Created by Laverne Dahlin, Winnipeg Branch Presented by Stan Bodal, Claims Training Schedule Of Loss...

Created by Laverne Dahlin, Winnipeg Branch

Presented by Stan Bodal, Claims Training

Schedule Of Loss Workshop

AgendaSchedule of Loss Forms

Workshop

• Importance of schedule of loss forms

• Obtaining appropriate information

• Claims Advisor versus Field Rep handling

• Examiner handling of Schedule of Loss

• Verifying Schedule of Loss

• Handling Proof of Purchase

• Summary - investigate, evaluate,

negotiate & settle claim

• Questions & Answers

Why Are Schedule of Loss Forms Important?

Why SOL is Important

Can be used to obtain appropriate information regarding description, purchase price, age and replacement cost for items lost or damaged.


Provides a column to calculate actual cash value so you can provide a cash advance as expediently as possible with supporting documentation on file.


Provides details on proof of ownership. Insured will need to provide original receipts, canceled cheques, credit card receipts or statements, manuals and photographs.

Claims Advisor Vs Field Rep

When the claims advisor is handling content losses, the claims advisor must complete the schedule of loss obtaining all appropriate

information listed on the SOL.

Use of an electronic form will assist in taking down the details over the phone.

Initial contact with the insured is within within times specified under various protocols, ei. Water damage requires 2 hours


Claims advisor is to take a recorded statement by telephone with as much detail as possible on what was lost or damaged for reserving purposes

Request police report for B & E claims comparing it to the statement that was taken (if required)


Claims advisor is to question claimant if there are discrepancies.

Should there be any red flags claims advisor to discuss claim with supervisor or manager to determine if claims investigation is to be involved.


If insured has a few items

left to replace and this is

what is preventing you from settling

the claim then offer to pay

slightly more then the ACV and close the

file.

If the number of

items makes the task

challenging to complete

by telephone,

a critical path letter is forwarded to the insured

with the SOL forms. CA to

follow-up every 30

days.

A field adjuster (employed or contracted with supervisor’s or manager’s approval) can be dispatched to assist claims advisor with task assignment to complete the SOL, conduct site investigation, etc.

When the forms are returned, the claims advisor should verify pricing through Aviva’s preferred vendors to obtain the best possible price.



Obtain an Authorization at the time of the interview to reserve Aviva’s right to

secure purchasing information.


Claims advisor to request photos of exterior premises from contractor.


Field reps are to contact insured within the time frame specified in the protocols and to

make appointment to attend site within company protocols; Water 2 hours, 24 hours

for site investigation.

Obtain a n Authorizationa t the time of the interview to reserve Aviva’s right to secure

purchasing information.


Field reps to conduct site investigation, take relevant photographs (including exterior photos) provide SOL forms referring the

insured to self-explanatory instructions, take a recorded statement to detail as much of the

loss as possible for reserving purposes, do critical path letters and follow-up with insured

every 30 days.


Verify the SOL items through our preferred vendors to obtain the best pricing. Question any discrepancies,

refer any red flags to supervisor or manager to determine if claims investigation to be involved.

Examiner Handling Of

The SOL

Contributions by Steve Dryer

National Analyst

Global vs Line By Line Depreciation

• Some Independents prefer to depreciate Globally but Line by Line Depreciation is the preferred method.

• Advise Independents not to transfer schedules to Excel spread sheets when they receive them on Aviva forms.

Spot ChecksUse a tape and calculator to make sure that the math is correct.

Ensure that the Independent has spot checked at least some of the items on the schedules to ensure that they are reasonable and accurate.

Spot check if preferred vendors have been used to price the items.

Spot Checks

Ensure that the Independent has secured

independent quotes on higher end items such as

jewellery.

Some times you can calculate the ACV with the information on file and not

wait for the Independent to do this for you.

Obtaining Appropriate Information

All SOLs require execution by a

Commissioner of Oaths. An adjuster can use judgment when requesting

the commissioning of SOL forms that

are under $5,000.

A commissioned SOL and Proof of

Loss is required for all claims that

become questionable.


It is important to explain to the insured that not receiving the

required information on the SOL forms there will

be delays in the handling of the claim.

Insured should be advised to number proof of ownership documents to correspond with SOL

items.

• If insured requires receipts returned they are to be stamped with appropriate stamp, initialed, copied and returned.

• Keep receipts in numerical order at the back of the SOL forms. They can be bound with a cover sheet showing RC #1, RC #2, etc.

• Insured to match the replacement cost receipts to SOL page and item number.


Verifying SOL

Insured submits SOL forms with columns 1-8 completed. (see example on the course page) If not completed properly arrange a meeting to discuss what needs to be done. Assist as much as possible to limit delays.

Process replacement cost receipts in red ink. This will be the copy you return to the insured with your critical path letter. Be sure to make copy for your file.

Verifying SOL Insured should submit replacement cost receipts to correspond with the page and item number; ie: if claiming at page 2, item 1 –

item 24 shirts; Request one receipt for 24 shirts. Alternatively, it can be listed in groups of 4 or 5 if insured is

shopping over a period of time. This may avoid confusion by using only one line on the SOL to track what items are outstanding.

Verifying SOL

Do ACV calculation by using depreciation guidelines located in claims procedure manual (example can be found on course page) bulletin 3.7. Each item needs to be depreciated in accordance with its age. Page

26

Verifying SOLDo adding machine tape to calculate the Actual Cash Value and

Replacement Cost amounts for each SOL page and affix the adding tape on the SOL form.

You can fold over the SOL forms to 11 inches,

affix the tape to the back of the SOL form.

This will make the calculations readily noticeable.

You will calculate all the SOL page totals to grand total the ACV and R/C amounts. This can be affixed to the initial submission appropriately marked RC #1, ACV #1.

You will continue to do this for each submission. You will only need to photocopy the pages where amounts are calculated.

Verifying SOL

Step 1: Investigate

Claims Advisors and Field Adjusters are to

compare the INVESTIGATION

information to what is being claimed on the

SOL confirming that the claim is appropriate, eg proof of ownership, like kind and quality, items

repaired.

Step 2: Evaluate

Claims Advisors and Field Adjusters are to EVALUATE all replacement cost values

through independent sources, utilizing preferred

vendor pricing where applicable, eg.; WCC, Birks,

ICC

Step 3 & 4: Negotiate &

SettleWhen the Claims

Advisors and Field Adjusters are completely

satisfied that the SOL has been properly

completed, commissioned, scrutinized with

appropriate documentation on file and the mathematic

calculations are verified the claim can be

NEGOTIATED and SETTLED. Page

31

thank you for your participation

&Questions

AnswersContact your immediate

supervisor [email protected]

Created by Laverne Dahlin, Winnipeg Branch Presented by Stan Bodal, Claims Training Schedule Of Loss...

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