This is the initial stage of the claim process.
Once the RF assigns us a claim by providing materials and communication, we proceed with Deal Creation, setting the deal stage to Originated.
Ideally, the claim should advance to Estimating once all Deal Creation steps and CRM E-list are complete. However, if critical information is missing, the stage will remain in Originated until the necessary details are obtained.
Examples of missing information that may delay progress include:
Missing SOL
Missing MR (EV/Hover report)
Missing Photos
RF’s initial supplement confirmation
Need info from RF
Need info from Insurance
CSP’s supplement confirmation
Example:
WHEN TO MOVE THE STAGE?
If the Deal Owner is "Zoho Developer":
After Deal Creation, proceed to CRM e-list.
If there are no "NO" answers, move the stage to Estimating and task Vicki to create an estimate (due the next business day).
If there is a "NO" answer, keep the stage in Originated and assign Zoho Developer to review Deal Creation and the e-list (due the next business day).
If the Deal Owner is "Yourself":
After Deal Creation and CRM e-list review, regardless of the e-list answers:
If you are ready to move the claim forward and no critical information or documents are missing, update the stage to Estimating and task Vicki to create an estimate (due the next business day).
If the Deal Owner is Another Account Manager (AM):
After Deal Creation and CRM e-list review, regardless of the e-list answers:
Do not move the stage to Estimating.
Task the Deal Owner to review Deal Creation and CRM e-list.
After their review, the Deal Owner will move the stage to Estimating.
When the Deal is in Estimating, this means that we have all the necessary info to have the deal move forward.
The deal is ready to be assigned to the Estimator’s queue for an estimate to be created.
The Estimator will then create a task for the Deal Owner to REVX the supplemental estimate, at this point the stage will still be in Estimating.
Please review REVX + Client Approving for REVX and Client Approving steps.
WHEN TO MOVE THE STAGE?
If GGR claim:
After REVX, if all good and no revision needed on the estimate:
Move the Stage to Ready for INS.
Create a task to SUBX (due on the same day or next business day).
If NON GGR claim:
After REVX, if all good and no revision needed on the estimate:
Send the Clean copy of the Estimate to the RF for Approval then move the stage to Client Approving.
If Revision is necessary:
The stage will remain in Estimating.
Create a task for the Estimator to do revision (due next business day).
For non GGR claims, after REVX the clean copy of the supplemental estimate is sent to the RF for approval,
Whilst waiting for an approval or any feedback from the RF, the deal stage will remain in Client Approving.
WHEN TO MOVE THE STAGE?
If Revision is necessary:
If the RF requested to revise something from the estimate:
Move the stage back to Estimating.
Create a task for the Estimator to do revision (due next business day).
After Revision is done:
Send it back to the RF, move the Stage to Client Approving.
If NO Revision is necessary/ All good with the RF:
Move the stage to Ready for INS.
Create a task to SUBX (due on the same day or next business day).
The deal will be in this stage when the RF requested for the supplementation to be placed on HOLD.
Only the Deal Owner should move the stage to On HOLD.
WHEN TO MOVE THE STAGE?
If the RF gave a go signal to continue or pursue our process:
then move the stage to whichever stage it was previously at.
The deal will enter this stage once the Deal Owner has completed reviewing the package (supplemental estimate, honest estimate, re-inspection estimate, etc.) and obtained RF approval if required.
At this point, the estimate is all good and ready but has not yet been submitted to the Insurance.
Ideally, the deal should remain in this stage for only one business day, with a task created to complete SUBX.
Exception: For StateFarm claims, the deal may stay in this stage for more than one business day, as SUBX is only performed after 30 business days from the inspection date.
Example:
WHEN TO MOVE THE STAGE?
The deal will enter this stage when the SUBX - submit to insurance task is completed.
At this point, the supplemental package is already sent to the Insurance.
There should be a next task created to confirm receipt of the package.
Example:
Verify the email address the package was sent to.
Request the best email address for resending.
Create a task to SUBX again.
Keep the stage in Sent to Ins until confirmed receipt.
If INS/ADJ confirmed that supplement package is received:
The deal will move into this stage once the supplement package has been confirmed as received by the INS/ADJ AND we have a scheduled date for when the assigned adjuster will review the estimate.
At this point, we have the date provided by the adjuster for when they will review the estimate. It will remain in this stage throughout the Revised Estimate follow-up process until we receive the revised estimate from the INS/ADJ.
Please review KB - Calls and Follow-ups (CX) for the Follow up process.
