Were initial contacts made timely with all appropriate parties?
Was acknowledgement letter (FAQ) sent?
Were all Claims Bulletins, Global Claims Bulletins, and/or Special Account Instructions followed?
Were all inquiries responded to timely and effectively?
Were all payments timely and accurate following receipt of the information to support the payments?
Was the investigation focused on an appropriate resolution of critical liability issues?
Was the investigation focused on a timely resolution of critical liability issues?
Was the investigation appropriately developed utilizing all necessary resources?
Were critical liability issues evaluated accurately?
Was Rental / Loss of Use managed appropriately?
Were the type and extent of damages evaluated accurately?
Were the type and extent of damages evaluated timely?
Were electronic and hard copy files properly documented?
Was an activity based diary used appropriately?
Was the file re-segmented appropriately?
Were all key data elements properly recorded in the electronic claim system?
Was the file handler properly licensed to adjust claims within the jurisdiction?
Was the claim acknowledged timely in accordance with the jurisdictional statutes and regulations?
Was the investigation conducted timely in accordance with the jurisdictional statutes and regulations?
Was the claim accepted/denied timely and appropriately in accordance with the jurisdictional statutes and regulations?
Were all statutory forms /reports/interim letters and/or all other regulatory requirements filed/completed timely and appropriately?
Were all indemnity and/or benefit payments made timely in accordance with the jurisdictional statutes and regulations?
Were all indemnity and/or benefit payments made accurately in accordance with the jurisdictional statutes and regulations?
Were all payment(s) or closures that required secondary approval been properly approved?
Were the applicable processes and service standards for intercompany communication and billing adhered to?
Were all potential recovery / contribution possibilities handled appropriately?
Was there a timely referral to GRS or the local Recovery Agent, when appropriate?
Were Key Investigative Indicators applicable to the Line of Business appropriately identified and assessed at each and every stage throughout the life of the claim?
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