Verification Matrix

The LOR (Letter of Representation) must be on file before we can release any information about the claim to our insured's attorney.

• True

• False

Which of the following can you NOT release to our insured's attorney?

• Liability Decision

• Insured's Recorded Interview

• Policy Coverages

• Insured's Personal Information

Click all of the following that we CAN release to a health insurance provider after verification.

• If policy has PIP/Med Pay Coverage

• If we have received a medical claim

• Information about medical payments we have made

• Coverage limits for PIP/Med Pay

Which of the following CAN we release to a body shop?

• Claim Documents other than Estimate

• Claim Status

• Deductible Amount

• Payment Information

Answer explanation

The only information we are allowed to release to a body shop is the claim number, payment info, and the estimate (WITH PERMISSION).

Click all of the following that we CAN release to the CLAIMANT after verification.

• Liability Decision

• Payment Information

• Coverage Decisions

• Whether or not we have made contact with insured

• Insured's Policy Limits

If we cannot obtain a claimant's last 4 of the SSN, DOB, or Pin which of the following would NOT be a suitable substitution for verification?

• Home Address

• Home/Work Phone Number

• Just Document the last 4 of the SSN or DOB

• Claim Number

Answer explanation

If unable to verify SSN/PIN/DOB then:

The caller's full name

AND

The claim #-or-Policy # -or-Phone # that we called (claim locator)

AND

The IP’s address-or-The IP’s home phone number-or-The IP’s work phone number

OR

*Document the last 4 digits of the caller's SSN or DOB

If the insured's DAD calls in we would verify them just as we would the insured themselves, and we would need DOCUMENTED permission to release most information.

• TRUE

• FALSE

Answer explanation

*After permission granted, document the last 4 digits of the caller's SSN or DOB and that permission was given in the Insured’s comments field on the Interested Party Tab. If full permission was given, “permission granted” is sufficient documentation.

If the insured's ex-wife calls in because the insured has passed away we would want to contact ___ before releasing claim information.

Which of the following can we NOT release to the AC (Adverse Carrier) without our insured's permission?

• Liability Decision

• Coverage Decision

• Vehicle Information

• Facts of Accident

• Policy Number

Click all of the following that we can release to the AC (Adverse Carrier) with our insured's permission.

• Policy Numbers

• Policy Coverage Limits

• Insured's Contact Information

• Insured's DOB

• Effective Policy Dates