Dear CIB Broker-Partner
We have been receiving different feedback over the last few weeks about the current claims procedures and processes. Your feedback is invaluable to us and helps us identify and address burning issues that we would otherwise not be aware of. Different companies might follow different procedures; however we would like to align ourselves as closely as possible to your business needs in order for you to provide the level of service your clients expect and in many instances, demand.
We understand that there are times where differences of opinion may occur on certain claims, and we are always available to discuss these issues as and when they arise. We would like to appeal to you to support the new initiatives and allow us the time to implement them so that we can review and evaluate their effectiveness properly.
Below are the changes that have been implemented to the claims procedures in order to address the most pressing
concerns that have been raised. As with any new process, we value your feedback and welcome any queries or comments.
1) Fast Track Claims – This refers to all claims under R2 500
You will only require the following –
- Claim form with – date, place, time, and item description.
- We will request PQ and where the insured does not have it, the limit will be set as:
- All claims above R2 500
- PQ may not hold up any of these claims but will be used to try and place the insured back in the position they were prior to the loss. If you obtain a detailed description of the item, this will suffice.
- For a cell phone claim – you will need the black listing number, not the written confirmation.
- AOL (changes to the system are being made so that an AOL will be system generated). These AOL's will be modified that there will be no signature on behalf of the company. But for now, a standard AOL will be sent out.
- A request for a quotation/s for the claimed items will be mail generated – this is being developed with procurement. The groupings have been setup already and are in the testing phase at the moment. This should speed up the response times from our suppliers as well as eliminating the need to send multiple individual e-mails to different suppliers.
All Fast Track Claims will have a required maximum 48 hours turnaround time. The claim will be monitored by the team leader to ensure speed and efficiency.
Note: We need feedback on the process and turnaround times to streamline this initiative. Please notify us should a Fast Track Claim extend past 72 hours once the requirements have been met.
2) Proof of purchase – applicable to all other claims (Over R2 500)
We will request PQ and where the insured does not have it, the limit will be set as:
3) Mandates are confirmed to be:
- Claims technicians' and Crystal technicians' mandates remain the same.
- Team leaders up to R100 000.00, and all claims where the loss was within the last 6 months, driver is younger than 30 and late notification files.
- 2IC – up to R150 000.00
- Michelle & Andrew sign off - Above R150 000.00
This will alleviate the infamous 'referred to management' and will allow decisions to be made quicker and avoid the passing of the buck. You will also now know who is responsible and where the query will sit in the chain.
4) System A will now be used by all assessors, they will:
- Confirm appointments made with the insured on user notes.
- Give weekly updates on claims progress on user notes.
- This will be diarised to the technician and is to be copied and mailed to brokers who are not using System A, till this is rectified.
This will ensure that the progress of the claim, the assessment and any problems are recorded on the system on a regular basis by all concerned. Please ensure that you / the relevant staff in your offices are up to speed with the system so that we can get the full benefit of this.
5) Management will now be named:
'File to Andrew', 'File to Michelle, for sign off as over mandate' etc. - The word 'management' will now have a person's name attached to it.
The infamous 'management' – the mandates set out above as well as the naming of the responsible person will now ensure that you know who had/has the file, why they have it and allow you to direct any queries you may have directly to the person that is responsible. This means that the claims technician, the team leader or even those higher up the chain cannot hide behind that all encompassing term management and delay a claim unnecessarily.
6) Anthony Marques (head of procurement) will be implementing the PE and Durban suppliers lists:
- He will see the brokers and vet their requested suppliers.
- His first focus for these areas will be assessors, EE suppliers and plumbers.
Please advise us if you are experiencing problems with the suppliers that we have on our panel in your areas, or if there are simply not enough to cater for the needs of your clients. We will then request that you forward us the proposed suppliers and our procurement division will then embark on the process of vetting them and if they are then successful, appointing them to the panel.
7) The double referring of files prior to settlement:
The technician will complete the necessary and forward the file with noted settlement recommendations, and forward the file in relation to the applicable mandates. A file over R150 000.00 will be forwarded to Andrew and Michelle who will separate the files to sign off efficiently, etc. No longer will the file be checked by a team leader and then 2IC before reaching Michelle and Andrew.
8) Written off or stolen vehicles:
- No longer need the team leader / 2IC's to agree with the assessors first. Unless doubt exists.
- All write off and stolen vehicles will have 2x dealership quotes, and the M&M and a copy of the auto traders. From this the people with the applicable mandates will confirm the vehicle settlement (market / retail value). Till this process is fine tuned, all these files with this documentation are to be referred to Andrew and Michelle.
Please pay special attention to the attachment named "Vehicle Values". This is a new initiative and is in line with other initiatives that have recently been rolled out in the market by other parties. Please take the necessary time to read the document properly. If there are any queries or concerns they need to be highlighted to us asap.
9) The password of a user will be forwarded to the team leader when the employee is off, such that the diary and user notes can be obtained and actioned in someone's absence.
10) If a file is returned by a particular team leader back to a technician, then the corrective action is to be returned to the same team leader.
11) All correspondence, both internally and externally is now to be done by means of "User Notes"
Please ensure that you / the relevant staff in your offices are up to speed with the system so that we can get the full benefit of this. The User Note function ensures that there is full correspondence captured within the claim. The person responsible and the action taken / required. They are date and time stamped, ensuring that response times as well as adequacy of the feedback, claim handling are now captured.
The outstanding matters that further advices will follow on is –
- CIB motor panel – any changes or developments
- Repairs under R5 000
- Standard claims documentation pulled into the system
- Payment process duplication and reviewing, causing delays in the processing of the payments
- Appropriate check lists for checking and system development
In addition to the above which are procedure / process changes, there are other additional initiatives that we are in the process of implementing. These will be communicated separately and will be dealing with our procurement and supplier initiatives, as well as the ever pressing matter of motor claims and the settlement thereof.
If you have any queries, please discuss them with your broker consultant or alternatively you can contact any senior in the claims department.
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