Questions and Answers
Which party is responsible for disposing of motor salvage according to the procedures?
What should be included in invoices to meet compliance with VAT regulations?
Who must authorize payments that exceed a staff member's mandate?
What is essential for the authorizing manager before releasing payments?
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What should be checked to prevent duplicate payments?
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Which of the following describes the protocol for confirming banking details?
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What must claims handlers do once a vehicle is owned by the insurer post-claim settlement?
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What is tracked to ensure controlled handling of banking details?
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What is the primary role of the Quality Assurance Officer in the claims process?
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Which action is essential for ensuring open claims statuses are accurate?
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What is required when attaching claims documentation?
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Why is it important to keep clients informed about the progress of their claims?
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What should claims consultants do if documents contain sensitive information?
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When should claims staff record actions related to open claims?
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What is required when setting up an out-of-office auto-reply on your email?
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What is critical for maintaining an accurate audit trail during the claims process?
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What types of automated emails can be accessed under Tial?
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What is the central mailbox used for receiving complaints?
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Which document can be disclosed without the Insurer's consent?
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Within how many business days should a complaint be acknowledged in writing?
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Who should be informed about serious complaints related to external service providers?
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Which automated emails are available in JIRA related to claim processing?
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Who is responsible for handling claim-related complaints?
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Which group should be involved in complaints related to misconduct by claims staff members?
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Study Notes
Tial Automated Emails
- Automated emails can be accessed under policy attachments in Tial for processes like registration and repair authorization.
JIRA Automated Emails
- Automated email notifications include events such as assessor appointment, report reception, and settlement decisions (both replace and cash).
- Email notifications also cover approval requests, payment confirmations, and rejections.
- Access JIRA automated emails through the History and Comments tabs.
Disclosure of Claims Information
- Claims information, including recordings and legal opinions, cannot be disclosed without the Insurer’s consent, except for original client/adviser documents.
- External parties like assessors and attorneys require consent for claims documentation, with exceptions for reinsurers and appointed external service providers.
Complaints Process
- Complaints can come from clients, advisers, service providers, insurers, and via social media or ombudsman channels.
- Acknowledge complaints within five business days and register them, investigating the root causes.
- Serious or repetitive external service complaints need reporting to Insurers; misconduct complaints involve PSG Human Resources.
Payment Process
- Claims handlers and finance teams must separate the request and approval of payments to avoid conflicts of interest.
- Documentation supporting authorizations must be verified by the authorizing manager, especially for claims exceeding set mandates.
- PSG's Finance Department oversees payment releases and verifies payment requests against approved claims to ensure accuracy.
- Strict protocols are in place for invoice compliance, duplicate payments, and account detail verification.
Controlled Handling of Banking Details
- Banking details must be updated with verification from a Team Leader or Manager, maintaining an audit trail for changes.
Motor Salvage and Stolen Vehicle Claims
- PSG is responsible for disposing of motor salvage through approved agents, ensuring proper documentation and adherence to deadlines.
- Maintain accurate claim statuses and activities in systems like JIRA, Tial, or SKI, ensuring all documents are attached and properly named.
Out-of-Office Notifications
- Set an email auto-reply indicating leave dates and providing contact details for a team leader or manager.
Quality Assurance Officer
- The role focuses on improving service delivery, assessing claims process effectiveness, identifying gaps, and suggesting training needs.
Claims Documentation
- All claims documents must be attached to the operating system and properly uploaded/renamed to maintain completeness and audit trails.
- Documents with sensitive information should be marked as confidential.
Communication with Clients
- Keep clients continuously updated about their claims, informing them about any delays that could affect finalization.
- Automated emails are sent at specific claims process points, emphasizing the importance of maintaining updated claim statuses.
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Description
Explore the key processes involved in automated emails and claims disclosure policies. This quiz covers automated email notifications in Tial and JIRA, as well as the rules for disclosing claims information. Test your understanding of these essential aspects of operational policy.