Highways England GREEN CLAIMS PROCEDURES MANUAL

GREEN CLAIMS  PROCEDURES MANUAL

Highways Agency Green Claims procedure manual (with personal dated redacted)

Text:


Archiving a File


Once a claim has been fully paid by the third party representatives, you should receive a Cashiers Receipt from the Cashiers department, which clarifies that the claim has been paid.

Once the case officer has received the receipt the database needs to be updated. An action needs to be added that the file has been paid and archived. The file status needs to be changed to completed 03/06, (please be aware that this changes every financial year). The file then needs to be archived. To do this you need to go onto the main menu for the green claims database and select system admin.

This then brings you to a menu of 6 options, one of them being Archive. Select Archive and type in the relevant HA reference for the claim that you are archiving.

The case officer then needs to select Archive Record. A number of boxes will appear after this has been selected and the case officer needs to select yes on all of them.


Cashiers Receipts


All payments received in the Highways Agency are dealt with by the cashiers who list a daily schedule containing all payments received that morning. This schedule (example shown below) is then passed on to the Accounts Receivable team (AR) where they allocate payments to the appropriate accounts in Oracle.

AR forward a copy of this schedule on a daily basis, with all paid invoices relevant to TPC attached.

Copies of these invoices are taken and each invoice copy is attached to a receipts schedule copy, which is then forwarded to the relevant TPC case officer.


Claims over £20,000


If a claim is sent through to a case officer and the final costs amount to over £20,000, the claim needs to be re-assigned to the Team Leader to investigate. This is because the claim will take longer to work on due to questions that will be raised by the third party representatives.

Please refer to re-assigning claims in order to re-assign any claims over £20,000 to the Team Leader.


Counter Claims


Sometimes an accident can be caused by the negligence of the Highways Agency. These can vary from debris that was on a trunk road to surface damage on the Highways.

The Highways Agency has contractors i.e. Managing Agents, that are acting on our behalf by looking after, repairing and maintaining the Trunk roads which the Highways Agency own.

There is a team designated to investigate claims that are being made against the Highways Agency. They are called Red Claims and they are based in the Birmingham branch.

If a case officer has been passed a claim that could possibly be as a result of debris on the road, oil spillage etc, then the case officer needs to contact the Red Claims Team in Birmingham – (you will find their details on the G drive under red claims contacts). You will need to provide them with all the information that you have been given and they will then advise you of whether a claim against the Highways Agency has been made.

If a claim has been made against the Highways Agency then you should stop working on the claim until further notice is given from the case officer in the Red Claims team.

If the Red Claims team have not been notified of a claim made against us then you should carry on pursuing the third party representatives for reimbursement of our outlay.


County Court Judgements


An Insurance Company may refuse to indemnify their client for the following reasons:

  • The driver was not a named person on the clients’ policy
  • Their client was in breach of their policy
  • Their client has not responded to their letters requesting information regarding the accident

The insurance company will then request that we apply a County Court Judgement against their client, only when this has been obtained will they take the role as Road Traffic Act Insurers.

The case officer needs to make sure that the claim has all the information that is needed for a county court judgement to be obtained. A checklist needs to be completed to make sure that all the information is there. The checklist can be found on the G drive in the County Court folder under County Court checklist, please find a copy attached.

The relevant case needs to be re-assigned to Sue Coffey, who has been elected to deal with these types of claims, she will then apply for a County Court Judgement.


Economic Loss


Economic loss refers to manpower time only, where no physical repairs have been undertaken. Examples of economic loss are listed below:

  • Road closure
  • Diversions
  • Clearing debris / spillage
  • Traffic management
  • Emergency call out (electrical / non electrical)
  • Sign erections / removals
  • Emergency attendance at RTA (no repairs undertaken)

If a works order or costs breakdown is attached to the TR430, carefully consider the breakdown for indications of any repair work done. For example, on clearing oil spillage if a bag of oil dry chemicals has been used, then the agency have used materials so can claim for the whole of the costs of repair (even just the economic loss part of costs).

