MANDATORY EXPECTATION SETTING SCRIPT (DO NOT SKIP)I have documented the reported loss and will submit this claim for handling. As required by California's Fair Claims Settlement Practices, we will process your claim promptly. Please let us know if you need assistance locating an approved repair facility. A claims representative will review the details, and if additional information is needed, we will contact you using the phone number or email on file. Timeframes can vary based on the type of loss, injuries, vehicle damage, and state-specific requirements.
Standard Procedure (All Jurisdictions): Before initiating a new FNOL in the Claims Intake Platform (CIP), the consultant MUST verify the caller identity and relationship to the policy using approved CPN verification procedures (see POL-102 and CLAIM-VERIFY-11 for special handling overrides). After verification, determine whether the caller is reporting a new loss, checking status on an existing claim, or requesting roadside/towing only. If the interaction is a new loss, capture the date and time of loss, garaging location, exact loss location, involved vehicle(s), driver at time of loss, police report status, injuries, witness availability, third-party involvement, drivable status, current vehicle location, tow destination if applicable, and whether photos or video exist. Enter all required details on the Loss Details screen before proceeding to liability, injury, and specialty handling questions. If the customer reports any injuries, emergency response, suspected fraud, hit-and-run, vehicle fire, total loss indicators, attorney representation, or a commercial exposure on a personal line, pause the standard path and follow the escalation rules below. Once intake is complete, the consultant MUST summarize next steps, provide any required disclosures, confirm best contact information, and route the claim to the correct downstream queue.
CRITICAL: Strict adherence to Fair Claims Settlement Practices Regulations. If claimant requests repair guidance, provide the approved repair-choice disclosure and note whether the vehicle is garaged in-state or out-of-state. If injuries are reported, do not speculate on medical payments or liability outcomes.....
CRITICAL: Pure contributory negligence state. If the insured is even 1% at fault, they may be barred from recovery. Investigate all third-party liability meticulously.
MEDIUM PRIORITY: Zero deductible glass state if the insured purchased full safety glass coverage. Do not apply the comprehensive deductible for windshield repair or replacement claims......
CRITICAL: Strict adherence to Fair Claims Settlement Practices Regulations. If claimant requests repair guidance, provide the approved repair-choice disclosure and note whether the vehicle is garaged in-state or out-of-state. If injuries are reported, do not speculate on medical payments or liability outcomes.....
FRAUD WARNING & MOTORCYCLE COMPLIANCE DISCLOSURE: Submitting a fraudulent insurance claim is a crime punishable by law. Please be advised that coverage for Custom Parts and Equipment (CPE) and safety apparel is strictly limited to the endorsements specifically listed on your declarations page. You will be required to provide receipts or prior photographic evidence of any claimed aftermarket modifications. We may also review local traffic and helmet law compliance as it pertains to comparative negligence and bodily injury recovery.