WHEN TO MOVE THE STAGE?
If the Revised Estimate is received:
Copy and paste the email with the attachments to the CRM note.
Move the stage to Received from INS.
The deal will move into this stage upon receiving the Revised Estimate.
Please review KB - Highlighting and Handling RE (HLX) for Handling RE.
During negotiations—when the Deal Owner is discussing line items with the Adjuster—the deal will remain in this stage unless INS/ADJ requested for more photos, additional documents, revision on the estimate etc.
NOTE: The Stage of the deal is expected to move around between “Sent to INS”, “In Negotiation”, “Received from INS”, and “Info Needed by INS” during the process of negotiating for line items to be warranted.
WHEN TO MOVE THE STAGE?
If INS/ADJ asked for additional info (photos, documents or etc.) and you have these ready and handy:
Send it to INS/ADJ (via email or portal).
Move the stage back to Sent to INS.
Confirm receipt then move the stage to In Negotiation.
Do the follow up process then move the stage to Received from INS when the latest Revised Estimate is received.
If INS/ADJ asked for additional info (photos, documents or etc.) and you need time to look for these additional info:
Move the stage to Info Needed by INS.
Create a task to look for the things needed to send to INS/ADJ for review.
If there is nothing more to fight or negotiate:
Do the CLOX process and move the stage to Bill the Client.
The deal will reach this stage during the negotiation process when INS/ADJ requests additional information, and the Deal Owner requires time to gather it.
Example: This is a water mitigation claim. For the Deal Owner to proceed with the negotiation, she requires the necessary information (as stated in the email) from the RF to submit to INS/ADJ.
WHEN TO MOVE THE STAGE?
If the Additional info is ready:
Send it to INS/ADJ (via email or portal).
Move the stage back to Sent to INS.
Confirm receipt then move the stage to In Negotiation.
Do the follow up process then move the stage to Received from INS when the latest Revised Estimate is received.
The deal moves into this stage once negotiations are complete and all line items have been settled.
By this point, the Closing process is finalized, and a task should be assigned to Vlad to bill the Client.
From this stage onward, Vlad takes over the Deal.
Example:
WHEN TO MOVE THE STAGE?
The deal will enter this stage once the entire process is completed.
Only Vlad should move the stage to Completed.
WHEN TO MOVE THE STAGE?
If there is a new deal creation for the same Homeowner with the same Loss Address:
Update the necessary information.
Move the stage to Originated or Estimating (whichever applies).
Please refer back to Originated or Estimating stage procedure.
The deal will reach this stage when the RF prevents us from following our usual process.
The Deal Owner should task BERNA to cancel the job, and BERNA will be the one to move the stage to this.
Example: After a meeting with the RF, the RF requested for the job to be cancelled.
The deal will reach this stage when we (CSP) decide to close it instead of following our usual supplement/deal process.
We may close a claim due to reasons such as overpayment or low potential value.
If, after reviewing a claim, we determine there is nothing more to fight for or work on, we choose to close it rather than pursue supplementation.
The Deal Owner should task BERNA to close the claim, and BERNA will be the one to move the stage to this.
Examples: Close deal due to Overpayment and Close deal due to Low Potential.
WHEN TO MOVE THE STAGE?
If there is a new deal creation for the same Homeowner with the same Loss Address:
Update the necessary information.
Move the stage to Originated or Estimating (whichever applies).
Please refer back to Originated or Estimating stage procedure.
Originated – The initial stage where the deal remains if important documents are missing.
Estimating – All required documents are received, allowing the claim to move forward.
Client Approving – The RF has received a copy of the estimate & is currently reviewing it (not applicable to GGR deals).
On HOLD – The process is paused at the RF's request.
Ready for INS – REVX is complete, but the claim has not yet been submitted to insurance (SUBX).
Sent to INS – The estimate/items have been submitted to INS.
In Negotiation – Insurance has confirmed receipt AND we have a scheduled date for when the assigned adjuster will review the estimate.
Received from INS – RE has been received from INS/ADJ
Info Needed by INS – INS/ADJ requires additional information, and the Deal Owner needs time to gather it.
Bill the Client – CLOX is complete, and Vlad takes over from this stage.
Final Stages: Only Vlad can move the deals to COMPLETED. For CANCELLED and CLOSED, DO should task Berna to move the deal to these stages.
Completed – Billing is finalized.
Cancelled – Initiated by RF.
Closed – Initiated by CSP.