The case officer should process an Economic loss claim as normal. If the third party representatives advise that they are not willing to pay the claim as no materials were used we would then consider withdrawing our claim and writing off the outstanding amount. We would not go to court regarding an Economic loss claim.


Highways Insurance


Highway Insurance are currently raising a few queries relating to damage caused to Crown Property. They have a standard letter that they send out with a number of questions regarding the age of the barrier, how long before the accident were inspections carried out etc. There are normally 10 questions on this letter but that can differ.

We have referred this letter to our legal department for them to review and advise us on how to send out the adequate answers.

Whilst we are waiting for them to provide us with adequate answers the following needs to done:

Liability needs to be admitted by Highway Insurance before we are able to re-direct our claim to our legal department. Once liability has been established the status on the database needs to be changed to Highway Insurance:

An action needs to be added ‘letter received from Highways Insurance, claim referred to Sue Coffey’. Sue Coffey is the contact in our office for our legal department.

The brought forward date needs to be set for a month after the last action has been updated.

The claim can then be filed away.

When our legal department advise us of a adequate response to the letter, a report will be run by Sue Coffey or the manager of the Green Claims Team, bringing up all Highway Insurance claims. The case officers will then be passed back their relevant claims and be asked to respond to Highway Insurance.


Invoice Templates/Invoicing


Before an invoice can be raised, liability has to be clearly established. If the culprit or their insurer state that liability is being investigated but in the meantime they request documentation in support of our claim, an invoice should not be raised; instead a complete costs breakdown and any details from the police indicating the culprit as responsible for causing the damage, together with the insurer’s letter requesting the information should be sent, (please refer to Annex A, Pre – invoice letter).

If a third party representative forward us a cheque for the amount of our claim before an invoice has been raised and sent, the relevant case officer will need to raise a

RETROSPECTIVE INVOICE. The case officer will complete an invoice template as usual. When completing the invoice template the case officer will add under ‘any additional information’ that a cheque has been received and the amount of this cheque.

When an invoice is ready to be raised, an invoice template (copy overleaf) is completed and sent to the Accounts Receivable (AR) team for production of invoice. TPC case officers send their invoice requests (templates) direct to the TPCInvoiceRequest Inbox as an attachment via e-mail. 

In case of TPC invoices, place a copy of the template in the claim file. At this point photocopy the following documents :

Limited Particulars or part of the report if it clearly shows that the culprit is liable

Complete costs breakdown from the agents

Letter or phone log of insurance/culprit requesting invoice.

Keep these copies in readiness for when the invoice has been produced by AR to send out as backing documents along with the invoice.

In the claims database an action is logged against the claim stating invoice has been requested and date this was done. The file status is amended to invoice raised.

All templates must be double checked and approved by TPC. This is why the case officer forwards the invoice template to TPC. A claims officer cannot approve their own template request. A print of the template is taken by the person checking and passed to the case officer for file copy. The template is then sent as an e-mail attachment to AR Invoices by the person who has checked the invoice template.

You must check on the invoice template that you have the following information down correctly: The Insurance Reference

The Insurers address

The Debtors Name

Location of accident

The correct costs are put in the relevant fields

E-mail address for the case officer that raised the invoice

If the invoice is a Retrospective Invoice then under ‘any additional information’ the case officer needs to put cheque received and the amount of the cheque.


Invoice Templates


Once the template has been completed the case officer will need to save the template in their named file on the G drive under awaiting TPC.

The case officer will then need to send an e-mail to the TPC team attaching the invoice template.

Once this has been sent the invoice template needs to be moved from the ‘awaiting TPC folder’ to the ‘sent to TPC folder’.


Template Number


Once the e-mail has been sent to TPC and they check the invoice template, they assign the invoice template a template log reference. They add this template log reference to a spreadsheet on the G Drive and forward the invoice template, along with the new template log reference to the AR department. The person checking the invoice template will then give a paper copy of the invoice template, along with the template log reference, to the case officer that sent the e-mail across.

The AR (Accounts Receivable) department then format the invoice template into an invoice, which is then sent via e-mail to the case officer who originally completed the invoice template.


