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marketing ims insurance management system

Activity: Training 08/14/2024 Discussion - Creating a client Profile in Epic

Processor Activity: Creating an Account PI: Look - up code - NB GL - Created an Account in IMS >

Shadower

ACT: Training PI: Shadowing - Look - up code - NB GL - Created an Account in IMS

Processor Activity: Marketed Submission Policy Identifier: Look-up (code) - NB GL - Company Name - Marketed Submission

Shadower Activity: Training Comment: Shadowing - copy the PI of the processor

Naming Convention Incoming: AMMK - Requestor's Name - Date Today

2 Correspondence Outgoing: AMMK - Yourname - Date Today

File Name: AMMK GL NB 2024-2025 - Company Name - Submissions

Naming Convention

Incoming - Created an Account - Requestor's Name - Date Today

22 - Correspondense

Outcoming - Created an Account - Requestor's Name - Date Today

Company Name - Snip of the account

Intake Sheet - 22 Application - Intake Sheets

Kredo Time| 08/15/24

First Lesson: Submission: comprehensive

Mitigate - reduce mispricing Suitability - need of the customer

INSURANCE SUBMISSION ERRORS

  1. Delays on the application
  2. Incorrect coverage
  3. Claims issues
  4. Customer frustration
  5. Legal Consequences

What are the 3 types of Submissions?

New business - firstime insurance application. Existing policies under one carrier and aply for differnt line of business

Renewal - 60 days prior to the exp date of the policy *Commercial 90 days Renewal submission

Non renewal - did not inccur the 9:28 AM 8/15/2024

Remarket - ask the carrier to rewrite the policy. When thery trying to move from current to another carrier. Carrier canceled the insurance policy due to: a. Multiple claims b. Missed payments c. false declaration d. can no longer provide the policy

APP - 125,126 Comercial - 125, 140 Acord 80 - Home owners acord 90 - Personal auto acord 125 - Commercial application acord 126 - Commercial general liability acord 127 - Business auto | Business section (details of the car) acord 130 - Workers compensation acord 131 - Excess and umbrella acord 137 - Commercial auto (limits, coverages) acord 140 - Commercial property section acord 160 - Business owner acord 829 - Endorsement

ACORD form - (Association for Cooperative Operations Research and Development)

Uniformity and Standardization - ensure consistency

Reduction Errors - reduce errors that may occur due to inconsistent data formats

Comprehensive Information - Policy details

Integration with Technology - Electronic data interchange and seamless Integration

Acquiring and Understanding Critical Underwriting Documents

Underwriters assess potential policyholders to determine:

  1. their eligibility for coverage

  2. the appropriate premium to charge

  3. the specific terms and conditions of the policy

Underwriting | Methodology - to assesing risk (step by step procedure)

The Impact of Accurate Documentation on Risk Assessment

Inaccurate or missing documentation can have far-reaching consequences for both insurance companies and policyholders.

Effects on the Insured

  1. Delayed or denied claims
  2. Inaccurate quoatations during application
  3. Higher premiums - A risk pool with high-risk individuals can lead to increased.
  4. Limited coverage - vulnerable
  5. Reduced trust -

Motor Vehicle Records

What is an MVR? comprehensive report detailing an individual's driving history.

Department of Motor Vehicles (DMV)

License Status: *Past and current driver's license status including suspensions, revocations, and cancellations.

*Driver's license class.

*Any restrictions on the license.

Personal Information: *Age *Date of birth *Gender *Eye and hair color *Weight and height

Driving Record - This section outlines the individual's driving history, including traffic violations, accidents, and points accrued.

Points - Accumulate points, with more severe offenses resulting in higher point values.

Minor violations: Typically result in one point. Examples include speeding less than 15 mph over the limit, running a stop sign, or making an illegal turn.

Major violations: Generally result in two or more points. Examples include speeding over 25 mph over the limit, reckless driving, DUI, or hit-and-run accidents.

Flood Zone Determination

Special Flood Hazard Area - 1%

Moderate Flood Hazard Areas (Zone B or Shaded Zone X) - 100-year and 500-year floods. lower chance of flooding compared to high-risk zones.

Low Risk Flood Zones (Zone C or Unshaded Zone X) - 0.2-percent-annual-chance flood.

Impact of Flood Zones in Underwriting

  1. Assess risk
  2. Pricing
  3. Coverage options

What are Flood Maps? The Federal Emergency Management Agency (FEMA) - essential tools for determining flood risk

Obtaining Flood Zone Information for Properties

*FEMA Flood Map Service Center - Provides access to flood maps and zone information.

*Local government offices - governments maintain flood zone data and can provide information.

*Third-party data providers - Some companies offer flood zone determination services.

