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Help customers decipher insurance policies

Monday, July 1, 2019 - 07:00
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As repairers watch new technology advance in the vehicles they repair, it becomes apparent that others who claim to be “interested parties” in the repair process also need to recognize these same advances. Questioning the need to test for potential problems in these complex systems seems to be a fool’s game given the frequency of DTCs not identified by dash code diagnostics. All vehicle manufacturers have established the baseline from which to begin the repair process within their engineering documentation. Whether or not the documentation indicates the testing is “required or recommended” should be left to the determination of the repair professional, the repairer. These decisions should be free from interference, but they’re not. After all, whose reputation is on the line?

Educate the policyholder

Conversations regarding the “need” to follow manufacturer required procedural steps — well, these should have ended long ago. However, the need for insurers to continue to control costs plagues the repair industry. As this need for their control continues to grow, so does the friction. So, what can we do about this?

Maybe it’s time for repairers to look closely at the insurance policy and learn about what the policyholder is entitled to so that they can leverage that information in discussions with their customer. Understanding the policy entitlements would help you educate the consumer on what they can expect when the repairer is faced with the inevitable “We don’t pay for that” or “Skippy’s down the road doesn’t charge for that.”  The repairer needs to take control and help point out when the insurer is, in some cases, not completely representing the steps in the repair processes and help the customer understand that they have the power in the claim process. Denials are something that insurers must take seriously, even partial denials. These should be provided to the customer in writing and should give the specific details: where the exclusion is found in the policy, the page number, the paragraph, and line for which the denial is made. 

Why is this so important? An insurer owes for everything that the policy declarations page and accompanying details identify unless specifically excluded. The declaration page includes vehicle coverages and the deductible. The policy contains limits of liability, exclusions and “what we pay for in the event of a loss,” but most folks who buy a policy don’t read the fine print — the details about the who, where, what, when and why of the policy. These are the things that the repairer can help the customer look into in order to develop questions concerning claim handling and what they are entitled to. 

The vehicle must be fixed correctly. Why there is any reluctance on the part of anyone to pay the repairer the proper amount for the repair is the great unknown. Cheaper doesn’t mean correct, cheaper doesn’t mean adequate, cheaper certainly doesn’t mean better. Cheaper just means saving money for the insurer. It does mean that the repairer is not paid adequately for what is required to fix the vehicle, which leaves the repairer subsidizing billion-dollar companies. Why? Because the repair professional, in most cases, will not leave the vehicle in an “unrepaired state,” meaning putting the customer in an unsafe vehicle. This positioning doesn’t do anything to get the repairer properly paid for repairing the vehicle correctly unless the customer is charged directly for the items omitted from the insurer’s estimate or arm-twisted away from the repairer by the typical “we don’t pay for that.” 

Policy definitions

So, what can the repairer help the customer to understand? Learn about the policy and point out where the customer has areas that they can question. Here are some examples:

Actual Cash Value — ACV

Actual cash value (ACV) is a term used by car insurance companies to describe the reasonable amount that an individual’s car is worth minus any depreciation. This term is typically used if an accident takes place resulting in a complete loss. Most car insurance companies will gather information about your vehicle and its condition and offer you a settlement. In many cases, it is far less than you would receive if your car were sold on the open market.

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