Invoice Printing


When the case officer receives the invoice back from the AR department, 2 copies need to be printed off. One copy will be for the file. The second copy needs to be sent out the third party representatives that have admitted liability. Before sending out invoices the database needs to be updated. The case officer needs to fill in the Invoice Number, Invoice Date and Template Number. An action needs to be added that an invoice/retrospective invoice has been sent. The file status is then changed to Invoice sent.


Covering Invoice Letter


Once the database has been updated, the case officer will need to send out an invoice to the party that have admitted liability. The case officer will need to send the party the information that they photocopied, a copy of the invoice and an invoice covering letter. A Letter can be found on the database by highlighting the relevant claim and selecting Create Letters. There should be 7 options available, the case officer will need to select Insurers. They then need to select option 1 – Invoice Covering Letter. They need to print off 2 copies and send one copy out with all the information above and leave another copy for the file.


Retrospective Invoices


When the case officer receives a Retrospective Invoice back from the AR department they only need to print off 1 copy. This is for the file. The third party representatives have already paid the claim so there is no need for an invoice to be sent to them. The case officer needs to update the database accordingly, as they would for a normal invoice. They then need to e-mail the cashiers department with the following information: Invoice Number

Invoice Amount

Debtors Name

Highways Agency Reference

Date


Invoice Letter


Annex A

Ground Floor

Hempstead House

Our ref:   HA 112/***/***                                           2 Selden Hill

Your ref:

 

 

Hemel Hempstead HP2 4XW
[insert insurer’s address] Direct Line: 01442 346
Fax:             01442 346196
[insert date]

 

Dear Sirs

 

DAMAGE TO CROWN PROPERTY:

ACCIDENT DATE and LOCATION: 

YOUR INSURED: 

VEHICLE REGISTRATION:

Further to your letter dated [insert date], please find attached details of the repair costs together with documentation from the police authority attending the scene showing your insured’s involvement in the above accident.

This letter does not constitute an invoice.

On considering the documents provided, if you accept liability for our claim please advise this office, upon which an invoice will be issued to you.

Should you have any queries, please contact me on the above direct line.

Yours faithfully

Case Officer

TPC Green Claims


Ministry Of Defence (Civil and Military) Claims


If an accident occurs in which the damage to our furniture was caused by a vehicle owned by the Ministry Of Defence and was being driven by an officer, the Agency can only claim for reimbursement if the costs are over £10,000.

Claims below £10,000 need to be submitted for write off – please see section 4001.

If the claim is over £10,000 then the claims handler will pursue

An exception to this rule applies when an  MOD officer is driving a private vehicle which should be covered by their insurance. In such cases we can pursue the whole amount of the claim.


Motor Insurers Bureau


The Motor Insurers bureau is an organisation that has been set up to compensate the victims of uninsured or untraced drivers. They also have a green cards department which enables insurance companies or third party representatives to obtain UK Handling Agent details for foreign vehicles and foreign insurance companies.


Uninsured Drivers Agreement


Whilst dealing with a claim it may become apparent that the person driving the vehicle that caused the accident or caused the damage to our property was not insured. In cases like this we submit an ‘Uninsured Drivers Agreement’ to the MIB.

The case officer will need to update the database by adding an action of MIB uninsured drivers agreement sent. The brought forward date needs to be out forward 1 month from the date the agreement is sent.

You will then need to highlight the relevant claim and select create letters. Select MIB, a number of options should then appear. You will need to select number 11 – Uninsured Drivers Agreement.

You should then have an application on your computer that needs to be completed.

You will need to make sure that the application form discloses the following information:

Final Cost of our claim

Driver/owner details

Vehicle Details

Accident Location

What actions were taken to obtain insurance details’

Were the driver or owner of vehicle contacted

The application form has relevant fields for all of this information, once all the information has been included and the application form has been completed the case officer will need to sign the agreement on behalf of the Highways Agency.

