Claims Handling Procedures
- When notice of loss is received from the insured, send a letter acknowledging receipt of the claim and tell them to contact you if they don’t hear from the adjuster soon or if they experience a problem with the loss adjustment (SeeSample Letter)
- If notice of loss is received from anyone other than an insured, contact insured for verification. If the insured says they don’t want to turn in a liability claim, see your supervisor. Our agency relationship with the carrier requires us to report all liability claims that come to our attention.
- Open client file and complete appropriate ACORD loss notice.
- Transmit loss notice to carrier immediately.
- Suspense for 3 days to perform client follow-up, if appropriate.
- If client contact after three days is appropriate, contact insured to determine current status of claim.
- Contact carrier if necessary.
- Update claim file.
- Suspense for 60 days for resolution of claim.
- If claim is settled within 60 days, update file with closing claim information and clear suspense.
- If claim check or draft is received by agency, transmit to insured the same day using form letter.
- If claim is not settled within 60 days, contact carrier to determine current status and re-suspense for 60 days.
- If claim is not settled after 120 days, notify management to take appropriate action.
- When claim is resolved, update client file and clear suspense.
NOTE: Any summons and complaint or other legal papers received on any claim must be transmitted to the carrier via fax or overnight mail (in accordance with company instructions) the day they are received in the office to avoid any default judgment being entered against our insured. Review the entire file to determine any other policy could possibly apply to the claim and submit to all potential carriers.