In the second of our three-part series, we examine the review and processing phase of a vehicle accident claim and explore best-practice patterns. To access the first part, which focuses on the initiation phase, click here.
Once a claim has gone through the initial FNOL process, it moves on to the review and processing phase. Typically, the desk reviewer (DR) examines the damage repair estimate to ensure it is compliant with all of the business rules in place. If the DR finds any discrepancies or if the carrier is required to do so on direct repair shops, then a re-inspection may be ordered. This can set in motion several additional processes involving more people and more reports, for example:
- A claims manager may need to report the results of the re-inspection to various state agencies.
- Results may also be used to confirm compliance and to ensure that the body shop has adhered to the carrier's direct repair program guidelines, as well as repair industry standards.
Medical Claims
Concurrently, if the accident resulted in bodily injury, then an adjuster will review the corresponding medical claim to make certain that it complies with state-specific requirements regarding the path of treatment.
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