Once the Uninsured Drivers Agreement has been completed and signed, the case officer will need to print off 2 copies of the agreement. One is for the file and the other is to forward to the MIB. The case officer will need to photocopy the following information: Limited Particulars

VQ5

MID Search results

Letters that have been sent to the owner/driver

Final Costs and a breakdown

The case officer will then need to print a covering letter for the agreement to send to MIB. This can be found by highlighting the relevant claim, selecting create letters, selecting MIB, then option 7 – completed application. A screen, like the one below, should appear. If the accident involved more than 1 vehicle then the case officer will need to select the correct vehicle index – this being the one without insurance.

The case officer will then need to select create letters. A letter will then appear and the case officer needs to amend this letter accordingly and print of 2 copies. One copy being for the file.

The case officer will need to send off a completed uninsured drivers agreement along with the photocopied information and covering letter to MIB. This should leave a copy of the agreement and a copy of the covering letter for the file.


Untraced Drivers Agreement


The untraced drivers agreement was set up for people that have been involved or affected by accidents in which the vehicle registration was recorded but the driver has never been identified.

The only time the MIB will be able to accept an Untraced Drivers Agreement is if the accident was under 9 months from the date of the application.

This process is similar to sending an Uninsured Drivers Agreement. The case officer will need to update the database by adding an action of Untraced drivers agreement sent, the brought forward date needs to be put forward by 1 month.

The case officer will then need to go to the same menu as they would if they were completing an uninsured drivers agreement, but instead of option 11, they will need to select option 12 – Untraced Drivers Agreement.

The case officer will need to fill out the untraced drivers agreement, making sure they include the following information:

Final Costs of our claim

Details of the vehicle that caused the accident

Location of accident

Police details – If any have been obtained

Once the agreement has been completed the case officer will need to print out 2 copies, one for the file and one to send to MIB. They will also need to photocopy any information that they have in their file to forward to MIB.

The case officer will also need to print off 2 copies of a covering letter for the agreement. They will go to the same covering letter that is printed off for an Uninsured Drivers Agreement and amend as necessary.

Once the Untraced Drivers Form has been completed the case officer can forward this, along with the photocopied information and covering letter to the MIB. There should be a copy of the covering letter and a copy of the Untraced Drivers agreement left for the file.

Foreign Vehicles 

If an accident was caused by a foreign registered vehicle then the MIB advise us of who the UK Handling Agents are for the foreign Insurers. We then direct our claim to the UK Handling Agents.

The claims handler will need to update the database by adding an action of letter sent to MIB to determine UK Handlers. The brought forward date needs to be put forward 1 month from the date of sending the letter to MIB.

The relevant claim needs to be highlighted, then they need to select create letters.

The case officer needs to select MIB, then option 4 – Foreign Vehicle. A letter should then appear. The case officer should amend the letter as necessary and print of 2 copies. One should then be sent to MIB and the other should be for the file.

Part Paid and Fully Paid 

Part Paid

An insurance company may only pay part of our claim due to a number of reasons:

  • Mobilisation Costs, Contract price Fluctuation and Admin Fee may be disputed as the third party representatives only feel that their client is liable for the actual repair costs, not the overheads
  • The client may be paying our claim directly and therefore have an arrangement with Credit Control to pay in instalments
  • There may be a number of vehicles/drivers that were involved in the incident and the third party representatives may have agreed to split our costs between them

The cashiers receipt will be passed to the claims officer, this will advise them on whether the claim has been fully paid or part paid. If the claim has been part paid the claims officer needs to do the following:

Firstly find out why the third party representatives are not paying the full amount, if it is down to a costs dispute and they are requesting further information, then it is the case officers job to answer their queries. For example if they are disputing the overhead costs and require further information explaining them then we would need to revert to our Managing Agents. Please refer to section  ‘requesting further information from Managing Agents’.

If the claim has been split between a number of Third Party Representatives, the case officer may receive the payments at different times. Once the first payment has been received an action needs to be added ‘Invoice part paid’. The case officer then waits to receive the outstanding amount from the other Third party representative.

If the part paid is due to a client paying in instalments then the claim will be referred to Credit control to deal with. The case officer will receive confirmation of an instalment that has been paid via a cashiers receipt. An action needs to be added ‘Instalment paid’. The Brought forward date needs to be set a month from the last action date and the claim can then be filed.

