New Beginners Claims Training. Presenter Alan Romero Director of Claims

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1 New Beginners Claims Training Presenter Alan Romero Director of Claims

2 New Beginners Training Policy Review Claims Process Direct Repair

3 Conference Overall Evaluation Cyber Café Picture

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5 Claim

6 Notification Contact AMERIND Risk Setup a Claim JerriDine O Donnell Or a Claim Representative

7 Reporting a Claim JerriDine O Donnell Or a Claim Representative

8 Top 7 Duties in reporting a Claim I Don t know Certain Peril s of Loss need to be reported timely Authorization of Policy Holders Authorization of Permanent Repair (approval) Lack of Cooperation Understand your Duties Reporting your loss timely

9 Policy Timeframes

10 Policy Timeframes Focus Program Green level Yellow level Red level

11 AMERIND Website AMERIND Risk Tribes Protecting Tribes

12 Portal System AMERIND Website:

13 Customer Portal AMERIND Portal

14 Customer Portal Facts Facts to Remember Username/Password required AMERIND Portal

15 Customer Portal Facts Facts to Remember Only Property claims should be submitted NEVER submit Liability submissions AMERIND Portal

16 Customer Portal Facts Facts to Remember Submit vs Pending submissions Closed status AMERIND Portal

17 Customer Portal Facts Facts to Remember Claim # Claim Acknowledgement via AMERIND Portal

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19 Compare Services Fast Track Process Claim # DRP Time Frames: Assigned: Estimate returned Desk approval 3/26/2015 3/ /31/ days response time Permanent repairs..\..\fast Track Form example.pdf

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21 Approved Adjusters Assignments submitted electronically

22 Approved Adjusters Assignments submitted electronically ctanalysis/welcome.jsp

23 AMERIND Risk field adjusters Site inspection

24 Cochiti Pueblo, NM 17 years of service Residential Property claims Claims Experience Desk & Field adjusting Small to Large loss claims

25 Zuni Pueblo, NM 12 years of service Residential & Commercial Property claims Claims Experience Desk and Field adjusting Small to Large loss claims *Trainer for Direct Repair Program

26 Jemez Pueblo, NM 5 years of service Residential Property claims Claims Experience Desk and Field adjusting Small to Large loss claims

27 San Felipe Pueblo, NM 5 years of service Residential Property claims Claims Experience Desk and Field adjusting Small to Large loss claims

28 Santa Fe, NM 5 years of service Residential Property claims (Undergoing Liability training) Claims Experience Desk adjusting Small to Large loss claims (Undergoing field adjusting training)

29 Downey, CA 2 years of service Liability Specialist (Residential Property Claims) Claims Experience Liability desk adjusting Property small to large loss claims (Undergoing field adjusting training)

30 Acoma Pueblo, NM 5 months of service Property/Liability claims Claims Experience New Hire to Claims Team

31 Direct Repair Program Emergency Services Permanent Repairs

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33 Closer Look DRP Programs Eligible under the Program Optional

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35 Program Benefits Licensed/Bonded TERO Certified Xactanalysis (monitor all jobs) Deductible waived Service Warranty Direct assignments (avoid bid process) Catastrophic prepared Protocol guidelines Native American

36 DRP How it Works Claim Occurs Emergency Services

37 DRP Assignment Xactanalysis

38 Direct Repair Program Attend the Schedule Wednesday: 9:00 10:30am Wednesday: 3:15 4:45pm Thursday: 1:00 2:30pm Salt River 7 Salt River 6 Salt River 8

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40 Table of Contents Sections of your policy Claim Reps will always refer back to your policy for addressing coverage issues

41 7 Important Policy Facts Why did I buy this Policy Not everything is Covered Sections such as Property Not Covered & Exclusions Some sections of your policy contain (deductibles) Additional Coverages Important Time Frames Duties & Responsibilities You should be aware of Understand your policy

42 Coinsurance Coinsurance Language If at the time of loss, the amount of insurance in this policy on the damaged building is less than 80% of the full replacement cost of the building immediately before the loss, we will pay that proportion of the cost to repair or replace, after the application of any deductible, with the total amount of the damaged building bears to 80% of the replacement cost of the building. However, we will not pay more than the stated value in the inventory report.

43 Coinsurance definitions Inventory Stated Value Square footage x Replacement cost Formula How it Works Did vs. Should Understanding Calculation

44 Coinsurance Coinsurance provision You are required to carry 80% of your replacement cost Formula How it Works Did you carry $(Replacement Cost) X 80% Percentage of Loss What you should have carried (Stated Value) $

45 Coinsurance Attend the Schedule Wednesday: 9:00 10:30am Wednesday: 3:15 4:45pm Thursday: 1:00 2:30pm Salt River 7 Salt River 6 Salt River 8

46 Time Limit Clause Rebuilding or Repair 18 months 1 year 1 year

47 Time Limit Clause Focus Program Focus Program Green level Yellow level Red level 6 months 1 YEAR 9 MONTHS

48 Thank You Thank You! Wednesday: 9:00 10:30am Wednesday: 3:15 4:45pm Thursday: 1:00 2:30pm Salt River 7 Salt River 6 Salt River 8