*Property deeds and surveys - May contain information about flood zones. ................................................................. 08/16/2024

Loss Runs Reports

Two Methods for Acquiring Loss Run Reports

Download from Carrier - you will have a login credential to access the carrier websites where you can download real-time the PDF version of Loss Run reports.

Request to Carrier - This is why you have to request the Loss Run Report to their carrier support and wait for 2-3 business days to acquire the requested report.

Components of a Loss Run

'Loss Valuation Date - calculated. It serves as a benchmark, indicating the currency of the information presented.

'Loss Date - when the incident happend.

'Date Received - date when the insured notified the insurance company about the loss.

'Actual Paid Losses - The total amount of money an insurance company has already paid out on claims.

'Recovery Amount - Money recovered by the insurance company from other partied involved in a claim. Ability to ask compensation on someones at fault (subrogation or salvage)

'Net Paid Losses - The actual paid losses minus the recovery amount.

'Current Reserves - estimate of the amount an insurance company expects to pay on claims that have already occurred but haven't been fully settled yet.

'Paid Reserves - A portion of the current reserves specifically allocated to claims that have already incurred some payments but still require additional funds.

'Allocated Expenses - Costs directly attributed to a specific claim, such as legal fees, investigation expenses, or adjuster salaries.

'Claim Status - indicates the progress of the claim from the time it's reported to its final resolution.

Brief description of the loss - A concise summary of the incident.

Common Claims Status

  1. Reported -The claim has been notified to the insurance company.
  2. Under Investigation - The insurance company is gathering information and investigating the claim.
  3. Pending Review - The claim is being evaluated and assessed.
  4. Approved - The claim has been approved for payment.
  5. Paid - The claim has been settled, and the payment has been issued.
  6. Denied - The claim has been rejected by the insurance company.
  7. Closed - The claim process has been completed, and the file is closed. .................................................................

X-Mod Rating Form or Worksheet - reflects its past workers' compensation claims experience. (worker's compensation premium)

3years

Rate 1.0 average loss experience. value below 1.0 - better than average loss history. value above 1.0 - indicates a worse than average loss history.

Company Information - Basic details like the company name, address, and industry classification code.

National Council on Compensation Insurance (NCCI) code - This code categorizes the company's industry based on risk level.

Payroll - The total payroll amount for the company, broken down by job classification (important for understanding risk within different departments).This is typically a three-year period used in the X-Mod calculation.

Claims History - Details of any worker's compensation claims filed by the company, including the date, type of injury, and cost of the claim.

X-Mod is calculated using a complex formula that considers factors such as:

Payroll - wages Loss history - The amount and frequency of workers' compensation claims. Industry classification - The type of business and associated risk level.

Rating bodies - They act as impartial assessors, analyzing data on workplace safety and risk factors for companies.

In California, the "Workers' Compensation Insurance Rating Bureau" (WCIRB) fulfills this critical role.

X-Mod rating, it is ideal to look for the "FEIN", .................................................................

Inspection Orders and Reports

Inspections provide underwriters with firsthand information about the risk being assessed. verify information provided by "applicants, identify potential hazards, and assess the overall condition" of the property or vehicle.

Lesson 6 - Experience Modification Rating (X-Mod) Lesson content Lesson 7 of 9 Inspection Orders and Reports By Staff Boom University Staff Boom University

Inspections provide underwriters with firsthand information about the risk being assessed. Through inspections, underwriters can verify information provided by applicants, identify potential hazards, and assess the overall condition of the property or vehicle.

Why is Inspection Order important?

'Loss Prevention - beneficial for both the insured and the insurer. can identify potential risks and hazards that may lead to future losses.

'Fraud Prevention - insurers can ensure that the details are accurate and that there is no intent to deceive. This helps maintain the integrity of the insurance system and prevents fraudulent claims.

'Provide the appropriate coverage - allow insurers to tailor insurance policies to specific risks associated with a particular property or individual. This customization ensures that the policy coverage and terms are aligned with the unique characteristics of the insured asset or person.

E-Signed Documents - ushering in a new era of speed, convenience, and efficiency

Commercial General Liability *Acord Applications *Business Description From *Additional insured Endorsement *Carrier supplimental app

Commercial Protperty *ACORD Applications *Commercial Property Questionnaire *Building Interrogation Form *Certificate of Occupancy *Lease Agreement (if applicable) *Carrier supplimental app

Commercial Auto *ACORD Applications *Commercial Auto Schedule *Driver Application *Vehicle Information Sheet *Motor Vehicle Record (MVR) Authorization *Driver Qualification File: *Carrier supplimental app

Personal Auto Homeowners Workers Compensation