Fully Paid

When a third party representative pays the full amount of our claim, the cashiers will pass the case officer a cashiers receipt that clarifies that the claim has been paid and the cheque has been banked. Please refer to section  ‘Archiving a File’ if you have received a fully paid receipt.

Re-assigning Cases to a different Case Officer

When a case officer is working on a claim, it may become apparent that the claim should be re-assigned to another case officer, the reasons for this are:

  • The accident may have happened in a different region to what the case officer has been allocated to work on
  • The claim may be over £20,000, in which case it needs to be re-assigned to the team leader
  • When it has been agreed by your team leader that a claim is to be written off as there is no possible way to recoup our losses

If any of the above apply to the claim that the case officer is working on, then the following needs to be done:

All the actions on the database need to be added and then saved. The case officer then highlights the relevant claim and selects re-assign.

A list of usernames will then appear, the case officer needs to select whichever username the claim should be under, i.e. if the case is going to written off, the claim needs to be re-assigned to write off.

A number of boxes will then appear, select yes on all of them.

Requesting a Police Report

 

When liability between the third parties is being disputed and the Limited Particulars that have been provided do not advise us of who was at fault for the accident, a Police Report is sometimes required. If one if the third party representatives have got a copy of the Police Report then we need to request a copy from them before purchasing one. The representatives may argue that we should pay half towards the Police Report. This is not true. Civil Procedures Rules (1998) requires both parties to ‘seek information from and provide information to each other about a perspective legal claim’

Pre action protocols encourage an early exchange of information to avoid litigation and support the efficient management of proceedings. The court is unlikely to look favourably on a situation where by one party would not have brought the case to court had they been in possession of all the facts, but the other party saw fit to withhold certain facts. We must disclose any evidence, which either sustains or prejudices our case.

 

After all this information is disclosed to the representatives, and they are still adamant on not providing us with the relevant information, the only way to go forward would be to request a police report.

 

Once limited particulars have been received, they should advise you on how much a police report for that particular accident should cost. Once the cost of the police report has been established and the police report reference has been provided, we are in a position to apply for a police report.

 

Check police references and address details are correct on database as specified in the Limited Particulars (often the reference numbers change, and occasionally our initial letter is forwarded to a different station).

Next, highlight claim on ‘All Claims’ screen and select ‘Create Letters’

At screen below select ‘Authorities’

At screen below select letter 2

In screen below check details and enter the PC’s name (if available) that took the report, the police station and the amount of the payable order (total cost of report).

Select ‘Create Letter’. A letter will appear as below: – (check the contents and enter your extension no and name)

Print the letter on headed paper.

Enter action on database against the claim:

Save.

At front screen enter BF date as four weeks from current date and check file status is

‘Live Case’.

Now go to HAMIS via the HA Portal or your desktop

From HAMIS

Select ‘Finance’ drop down menu.

Select ‘Payment without invoice’

Select ‘Non Project based PWI’

Select ‘PWI Control Sheets’

Select ‘New PWI Control Sheet’. The following window should appear: –

 

Click on drop down menu at ‘cost centre’ and select ‘4340 FSFC Green Claims’ or type it in the field

 

At ‘Vendor code’ use drop down menu to access search facility

 

Enter the name of the police authority (fully or partially) and select ‘search’. A list of options will appear. Highlight the relevant entry and select ‘accept’; this will transfer the vendor details into the main screen as follows:

 

 

At ‘payment date’ click on menu option to access calendar and select date five days from date PWI raised. Click on ‘OK’

At ‘Payment Details Screen’ page ‘Payment Type’ will automatically appear as

CHECK.

Select the box marked ‘Immediate Payment’.

 

Enter reason why invoice cannot be provided as:

Your Reference number: (the police report reference)

Payment required by police authority before issue of report to agency

Total claim value: £

Payment required by police authority before issue of report to Agency.

 

Enter police report reference number in ‘Description’ field.

Enter the total cost of the report.

