The ClickClaims Forms Builder contains an option that permits data to be incorporated from both Microsoft Word and ClickClaims using mail merge technology to quickly and easily generate customized letters. A Word document template, which includes ClickClaims’ Replacement Field source code, is created by a site administrator. Then, utilizing the “Create Form Letter” functionality via ClickClaims embedded Forms Builder, users can generate the template-driven letter with the claim-specific data automatically populated. This article provides a comprehensive review of this functionality.
TABLE OF CONTENTS
- Obtaining ClickClaims Replacement Field Codes
- Creating the Form Letter Template in ClickClaims
- Generating the Form Letter
- ClickClaims Replacement Field Code Table
Obtaining ClickClaims Replacement Field Codes
In order to automatically populate the Word document with the applicable claim data, you must first obtain the correct code for each ClickClaims Replacement Field needed in the letter and place it into the appropriate section of the Word template. Codes can be acquired from the table available in this article, or by a site administrator from the ClickClaims Forms Builder which is accessible from any form letter template.
Replacement Field Codes from Table:
- Locate the desired Replacement Field in the table found at the end of this article and copy the text from the “Replacement Field Code” column.
- Paste that text into the appropriate section of your Word document template.
- IMPORTANT: Replacement Field availability may differ from the table list depending on the configuration of your ClickClaims site. A complete catalog of the Replacement Fields available for your company can be obtained from the ClickClaims application itself. (See “Replacement Field Codes from ClickClaims”.)
Replacement Field Codes from ClickClaims:
- From the ClickClaims “Tools” menu bar button, users associated with the Owner or Administrator user role can mouse over “Manage” from the drop-list and select “Forms & Letters” from the flyout menu to advance into the “Manage Forms & Letters” page.
2. From this page, highlight any existing form letter template and select the 
button to open it.
3. All Replacement Fields that are available to your company can be found under the “Replacement Fields” section of the template’s “Header”, “Body”, and “Footer” tabs. Select one of those tabs to view it.
4. Next, use the 
button to expand the tree of each category and locate the Replacement Field you require.
5. Once you’ve identified the Replacement Field needed, double-click its name to place it into the section where your cursor was located in the Header/Body/Footer tab’s white textbox, or drag it from the “Replacement Field” section and drop it directly into the textbox. The Replacement Field’s code then displays in the textbox as indicated below.
6. Lastly, cut or copy that code from the textbox in ClickClaims and paste it into the area of the working Microsoft Word template where it should populate once the letter is generated from ClickClaims, as highlighted below.
7. Repeat the steps outlined above until the code for all desired Replacement Fields has been inserted into the Word document template.
Creating the Form Letter Template in ClickClaims
A form letter template must be created in ClickClaims so that it is accessible to users from within the application. The Microsoft Word template must be associated with this ClickClaims template so that when the end user chooses it from the claim’s “Documents” tab, the system can automatically generate the letter, using the templates to format the letter, populate it with the applicable claim data via the Replacement Fields, and place it into the claim as needed.
- First, ensure that the required Microsoft Word template has been completed and is accessible from your machine.
- Next, from the ClickClaims “Tools” menu bar button, users associated with the Owner or Administrator user role can mouse over “Manage” from the drop-list and select “Forms & Letters” from the flyout menu to advance into the “Manage Forms & Letters” page.
3. From this page, select the 
button.
4. Populate the required and desired fields on the “Attributes” tab ensuring “Word with Replacement Field” is selected within the “Export To” field.
- The selection of this export option displays the related “Upload Word Document (Use as Template)” field where you are required to associate the relevant Word template.
5. Click the 
button and navigate to the Word template accessible from your local machine.
- Note: Only .doc, .docx, .dotx, .dot, and .rft files are eligible to be uploaded here. An attempt to upload a file with a different extension will result in the document failing to upload and a validation message.
6. Once finished configuring the “Attributes” tab, click the 
button to save the changes to your ClickClaims Form Letter template.
