replaced, the company will waive any applicable deductible. All auto glass claims should be reported to the Alliance Glass Network. ( ) Temporary repairs of less than $500 may be authorized, if needed, to keep the vehicle running, i.e., headlight or radiator repairs. Temporary repairs exceeding $500 should have prior authorization from the Claims Department. AUTO INSPECTIONS Damage appraisal assignments are made by the Home Offi ce whenever the loss report indicates a vehicle is "undriveable", a possible total loss, or as determined necessary by the Claims Department. The auto appraiser will contact the vehicle owner within 24 hours to set an inspection time and site. Please note: Neither the appraiser nor the company will authorize repairs. Repairs can only be authorized by the vehicle owner. The damage appraiser will write "Agreed Price Only, Owner Must Authorize Repairs" on the repair estimate. If the vehicle owner has any questions, he/she should contact the Home Offi ce claim representative. 11/07 2

5 BADGER MUTUAL INSURANCE COMPANY ILLINOIS DIRECT REPAIR PROGRAM Badger Mutual has developed a preferred vendor repair program for auto and property losses. To assist the policyholder, Badger claim representatives will offer the names of auto body repair facilities or building contractors convenient to the insured for guaranteed quality repair work. Again, the claim representative will not authorize repairs, only the vehicle owner or homeowner can authorize repairs. LOSS PAYMENTS A. "FAST TRACK" 1. Auto Claims involving only property damage, with clear liability (third party) or no subrogation (fi rst party) and with two competitive damage estimates (under $1,000 and no "open" items) are handled as "Fast Track" claims. Typical Fast Track claims include glass losses, towing/road service, and small collision or property damage claims requiring no investigation. Fast Track claims may be paid the same day they are received and if so, generate no acknowledgment of receipt. 2. Property Fast Track service can be provided for small dollar losses (generally less than $1,000) that, when reported, are accompanied with a repair bill, invoice or estimate. Similarly, small theft losses which are accompanied with a police report, and scheduled jewelry repair/replacement claims will be expedited when submitted with proper documentation. B. SETTLEMENT 1. Auto Claim payments are mailed to the policyholder, claimant or service provider, unless other arrangements have been made. Payments for repairs to the insured's vehicle will be issued payable to the insured and the repair shop and/or lienholder. Direct payments to the insured, when there is no lienholder, are handled on a case-by-case basis. When the policyholder has authorized payment to be made directly to the repairing garage, payment will be issued to the garage on receipt of the signed authorization. Form 895 (Exhibit B) is enclosed with any property damage, collision, or comprehensive payment. 3 11/07

6 BADGER MUTUAL INSURANCE COMPANY 2. Property Settlement checks are mailed to the policyholder at the address indicated on the policy unless there is an alternative arrangement specifi cally requested by the policyholder. Payments for insured s dwellings will be issued payable to the insured and their contractor and/or mortgage company. When the policyholder has authorized payment directly to a repairing facility, payment will be issued to the facility upon receipt of the signed authorization. In the event the policyholder fails to pursue his/her claim on a timely basis, a reminder letter will be sent. STOP PAYMENT REQUESTS Because of an increasing number of stop payment requests, and the increasing costs of processing these requests, we have concluded that we must pass this cost along to the insured/claimant. Stop payment requests made because of actions on the part of the insured/claimant will result in a $50.00 processing fee, which will be deducted from the amount of the settlement on the reissued check. Many of these requests result from an insured/claimant losing a check or giving incorrect information regarding lien holders and mortgagees. If the insured/claimant returns the check with the request the check be reissued, there will be no need for stop payment and no charge will result. Your cooperation in keeping our records current as they relate to address and lien holder status is appreciated. Please remind your clients that multiple payees require multiple endorsements, one for each payee. If the checks are not properly endorsed, they will not be honored, and the processing fee may result if the check cannot be retrieved and returned to us by the insured/claimant. This will also slow down the payment. FOR FURTHER ASSISTANCE, PLEASE CONTACT OUR PROPERTY OR CASUALTY CLAIMS SUPERVISORS. 11/07 4