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SGC Net Total control of insurance claims

I just conference called GEICO with the insured. The CSR insisted she had to call the insured back on a private line to take the claim. The CSR Cynthia, made us hang up.
I called back and spoke to a supervisor and was told this was new policy. I did get the job faxed over a few minutes later. The point is SGC net is taking total control of OUR customers.

Re: SGC Net Total control of insurance claims

IMHO, They(sgc & lynx & all tpa's) are going to push every realm possible to control or restrict free trade, until someone or some multitudes stand up and force a change. Maybe they figure,,, anything is legal if no one hold them accountable!?????

Re: SGC Net Total control of insurance claims

Well, I have said in the past to force them to bring the customer into the threeway right after you make them admit on tape that they have a customer requesting your shop.

If they are then refusing to do this after that confirmation, then document the customer scheduling the repair, and the appointment for your services with your company, before the insured contacts the TPA.

In this way, you should build the evidence of Tortious Interference by the TPA in the contract of repair you have with the car owner, if the owner cancels your appointment after speaking with the TPA.

Frankly, after you get them to confirm that the customer is requesting your shop, I would think that this separate call would not happen.

THis is all about mixing the CLAIM and the JOB into what the TPA is supposedly hired to do, which is take FNOL. If the insurer isn't contracting repairs with the shop, and the job disappears after the customer schedules with you first, then the issue raised is, did the TPA contract for repairs with the customer under the guise of FNOL, and interfere with your pre-existing contract with the car owner?

I'm sitting here looking at a fax, with "JOB ASSIGNMENT" boldly written on the top of it. The customer is ours, the TPA had nothing to do with it. Who are they to "Assign the JOB"? Assign the Claim, mabey.....but the JOB? I don't think so.

Just my NON legal opinion, as always.

Re: SGC Net Total control of insurance claims

Its not going to stop until WE ALL stand up and do something about it.

The Last time SGC tried that with us the customer refused to hang up until she had the csr's confirmation with me on the line.We got the job and then the customer hung up and SGC called her back. They told her that they had a mobile tech in the area and he could be at her house in one hour or less and have her job done in 30 minutes or less. The customer laughed at the csr and told her she made her choice and she was going to stick with it.

I guess its a good thing we inform the customer of the steering issue and also explain the replacement process and the times.

Re: SGC Net Total control of insurance claims

SGC can "create" any procedure they want and claim it is the ins. co. policy.

I always call the ins. co. and ask if they are aware of the current SGC procedure and explain to them how difficult it makes it for their policyholder(some care and some simply do not). I explain how other networks process the claim which makes it easier on the policyholder. And then, if available, I have the policyholder conference in as well and explain their view of the claim process.

I always remind customers that SGC is the ONLY TPA that speaks exclusively with the policyholder. I tell them that the other major networks all let me handle the claim process, or at least most of it, with very little information needed from the policyholder. Because all the other networks allow this, we know there are no LAWS that prevent us from handling the claim for our customers. I also remind them that SGC (whom they are actually talking to, not their ins. co.) is also the ONLY major network that owns their own chain of auto glass stores.

Customers seems to understand exactly what is going on. Then when sgc calls then back in a few hours or next day to "verify" the coverage, the customers explain we already did the work, and they do not want the SGC tech performing the services.

Bottom line is we all know SGC is telling the ins. co. one thing, and telling all of us another. From pricing, to claim procedures, to "manual verifaction" terminology that allows them to steal my customer(when you call my customer later, tell them I am to busy to perform the services, and then inform them you can send your tech "right out" you are stealing).

Re: SGC Net Total control of insurance claims

Everyone it may not seem related, but check out the CAGG thread. Go register on their site they need our support, if we had a better benchmark pricing standard they couldn't dig so deep into our pockets. Even if it's never acccepted, at least we all tried.
I think NAGS plays a part in the whole insurance, TPA screw the little guy plan. YES I'M PARANOID, and also there is someone(s) out to get me

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