7. Once saved for the first time, you can navigate to the “Body” tab to obtain codes for Replacement Fields to place in the associated Word template (as discussed in a prior section of this guide), if needed, as well as configure the form’s attributes for clients, events, roles, claim codes, etc.
a. Note: Any text added to the white textbox of this template’s “Body” tab will not be saved since this template pulls that information from the related Word template and not from the embedded ClickClaims Form Builder. The “Header” and “Footer” tabs are also unavailable as they are not necessary for this type of template.
b. Note: Any time a revision is made to the associated Word template via Microsoft Word, the updated version must be manually uploaded to the Form Letter template again via the “Upload Word Document (Use as Template)” field’s 
button found on the “Attributes” tab so that the correct template version is attached.
c. Note: To view the version of the Word template that is currently affiliated with the Form Letter template, simply left click the hyperlink located within the “View Word Document Template” field of the “Attributes” tab.
Generating the Form Letter
Once the ClickClaims Form Letter template has been properly configured by a site administrator as detailed above, the form letter can be generated on the claim by authorized users from the claim’s “Documents” tab using the “Create Form Letter” action.
- Navigate into the “Documents” tab of the desired claim record.
- Select “Create Form Letter” from the
button’s drop-list. - Highlight the relevant Form Letter template from the popup window and select the
button, to generate the letter and have it automatically save to the claim’s “Documents” tab or click the 
button to generate the letter and save it locally to your machine first.
- If the
button is selected, the user has the opportunity to modify any of the fields located in the image directly below and must then select the 
button when ready to automatically save the generated document to the claim’s “Documents” tab in ClickClaims. The user does not have the ability to modify the content of the form letter itself.
b. If the 
button is selected, the user is required to save or open the file (depending on their browser settings) locally on their device. This action nevertheless populates the letter allowing modifications to be made, but the user must then manually save it to their machine and upload the document into the claim in ClickClaims when ready using the 
or 
action found under the 
button on the claim’s “Documents” tab.
4. No matter which button is selected, however, the letter generates as a Word document using the Word template format and automatically replaces the Replacement Fields code(s) with the value found in the associated claim's applicable ClickClaims field(s).
ClickClaims Replacement Field Code Table:
It is important to note that Replacement Field availability may differ from the table shown below depending on the configuration of your ClickClaims site. A complete catalog of the Replacement Fields available for your company can be obtained from the ClickClaims application itself by a site administrator.
Replacement Field Description: | ClickClaims Field: | Replacement Field Code: |
DYNAMIC FIELDS: | ||
Today's Date (mm/dd/yyyy) | Current Date (Format = mm/dd/yyyy) | !!DtodayS!! |
Today's Date (Mon dd, yyyy) | Current Date (Format = Mon dd, yyyy) | !!DtodayF!! |
Today's Date (mm/dd/yyyy h:mm tt) | Current Date/Time (Format = mm/dd/yyyy h:mm tt) | !!DtodayL!! |
1st Assignment Note (Company User) | 1st Assignment Note created by a 'Company' user type | !!AssignmentNote!! |
