Volume 12, Issue 3 - May/June 2010

feature

This Call
May Be Recorded…

An Inside Look at Some Possible Steering Tactics

Though third-party administrators and independent glass shops likely will forever disagree on whether unethical steering exists in the auto glass business, many in the industry have been recording their calls with customers, insurance agencies and third-party administrators, and AGRR magazine was provided access to some of these (devoid of company, personal or insurance information) for this issue. In the following pages, you’ll get a glance at what your customers may be hearing from third-party administrators. (Editor’s note: All personal information has been removed from the following transcriptions of actual calls.)


The “Tactic” – Wait and Switch

Many auto glass shops have reported cases in which their customers receive a call from a third-party administrator after they’ve either started the process, or, at minimum, booked the work, suggesting the customer take the work to one of its own shops. In the following transcription of an actual shop’s phone interaction with a customer, you’ll see a real-life example of this.

CSR: [Auto Glass Shop], this is XX, how can I help you?
Customer: My name is XX and I’m getting a windshield. Should I talk to one of the guys that took my whole order and wrote it up?
CSR: No, it’s okay, he’s actually not even here, but how can I help?
Customer: Okay, that auto glass place, whoever normally does windows for [my insurer] …
CSR: Okay …
Customer: Are you aware of them?
CSR: [XX], I’m assuming?
Customer: Uh-huh. They called me and said “are you ready to schedule your appointment?” And I went, “I already had it done.” They wanted to know if I paid my deductible or if you charged me more than my deductible, and I said “no,” and they said, “okay, well in order to send me a payment, we have to know how much the windshield cost.” I told them I didn’t have any idea and would have the man call them.
CSR: Okay, well what, actually what I’d like to do is, if it’s alright with you, we actually have a huge problem with [that company]. They’re a third-party administrator for [your insurer], but they also obviously offer their own auto glass service.
Customer: I know that.
CSR: We’ve had a problem with them, after you report the claim, calling and actually stealing jobs from us that way. What they’ll do is, and we have your insurance information here, I’ve already pulled it up. When did they call you, just now?
Customer: Yeah, like about 2 minutes ago.
CSR: Hang on one second and let me find out the best way to go about this. Hang on one sec for me.
Customer: Okay, I have another question, though. Pull my records and see what kind of claim number you have because they gave me a reference number and I’m just curious to see if you’ve got the same thing.
CSR: Sure.
Customer: I’m just curious if they’re talking about when I called one time and said I might like to get it fixed.
CSR: Absolutely, hang on just one second for me, because I did just find it, because I looked it up while we were on the phone. I wasn’t sure that I had that. It looks like the referral number—let me make sure it’s this one; the referral number they gave me was XXXX.
Customer: Oh, well maybe this is from when I called in the very first time, because this is XXXX [different number].
CSR: Yeah, that could be.
Customer: But they’ve already got your approval, right?
CSR: We do, so we have everything that we need.
Customer: So I’m not going to even call them back then.
CSR: No, there’s no need to.

“They wanted to know if I paid my deductible or if you charged me more than my
deductible, and I said ‘no,’ and they said, ‘okay, well in order to send me a payment,
we have to know how much the windshield cost.’”

The “Tactic” – Delay, Delay

Many industry auto glass shop owners feel delaying the time it takes for the customer to have his/her coverage verified for a windshield replacement or repair interferes with their ability to do business, by making the customer they’re trying to help wait for the service—and giving him/her extra time to decide to go elsewhere. Following are two examples of calls in which the third-party administrator was unable to verify coverage after a lengthy process on the phone.

