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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.
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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
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Claim Approval Matrix
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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
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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
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Customer Approval
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• 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?
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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?
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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?
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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?
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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?
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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.
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Claim Approvers - WestRegion – Name Email
Dan Desnoyers [email protected]
Lauren Rassachack [email protected]
Linda Mayer [email protected]
Monica Medeiros [email protected]
Karen Bodnarchuk [email protected]
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Claim Approvers - CentralRegion – Name Email
Central
Kim Stemmler [email protected]
Jeff Brown [email protected]
Krista Smith [email protected]
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Claim Approvers - EastRegion – Name Email
Angela Ramsey [email protected]
Mary Hamilton [email protected]
Joanna Bonarrigo [email protected]
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Reviewing Files
(Looking for Unapproved Projects)
Reviewing Files
To review files, go to the Search page, and select the following:
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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 [email protected]