At ‘Account code’ use drop down menu to select ‘33100-Compensation Payments’ or

type it in the field

 

Cost centre should be automatically generated as 4340 for Hemel.

Use drop down menu for ‘Aim’ to select ‘0230-Safer Travel’ or type it in the field

 

 

 

Enter date of resolution as the date police advised us of cost of report (usually on

Limited Particulars)

Use drop down menu at CIS to select X-non CIS

 

At ‘Certification’, click on box and in field ‘Enter code/description search string’ type in your surname (fully or partially) and click on search. Check the box next to your user name and click on ‘Accept’ (this will transfer your details to the main screen).

 

 

 

 

At ‘Authorisation’, click on box and in field ‘Enter code/description search string’ type in the surname (fully or partially) of the person who will be authorising this request and click on search. Check the box next to their user name (this will transfer their details to the main screen) and click on Accept.

Note: The authorising person cannot be the same as the certifying officer. Only pay band 3 and above can authorise this request.

 

 

 

Check details then click on ‘Create Order’.

‘OK’ at all screens. Check PWI when prompted. A Payment control Sheet will print (1 page only). Obtain authorisation for this.

 

Send documents to the following: –

 

To the Police – Letter requesting Police Report advising that a cheque is on its way.

 

To Payments team in Birmingham – original PWI with copy of letter requesting police report attached.

 

For Claims file  – copy of PWI with copy of letter requesting police report police attached.

 

The team manager will need to sign the copy of the PWI that is going to be sent to the payments team in Birmingham, as does the case officer that has requested the report.

 

In total (including originals) you will require 5 copies of police letter and 3 copies of the PWI.

 

 

Requesting further information from Managing Agents

Third Party Representatives often require further information regarding the incident that we are unable to provide, this may be:

 

A further breakdown of repair costs or further information regarding overhead charges

 

Photographic evidence of the damaged item

 

Clarification of the accident site, location and what furniture was actually damaged

 

A case officer may also need to request final costs from our Managing Agents once the third party representatives have admitted liability

 

 

The case officer will need to contact our Managing Agents for further information. This can be done by going into the G: drive and selecting the Managing Agents folder, the claims handler then needs to select claims contacts. This will bring up all the contact details for all areas. An email then needs to be sent requesting the information needed to the relevant area of the claim that the case officer is working on.

 

When the case officer clicks on the relevant e-mail address then it will automatically transfer it to Microsoft Outlook, allowing the case officer to contact the area worker for the relevant information that is needed.

 

Retrieving files from Archive or Write Off

Once a claim has been archived or written off it is possible to retrieve this file from archive. It may need to be retrieved for a number of reasons.

 

  • The claim may have been written off due to the fact that the insurance company have advised us that they will not be dealing with the claim, in the meantime they have passed the claim to solicitors who contact us.

 

  • Extra payment may be received from the third party representatives after the claim has been archived.

 

  • A file may have been archived in error.

If any of the above occur then the file needs to be retrieved from archive. To do this you need to -:

 

Select the main menu on the Green Claims database -:

 

You then need to select system admin and then restore -:

 

You then enter the relevant HA Claim reference and select restore record. Select OK on the following pop up menus.

 

The claim should be restored straight away on the database but the case officer still needs to request the paper file back from archive. This is done by -:

 

Going on to the G drive and selecting Impres PA Search request Form, please see a copy of this form attached.

 

The only fields that need to be filled in are:

 

Location: Bedford

 

Title: Requesting file from archive for Green Claims

 

Business Area: FS

 

Room Number: Green Claims

 

Other info: please send to Green Claims FAO case office

 

Request ordered by: relevant case officer who’s requesting the file

 

The underlined information above is what the case officer puts on to the PA Search request form.

 

Once this form has been completed a copy needs to be printed. The case officer then selects send and the form is sent electronically to One Stop Shop in Bedford.

 

You should then receive an e-mail from One Stop Shop (Bedford) advising you that they have received your request and are processing it.

 

Once the form has been submitted a spreadsheet needs to be updated to advise other team members that the file has been requested from archive.