Call No. One
TPA CSR: Thank you for calling XX, this is XX, how can I help you?
Shop CSR: Hi XX, this is XX over at XX. I have a customer with a cracked windshield who’d like to have it replaced and I’d like to make the claim.
TPA CSR:If the insured is with you, please put them on the line.
Customer: Hello.
TPA CSR:Hello, my name is XX, and I’m going to assist you with your glass claim today.
Customer: Uh-huh.
TPA CSR: May I have your name, please?
Customer: XX.
TPA CSR:Have you previously reported the claim?
Customer: No.
[The TPA CSR goes on to take the customer’s name and policy number.]
TPA CSR: And what day did the damage happen?
Customer: It was probably two months ago.
TPA CSR: For the claim, I have to put in a date, if you can give me an estimated date, that will work.
Customer: Uh, XX.
TPA CSR:[repeats date back]
Customer: Yes.
TPA CSR: May I have your zipcode please?
Customer: [provides zipcode]
TPA CSR: I’m having trouble retrieving your information. Can I have your home phone number, please?
Customer: [provides phone number]
[The TPA CSR then obtains the policyholder’s alternative number, address, city and state.]
TPA CSR: Would you happen to have your agent name and phone number?
Customer: Um, it’s XXX. The phone number’s XXX.
TPA CSR: Thank you, so I have [address, city and state], and your agent is XXX at XXX?
Customer: Uh-huh.
TPA CSR: And may I have the year, make and model of your vehicle?
Customer: It’s an old ’95 Dodge Ram.
TPA CSR: Is that a pickup?
Customer: Uh-huh.
TPA CSR: Is that a 2-door standard?
Customer: 4-door.
TPA CSR: 4-door pickup?
Customer: Uh-huh.
TPA CSR: What started the damage?
Customer: Uh, I have no idea. There was a crack in the bottom and it just took off all the way across.
TPA CSR: Is it just in your windshield?
Customer: Uh-huh.
TPA CSR: What’s the size of the crack? Is it larger than a dollar bill?
Customer: Oh yeah. It’s all the way across the window.
TPA CSR: At the moment, I’m looking to confirm coverage on the vehicle. I will continue to work on it and we’ll call you back when it has been confirmed.
Customer: Why can’t you confirm it?
TPA CSR: It happens quite often. We’re actually a third-party who processes claims on behalf of your insurance company, and sometimes it’s just a matter of two systems communicating with each other, since we’re not in the insurance company system.
Customer: Uh-huh.
TPA CSR:So usually that’s the case and we’re not able to verify it right away.
Customer: Okay.
TPA CSR: We have an offline verification department and they’ll look into it …
Customer: So is that within an hour or days or … ?
TPA CSR: Sometimes. Usually it’s within a couple hours, sometimes it may take a day or two.
Customer: Hmph.
TPA CSR: I’m sorry.
Customer: I had my truck sitting at this place with an appointment to put a window put in, so I’m sure they don’t want to wait days.
TPA CSR: Right, definitely, I can understand that. The shops are pretty familiar with when this happens. It happens quite often.
Customer: Okay.
TPA CSR: So, I’m not sure how they—each shop probably has their own way of handling it, but it happens often.
Customer: So who do you call when it’s verified?
TPA CSR: We’ll notify you and the shop.
Customer: Okay.
TPA CSR: And may I have an e-mail address where I can send a confirmation of the claim?
Customer: Uhh, you know, I don’t know my e-mail address at home.
TPA CSR: Okay, that’s okay. Well, that’s all the information I need from you. I do need to speak with [the shop CSR] for just a moment.
Customer: Okay.
TPA CSR: Do you have any other questions for me, sir?
Customer: No, that’s it.
TPA CSR: Okay, well, thank you for calling.
Customer: Thanks.
TPA CSR: You’re welcome.
Shop CSR: Hello?
TPA CSR:: Hello. May I have the phone number for the shop you’re at?
Shop CSR: [provides number]
TPA CSR: Okay. Can I have the spelling of your last name, please?
Shop CSR: [provides spelling]
TPA CSR: And I have the shop e-mail address of XXX?
Shop CSR: Correct.
TPA CSR: Okay, and I will go ahead and send over confirmation of the claim. I wasn’t able to verify coverage right away, but we’re going to do our offline verification process, and then we’ll notify you if coverage is confirmed.
Shop CSR: Okay.
TPA CSR: Any other questions?
Shop CSR: So there’s no referral or anything yet?
TPA CSR: No, not at the moment.
Shop CSR: Okay, thanks.
TPA CSR: Okay, well, thank you for calling, and you have a good day.
Shop CSR: You, too. Bye.
TPA CSR: Goodbye.
Call No. Two
TPA CSR: Thank you for calling the [insurer name]. This is XX. How may I help you?
Shop CSR: Hi XX, this is XX over at XX. I have a customer that has a cracked windshield and would like to have it replaced.
[The TPA CSR requests and verifies the Shop CSR’s name and phone number.]
TPA CSR: Go ahead and bring the policyholder on the phone, please.
Customer: Hello.
TPA CSR: Hi, this is XX with the [insurer name]. I’m sorry about your glass damage and I’m going to help you report the claim, alright?
Customer: Great.
TPA CSR: Before I proceed, I need to let you know that our calls are recorded for quality purposes and we are financially affiliated with XX. Is glass the only thing damaged on the vehicle?
Customer: Yes.
TPA CSR: Have the repairs been done?
Customer: No, I’m at the place right now.
TPA CSR: And do you have a claim number yet?
Customer: Uh, no, I don’t have a claim number, no.
[At this point, the CSR requests the customer’s name, phone number, alternate phone number, e-mail address, policy number and zipcode.]
TPA CSR: When did this happen?
Customer: Around XX.
TPA CSR: Around [repeats date]?
Customer: Yes.
TPA CSR: And what state was this in?
Customer: XX.
TPA CSR:And what time was that on XX?
Customer: Driving into work on XX.
TPA CSR: Do you know how it happened?
Customer: It was just expressway driving, probably a rock hit the windshield.
TPA CSR: Is there any damage besides the windshield?
Customer: No, just the windshield.
TPA CSR: Is it smaller than a dollar bill or larger? The crack?
Customer: Yes, it goes all the way across.
TPA CSR: Can I have the address of your policy?
Customer: Yes, it is XX.
TPA CSR: [confirms address] And the last six digits of your VIN number?
Customer: [provides last six digits of VIN]
TPA CSR: [confirms VIN]
Customer: Yes.
TPA CSR: And the year, make and model of the vehicle?
Customer: It’s a 1995 Nissan Altima.
TPA CSR: It’s a 1995 Nissan Altima?
Customer: Correct.
TPA CSR: Is that a two-door or four-door?
Customer: Two-door.
TPA CSR: Alright. Ma’am, at this time we are unable to verify coverage with the deductible information, but we will go ahead and verify that manually, and the process is typically completed quickly, but may depend on how much research is required to locate the coverage. In the meantime I can assist you with scheduling an appointment, and once the coverage and deductible are confirmed, [we] will notify you, and please be aware that if the repairs are done before
coverage is verified, you may be responsible for the cost of repairs.
Customer: Okay, but I already talked to my agent and he said it’s a $100 deductible.
TPA CSR: Okay, but we do have to verify coverage again. That shop again is XX, and, if you want to go ahead and bring XX back on the line, I’ll finish up the claim with him.
Customer: Okay, thanks.
TPA CSR: Thank you.
Shop CSR: Hello?
TPA CSR: Alright, XX, I’ve got a windshield replacement on a 1995 Nissan Altima for XXX.
Shop CSR: Okay.
TPA CSR: Her coverage hasn’t been verified yet, so we will contact you once we verify it.

