How to make a claim
Audience: Contact-centre agents and customer support representatives
Purpose: Guide agents to register a First Notice of Loss (FNOL) quickly, capture all required details, and set clear next steps for the customer.
Scope: Applies across products and regions; call out regional specifics where indicated (AU/SG/JP).
1) Establish entity & product
Say: “Before we begin, can I confirm your policy country (e.g., Australia/Singapore/Japan) and the product (Motor, Property/Fire, Marine, Liability, Travel, Life/Health)?”
Capture: Policy entity; product line.
2) Verify identity & policy
Do: Collect full name, DOB (if applicable), policy number, address/email, and broker (if any).
Say: “For security, I’ll verify a couple of details.”
Capture: Customer profile; policy lookup.
3) Check safety & urgent help
Say: “Is anyone injured? Are emergency services required?”
Regional cues:
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SG Motor: Advise immediate reporting and bringing the vehicle to an approved workshop within 24 hours/next working day.
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JP Auto: Offer the 24/7 accident line if language support is needed.
Capture: Safety flag; injury flag; workshop referral.
4) Explain the process & set expectations
Say: “I’ll register your claim, give you a claim number, explain documents we need, and what happens next (assessor/surveyor, repairs, timelines).”
Regional cue (AU Motor): Mention the online claim form and recommended repairers.
Capture: Channel (phone/online); expectations.
5) Capture an incident snapshot
Do: Record date/time, location, cause, circumstances, weather, third parties, witnesses, injuries, and police report number (if any).
Capture: Incident core fields.
6) Record asset/vehicle/subject details
Do:
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Motor: Rego/VIN, make/model, driver licence.
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Property/Fire: Address, affected areas.
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Marine/Cargo: Voyage, vessel, bill of lading.
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Life/Health: Condition/event.
Regional cue (Marine AU): Advise claim-form submission; TM may appoint a surveyor.
Capture: Object details by line of business.
7) Confirm coverage & discuss excess
Do: Check cover against the policy schedule; explain any applicable excess.
Regional cue (AU): Mention excess payment support and potential fast-track where there’s urgent financial need.
Capture: Coverage checked; excess approach.
8) Advise required documents
Do: Request typical items—photos, invoices/quotes, medical reports, police reports, repair estimates.
Regional cue (Property/Fire ID): May require a chronology, photos, technical reports, damaged item lists, and (for some perils) police/BMKG reports.
Capture: Required docs checklist.
9) Route to the correct channel
Do: Direct the customer to the appropriate submission route.
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AU Motor: Online claim form.
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AU Marine: Email the completed claim form to the marine team.
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SG Motor: Report at an approved workshop and/or via hotline.
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JP Auto: 24/7 accident line.
Capture: Chosen channel (URL/email/partner).
10) Register FNOL & issue a claim number
Do: Create the claim record; attach notes and documents; provide the claim/reference number; share the expected contact time from the adjuster/surveyor.
Capture: Claim number; SLA timer.
11) Set next steps & repairs
Do: Book assessment (or a surveyor for marine), provide the recommended repairer network for AU motor, and outline the inspection/triage path.
Capture: Tasks—assessment/repair.
12) Close with empathy & rights
Say (recap):
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Summary of what was captured
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Reminder to keep receipts and not admit liability
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Regional support notes (e.g., AU hardship/fast-track)
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Contact details and expected next touchpoint
Capture: Wrap-up notes; follow-ups.
Quick call script (optional)
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Open: “Thanks for calling. I’ll help you lodge your claim now.”
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Confirm entity/product: “Which country is your policy under, and what type of policy is it?”
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Verify identity: “I’ll just confirm a couple of details for security.”
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Safety check: “Is anyone injured or do you need emergency assistance?”
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Set expectations: “I’ll register the claim, explain documents we’ll need, and give you a reference number.”
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Gather incident & asset details: “Let’s go through what happened and the items involved.”
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Coverage/excess: “Based on your policy, here’s how your cover and excess apply.”
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Docs & channel: “Please provide these documents and use this submission route.”
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Close: “Your claim number is _____. We’ll contact you by ____ with next steps.”
System capture checklist (for CRM/claims platform)
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Entity & product: Policy entity; product line
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Identity & policy: Customer profile; policy lookup
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Safety: Safety and injury flags; workshop referral (if applicable)
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Process: Channel (phone/online); expectations set
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Incident: Core incident fields (date/time, location, cause, circumstances, weather, third parties, witnesses, injuries, police report #)
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Subject/asset: LOB-specific details (vehicle, property, marine cargo, life/health)
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Coverage & excess: Coverage confirmed; excess approach explained
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Documents: Requested docs checklist recorded
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Channel routing: URL/email/partner/hotline noted
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Registration: Claim/reference number; SLA timer started
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Next steps: Assessment/surveyor/repair tasks created
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Closure: Wrap-up notes; follow-up date/time set