1st Assignment Note (Any) | 1st Assignment Note created by any user type | !!AssignmentNoteAny!! |
Last Manager Review Note | Last Manager Review Note | !!MgrReviewNote!! |
Last Manager Review Note Entered By | Name of user who last entered a Manager Review Note | !!MgrReviewNoteEnteredBy!! |
DYNAMIC FIELDS - PERSON LOGGED IN: | ||
Full Name | First and Last Name - User Logged In | !!FullName!! |
Email Address | Primary Email Address - User Logged In | !!User-Email!! |
Company | Company Name - User Logged In | !!User-Company!! |
Title | Title (User Logged In) | !!User-Title!! |
DYNAMIC FIELDS - PERSON LOGGED IN - PHONE NUMBER(S): | ||
Office Phone | Phone Number (Office) - User Logged In | !!User-Ph(OFF)!! |
Home Phone | Phone Number (Home) - User Logged In | !!User-Ph(H)!! |
Mobile Phone | Phone Number (Mobile) - User Logged In | !!User-Ph(M)!! |
Fax Phone | Phone Number (Fax) - User Logged In | !!User-Ph(F)!! |
Other Phone | Phone Number (Other) - User Logged In | !!User-Ph(OTH)!! |
DYNAMIC FIELDS - PERSON LOGGED IN - ADDRESS(ES): | ||
Business | Address (Business) - User Logged In | !!User-Addr(B)!! |
Mailing | Address (Mailing) - User Logged In | !!User-Addr(M)!! |
Home | Address (Home) - User Logged In | !!User-Addr(H)!! |
COMPANY INFORMATON: | ||
Company Name | Company Name | !!msCompName!! |
Company Slogan | Slogan | !!msSlogan!! |
Tax ID | Tax ID # | !!msTaxID!! |
Main Address1 | Main Address 1 | !!msMainAdd1!! |
Main Address2 | Main Address 2 | !!msMainAdd2!! |
Main City | Main City | !!msMainCity!! |
Main State | Main State (Abbreviation) | !!msMainState!! |
Main Zip | Main Zip Code | !!msMainZip!! |
Main Phone | Main Phone | !!ms-Ph(Main)!! |
Alternate Phone | Alternate Phone | !!ms-Ph(Alt)!! |
Fax | Fax Number | !!ms-Fax!! |
Website | Website Address | !!ms-Website!! |
Invoice Address1 | Invoice Remit Address 1 | !!msInvAdd1!! |
Invoice Address2 | Invoice Remit Address 2 | !!msInvAdd2!! |
Invoice City | Invoice Remit City | !!msInvCity!! |
Invoice State | Invoice Remit State (Abbreviation) | !!msInvState!! |
Invoice Zip | Invoice Remit Zip Code | !!msInvZip!! |
CLAIM INFORMATION: | ||
CMS Number | CMS # | !!CMS#!! |
Carrier/Client File Number | Carrier/Client # | !!Client#!! |
IA Internal Claim Number | Internal File # | !!Internal#!! |
CAT Event Name | Event | !!Event!! |
Importer Event | Catastrophe Code | !!Importer-Event!! |
Peril Type | Peril (Name) | !!Peril!! |
Importer Peril | XactWare Peril | !!Importer-Peril!! |
Severity Code | Severity Code | !!SevCode!! |
Importer Severity Code | XactWare Severity Code | !!Importer-SeverityCode!! |
CMS File Create Date | Created (Age-Days) | !!Created!! |
CMS File Closed Date | Closed | !!Closed!! |
Date Insured First Contacted | Initial Contact | !!1stContact!! |
Loss Inspection Date | Loss Inspected | !!Inspected!! |
Date of Loss | Date of Loss | !!DOL!! |
File Type | File Type | !!FileType!! |
Date Reported | Reported | !!Reported!! |
Reporting Name | Reported By | !!ReportedBy!! |
Loss Description | Loss Description | !!LossDesc!! |
Cause of Loss | Loss Cause | !!CauseOfLoss!! |
Claimants | List of associated contacts of type "Claimant" | !!Claimants!! |
AOB Signed - Water / EMS Vendor Date | AOB Signed - Water / EMS Vendor | !!AOBSigned-WaterEMSVendorDate!! |
AOB Signed - Contractor Date | AOB Signed - Contractor | !!AOBSigned-ContractorDate!! |
Attorney LOR Received Date | Attorney LOR Received | !!AttorneyLORReceivedDate!! |
Public Adjuster Retained Date | Public Adjuster Retained | !!PublicAdjusterRetainedDate!! |
Pre-Suit Mediation Date | Pre-Suit Mediation | !!PreSuitMediationDate!! |
LSOP Served Date | LSOP Served | !!LSOPServedDate!! |