“At this time we are unable to verify coverage with the deductible information,
but we will go ahead and verify that manually.”

TPAs Speak Out on Coverage Verification Issues
Why do delays in coverage verification, such as the ones detailed in these calls, occur? AGRR magazine asked a number of TPAs that verify insureds’ coverage everyday to comment on what could possibly cause such delays.

HSG vice president of operations and administration Adriann Dalton says sometimes this might happen if the policyholder has made a recent update to his/her policy, but that this is rare.

“Typically, when there are coverage issues, they have to do with updates that have been made to the insured’s policy, but which have not yet been updated in the system,” she says. “For instance, if the policyholder bought a new vehicle, changed their address or changed their phone number, we would not be able to confirm coverage until we [have] receive[d] additional authorization from the insurance company.”

LYNX Services vice president of strategic initiatives Chris Umble says LYNX sees coverage verification issues rarely as well. He estimated that less than half of one percent of callers experience this.

“I don’t have the statistics in front of me, but this is not an issue that we hear about a lot,” he says. “There are times when a client has a system issue that goes awry for short periods of time, but that’s the rare exception”

He adds that if there is difficulty in verifying coverage due to a system failure, LYNX has processes in place to still expedite the claim.

“In every instance, in the interest of customer service, there’s a manual process which would be utilized, so typically the client’s policyholder doesn’t experience [a delay],” he says.

Dalton says HSG works to handle these issues quickly as well.

“We utilize a dedicated Verification Team which works any issues [in] real-time until they obtain coverage,” she says.

Officials from Safelite Solutions declined to comment on this issue.


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