 

The spreadsheet can be found on the G drive and is called Files requested from archive registry -:

 

The spreadsheet is very easy to follow and needs to be completed.

 

Once the claim has been worked on and completed the paper file needs to be archived – please see section 4421 regarding archiving files.

 

The spreadsheet on the G drive which the case officer filled in originally needs to be updated by the relevant case officer, entering the date of which the paper file has been sent back to archive.

 

Stolen Vehicles

 

In the event where a stolen vehicle has caused damage to the network, certain steps must be followed to ensure the correct conclusion for the case.

 

  • If the vehicle is reported stolen by its owner and the police have apprehended the culprit, the claim can be pursued via the owner’s insurance company or failing that via MIB if the owner was uninsured.

 

  • If the vehicle is reported stolen by the owner, the case officer must obtain a crime reference number either from the police or owner of the vehicle. This is to clarify that the vehicle has been stolen. If it they are able to prove that the vehicle was stolen and the police never apprehended the driver/thief, the case must be written off. We are unable to prove negligence in these cases and so must accept the word of the owner that the vehicle was actually stolen and was not caused by him/herself.

 

 

Submit Claim for Review

A case officer may a point in a claim that they are investigating, where they are unable to decide what the next best course of action is. In these cases the claim needs to be passed to the allocated case officer for them to review. The case officer needs to complete a ‘submitted for review’, which can be found on the G: Drive, in the write off folder, the case officer then needs to select ‘submitted for review/write off’.

 

 

The case officer then needs to complete the form and attach it to the front of the paper file with a paper clip. The file is then handed to the allocated case officer who are reviewing claims.

 

The allocated officer will then review the claim and add any further actions that are required on the recommendations part of the review form. The allocated officer will then pass the file back to the claims handler for them to carry out the further actions.

 

Tyre Blow Out

 

In claims where the accident is attributed to a burst tyre, we must have confirmation of this from the police records and the culprit or their insurer. Furthermore, the culprit (direct or via their insurer) must supply an MOT certificate covering the vehicle on the date of the accident.

The third party representatives should provide us with an MOT certificate and any service history that may be available on the car proving that it was in a roadworthy condition at the time of the accident. Once all the information has been received and it is obvious that the vehicle suffered a tyre blow out, we would then submit the claim for write off. As the accident could not have been avoided and was there was not any negligence on the drivers part.

It is only when we have received all this information before we can submit the claim for write off. Until the insurers prove that the vehicle did suffer a tyre blow out and was in a road worthy condition a case officer should still pursue recovery of a claim.

If the vehicle had a deflated tyre, not a tyre blow out, then it is dealt with like a normal claim. It is up to the driver/owner of a vehicle to maintain the vehicle in a road worthy condition. This includes the tyres.

Vehicle Fault

The third party representatives may advise us that their client was not at fault for the accident due to the vehicle catching fire or a mechanical failure. There are a few steps that need to be followed by the case officer:

The case officer needs to establish that a vehicle failure actually occurred. This can be done by the insurers providing us with independent evidence to prove that their clients vehicle was for example on fire. The case officer can also look at the repairs that our Managing Agents carried out, in most cases if the vehicle caught fire then there was damage caused to the road surface. The Managing Agents may also have some information on the accident circumstances.

Once the case officer has established the accident circumstances, and proves that it was a vehicle fire or mechanical failure, they need to request an MOT certificate from the third party representatives to make sure that the vehicle was in a road worthy condition at the time of the accident. The case officer also needs to request any service history. Once the representatives have provided the case officer with the information that has been requested, the case officer will need to submit the claim for write off. It was not the drivers fault that the vehicle had a mechanical failure if it was kept in a road worthy condition. NB – the third party representatives do not have to supply us with the service history of the vehicle, as it is not a legal requirement for the vehicles owner to get the vehicle serviced.

.The insurers may advise that the vehicles manufacturers are at fault for an incident and that the vehicle was faulty at the time of production. If this is the case then we need to obtain the manufacturers details and direct our claim to them.