EMS Amount in Dispute | EMS Amount in Dispute | !!EMSAmountInDispute!! |
EMS Settlement Amount | EMS Settlement Amount | !!EMSSettlementAmount!! |
Amount in Dispute | Amount in Dispute | !!AmountInDispute!! |
Claim Amount | Claim Amount | !!ClaimAmount!! |
Settlement Amount | Settlement Amount | !!SettlementAmount!! |
Expense Amount | Expense Amount | !!ExpenseAmount!! |
Office Code | Office (Office Code) | !!OfficeCode!! |
Office Name | Office (Office Name) | !!OfficeName!! |
Group Code | Group (Group Code) | !!GroupCode!! |
Group Name | Group (Group Name) | !!GroupName!! |
Reopen Reason | Reopen Reason | !!ReopenReason!! |
FLAGS: | ||
ALE - Temp Housing | ALE - Temp Housing | !!IsAdditionalLivingExpense!! |
Appraisal - Carrier Request | Appraisal - Carrier Request | !!IsAppraisal!! |
Appraisal - Insured Request | Appraisal - Insured Request | !!IsAppraisal-InsuredRequest!! |
Arbitration | Arbitration | !!IsArbitration!! |
Assignment of Benefits | Assignment of Benefits | !!IsAssignmentOfBenefits!! |
Attorney Represented | Attorney Represented | !!IsAttorneyRepresented!! |
Below Deductible | Below Deductible | !!IsBelowDeductible!! |
Causation in Question | Causation in Question | !!IsCausationInQuestion!! |
Civil Remedy Notice | Civil Remedy Notice | !!IsCivilRemedyNoticeFiled!! |
Commercial | Commercial | !!IsCommercial!! |
Companion - Flood | Companion - Flood | !!CheckFloodCompanion!! |
Companion - Other | Companion - Other | !!IsCompanion!! |
Concurrent Losses | Concurrent Losses | !!HasConcurrentLosses!! |
Controverted Claim | Controverted Claim | !!IsControvertedClaim!! |
Coverage in Question | Coverage in Question | !!IsCoverageInQuestion!! |
Denial | Denial | !!IsDenial!! |
Disputed Damages | Disputed Damages | !!IsDisputedClaim!! |
DOI Complaint | DOI Complaint | !!IsDepartmentOfInsuranceComplaint!! |
EMS Capped | EMS Capped | !!IsEMSCapped!! |
Examination Under Oath | Examination Under Oath | !!IsExaminationUnderOath!! |
Executive Approved | Executive Approved | !!IsExecutiveApproved!! |
Expert - Engineer | Expert - Engineer | !!IsEngineerReferral!! |
Expert - Water / EMS | Expert - Water / EMS | !!IsExpertForWaterEMS!! |
Fast-track Claim | Fast-track Claim | !!IsFastrack!! |
Invoices - Paid | Invoices - Paid | !!AreAllInvoicesPaidInFull!! |
Invoices - Review | Invoices - Review | !!IsAccountingReview!! |
ITEL Report | ITEL Report | !!ITELReport!! |
Jury Trial | Jury Trial | !!IsJuryTrial!! |
Lien | Lien | !!IsLien!! |
Litigation | Litigation | !!IsLitigation!! |
Litigation - Multiple Suits | Litigation - Multiple Suits | !!HasMultipleSuits!! |
Mark-Off | Mark-Off | !!IsMarkOff!! |
Mediation | Mediation | !!IsMediation!! |
Mold | Mold | !!IsMold!! |
Negotiated w/ Contractor | Negotiated w/ Contractor | !!IsNegotiatedWithContractor!! |
Negotiated w/ Water / EMS | Negotiated w/ Water / EMS | !!IsNegotiatedWithWaterEMS!! |
Open Recovery Cost Capture | Open Recovery Cost Capture | !!IsOpenRecoveryCostCapture!! |
Peer Review - Water / EMS | Peer Review - Water / EMS | !!IsPeerReviewWaterEMS!! |
Preferred Contractor Network | Preferred Contractor Network | !!IsPrefContractorNetwork!! |
Prior Loss(es) | Prior Loss(es) | !!HasPriorLosses!! |
Public Adjuster | Public Adjuster | !!IsPublicAdjuster!! |
Recoverable Depreciation | Recoverable Depreciation | !!IsRecoverableDepreciation!! |
Recoverable Depreciation - Paid | Recoverable Depreciation - Paid | !!IsRecoverableDepreciationPaid!! |
Reinspection | Reinspection | !!IsReinspection!! |
Reinsurance Reportable | Reinsurance Reportable | !!IsReinsuranceReportable!! |
Reservation of Rights | Reservation of Rights | !!IsReservationOfRights!! |
Roof Report | Roof Report | !!IsRoofReportOrdered!! |
Roof Tarp | