AF recently facilitated its latest filer/responder workshops on January 20 and 22 with 137 member company representatives in attendance. The purpose of these workshops is to drive decision quality by:   

• Sharing information to improve filing and responding effectiveness.   
• Answering questions attendees have regarding filing and responding workflows and procedures.   

The following are key takeaways from the January workshop:

Pending Total Losses (Rule 2-2)
If the total loss is paid by a responder but the salvage is pending, please follow the steps below:

• Under Feature Information in the workflow:
  • Select “Yes” for Total Loss under Company-Paid Damages.
  • Select “Yes” for Salvage Pending.
  • Enter known itemized damages for the total loss.

If a feature is pending, it cannot be selected under Feature Selection to be included in the filing.

• A responder cannot enter the previously paid total loss claim later if this process is not completed in the initial response.
• If filed as a supplement instead, a jurisdictional exclusion can be raised, placing the recovery out of jurisdiction (under Rule 2-4 for rule infraction).

Operating Expenses
Under Article First: Compulsory Provisions in the Reference Guide, insurers and self-insureds cannot recover:

• Insurer and self-insured operating expenses (associated with investigating and adjusting losses).
• Insured out-of-pocket expenses.
• Insurer or self-insured administrative fees as “costs” for pursuing a loss.

Insurer and self-insured operating expenses include:

• Costs that could apply to both insurers and self-insureds
• Costs related to adjusting the claim (investigation fees, adjuster fees, accident reconstruction, appraisals, etc.)
• Self-insured administrative fees that are costs associated with pursuing the loss.
• Costs that are not insurer or self-insured operating costs include:
  • Tow company charges (gate fees, cleanup, dolly fees, administrative fees, etc.)
  • Body shop fees (administrative fees, storage, vehicle wrapping, etc.)
  • Other third-party charges

Evidence

• Be sure to include all applicable and pertinent evidence.
• Offer explanations of items that may be confusing, such as negative supplements.
• Include formal, detailed quotes and estimates.
• For prior payments, include evidence showing the payment was cashed/cleared.
• Embed and/or highlight the specific section of lengthy evidence for the arbitrator to focus on.

Burden of Proof

• The burden of proof is the same for all parties. 
• For liability and damages, the filer must prove a prima facie case.
• If the responding company makes a dispute, they must prove their case.
• In damage disputes, the filer can rebut a challenge through a request to revisit and will get the last word.
• There will be times when a responder will not have evidence to support their damage position, such as a specific itemized invoice that was not provided, which does not invalidate the dispute.

Supplemental Filings

• The recovering company must only seek the supplemental damage amount and not include the damages from the prior hearing.
• The responding company must not declare a prior payment for the amount of the award from the prior hearing unless the filer has included that amount as part of the supplemental hearing.
• The filer should include all damage evidence, since arbitrators are not required to review evidence from the prior hearing(s), which may already be purged.

Artificial Intelligence (AI) and First Notice of Loss (FNOL)

• AI is used by some members to intake fact of loss information, which is being provided as evidence.
• When submitting this evidence, it is best to reference the page on which the information relevant to the liability determination is located.
• Highlighting the relevant information is also recommended.
• If the intake information is confusing, it may be helpful to include an adjuster note summary of the intake information as well.

AF Guides

• Do not use outdated versions of the AF Reference Guide or Guide for Arbitrators.
• Do save the Reference Guide to AF’s Agreements and Rules and the Guide for Arbitrators as favorites in your browser, if permissible. 
• Do note that the AF guides are updated on a regular basis.

Our next filer/responder workshop will be held on March 24 and 26 at 2 p.m. ET. Enroll on our website. We hope to see you there!