claim trak claim approval for admin

ClaimTrak

Claim Approval

Claim Approval

 New Business Rules will apply to Phase Closure as of October 31,

2011

1. In order for a phase to be closed on a jobs, the claim must meet the new business rules of the Claim

Approval Matrix. If the claim does not meet the established rules,

1. No phases can be closed on that claim until the issues are resolved OR

2. A manual Claim Approval override is done.

2

Objective

• To get rid of Private/Private as a common customer

• To force review of claims and better data collection

• To produce more accurate sales figures and information

4

Claim Approval Matrix

3

Adjuster Insurer Property Mgr Auto-Approved?

Yes Yes No Yes

Yes No Yes No

No Yes No No

No No Yes Yes

No Yes Yes No

What do you have to do?

1.Collect 2.Review 3.Clean

5

Changes to ClaimTrak

1. Customer Approval

2. Private, To Be Announced ,Unknown will no longer be a choice

3. ‘No adjuster’, ‘No Insurer’ are valid selections when inputting a

claim

4. Ability to find Unapproved Projects

5

Customer Approval

5

• All approved customers appear in

black type.

• Unapproved customer appear in

red font

• Applies to

– Adjusters

– Insurers

– Property Managers

Applying the Matrix

Scenarios

Adjuster Insurer Property Mgr

Auto-Approved?

Yes Yes No YesYes No Yes NoNo Yes No NoNo No Yes YesNo Yes Yes No

Scenario 1• Anne receives a claim over the phone from

the local Intact Insurance adjuster. She receives a – Claim number– Adjuster– Insurance Company– Name, address, etc.Is there enough information for the

claim to be approved?

10

Scenario 2• Betty receives a claim over the phone from a

local independent adjuster. She receives a – Adjuster– Name, address, etc.– Loss description

Is there enough information for the claim to be approved?

10

Adjuster Insurer Property Mgr

Auto-Approved?

Yes Yes No YesYes No Yes NoNo Yes No NoNo No Yes YesNo Yes Yes No

Adjuster Insurer Property Mgr

Auto-Approved?

Yes No Yes NoNo Yes No NoNo No Yes YesNo Yes Yes No

Scenario 3• Cathy receives a claim over the phone from

HBC. She knows that HBC is a Property Manager in the system. She inputs the following:– Store Name, address, etc.– Loss description

Is there enough information for the claim to be approved?

10

Scenario 4• Debby gets a claim from a PM. He says that it’s

an Intact claim. She inputs the following:– No adjuster– Insurer = Intact– Name, address, etc– Loss description

Is there enough information for the claim to be approved?

10

Adjuster Insurer Property Mgr

Auto-Approved?

Yes Yes No YesYes No Yes NoNo Yes No NoNo No Yes YesNo Yes Yes No

Scenario 5• Edith gets a call from Ima Bean. Mrs. Bean

wants FOS to come and clean up mould in her house, but there is no insurance coverage. How should this claim be entered when entering the adjuster, insurer, etc?

Is there enough information for the claim to be approved?

10

Scenario 5• How do truly private claims get approved?

Claim Approval Override!!

This is limited to a select group of individuals. You must request override and be able to justify.

10

Claim Approvers - WestRegion – Name Email

Dan Desnoyers ddesnoyers@firstonsite.ca

Lauren Rassachack lrassachack@firstonsite.ca

Linda Mayer lmayer@firstonsite.ca

Monica Medeiros mmedeiros@firstonsite.ca

Karen Bodnarchuk kbodnarchuk@firstonsite.ca

10

Claim Approvers - CentralRegion – Name Email

Central

Kim Stemmler kstemmler@firstonsite.ca

Jeff Brown jbrown@firstonsite.ca

Krista Smith ksmith@firstonsite.ca

10

Claim Approvers - EastRegion – Name Email

Angela Ramsey aramsey@firstonsite.ca

Mary Hamilton mhamilton@firstonsite.ca

Joanna Bonarrigo jbonarrigo@firstonsite.ca

10

10

Reviewing Files

(Looking for Unapproved Projects)

Reviewing Files

To review files, go to the Search page, and select the following:

5

Insert a reasonable date range.

Update the files listed

ClaimTrak – Claim ApprovalService Delivery Model

Access documentation, training aids and presentations on the

FOS Intranet under the Operations Tab – Claim Approval

Ingrid Himmelman ihimmelman@firstonsite.ca