 

If the third party representatives cannot provide us with any evidence of the accident circumstances or documentation that the vehicle was kept in a road worthy condition at the time of the accident, the case officer needs to carry on pursuing the representatives for reimbursement of our outlay.

Requesting a VQ5 from the DVLA

A VQ5 is needed to obtain owners details of a vehicle that has been in involved in an incident that caused damage to Crown Property. If somebody is driving a vehicle it does not necessarily mean that they own that vehicle. We need to request a VQ5 from the DVLA, this is done by:

 

Filling out a VQ4, which can be found on our G: Drive, under the VQ4 folder, then select blank VQ4.

 

The VQ4 needs to be completed as follows: Registration Mark – whichever vehicle registration that has been provided and you need to find out the owners, Enquirers Reference – the HA reference, Date of Event – the date the accident occurred on. The enquirers code at the top right hand corner of the VQ4 stays the same. At the bottom of the VQ4 the case officer will need to sign and date the form. The case officer then needs to print of 2 copies of the VQ4, one to be sent to the DVLA and one for the claim file. Please find a copy of a VQ4 form attached.

 

The copy that is needs to be sent is addressed to:

DVLA

Swansea SA99 1AN.

 

The DVLA will then sent us a VQ5 which advises us of who owned the vehicle at the date of the accident.

 

Weather Conditions

The third party representatives may be disputing liability due to the weather conditions at the time of the accident, i.e. strong winds, icy roads, heavy rain, sleet/snow on the roads etc.

 

In these cases the Green Claims Case Officer will need to revert back to the Managing Agents that sent them the TR430. They will need to request any information available regarding the weather conditions at the time of the accident.

 

In high value claims a meteorological report may need to requested, this is highly unlikely though as these reports are extremely expensive and in most cases not needed.

 

Once the information has been received from the Managing Agents it will need to be sent over to the third party representatives. Even if the information clarifies that the weather conditions at the time of the accident were adverse, it still is the drivers’ responsibility to adjust their driving to the relevant environment.

 

If the third party representatives are still disputing liability and if the claim is over £2000 it will need to be reviewed by the manager and if necessary referred to TSOL.

 

If the claim is under £2000 then it will need to be reviewed by the Manager and possibly submitted for write off.

 

Write Offs

 

A claim may need to be written off for the following reasons -:

 

  • Third party representatives have provided us with evidence that their client was not at fault for the accident it was in fact a vehicle fault i.e. tyre blow out, mechanical failure, fire etc
  • Third party representatives are not willing to pay one or any of the overhead charges, i.e. Agents admin fee, mobilisation/preliminaries, Contract Price Fluctuation.
  • Economic Loss
  • No culprit/vehicle details available
  • If the accident was caused by someone or something other than the driver i.e. pedestrian, animal, debris, road had not been maintained etc
  • If the claim is over 6 years old making it statute barred
  • If the vehicle that caused the damage was stolen and the driver has never been apprehended
  • If a claim needs to be referred to MIB and the final costs are under £500

If the claim falls in one of the above categories then a ‘Submitted for write off sheet’ needs to be completed. This can be found on the G drive in the write off folder under ‘Submitted for write off/review ‘,

 

 

 

Once you have completed the sheet you then pass the claim with the sheet attached onto your manager. Your manager will then review the claim. If they feel that there are more avenues that the claims handler can go through to obtain reimbursement, they will advise you of these under recommendations on the sheet. The claims handler will then action the file as necessary.

 

If the manager agrees that the claim should be written off then the claims handler needs to update the database by going into the relevant HA claim, changing the status to Pending Write Off. Under the fields where costs are entered i.e. repair costs, agents admin fee, mobilisation etc, there should be a field titled write off. The amount of the claim that is being written off needs to be entered in to this field:

 

If an invoice has not been raised for the claim that is being written off then the claims handler will need to enter the following. In the Invoice No field – None and under Template No field – 0.

 

 

An action needs to be

entered that the claim is being submitted for write off. The BF Date needs to be changed to the date that the claims handler is submitting the claim for write off.

The claim then needs to be re-assigned to the write off user name.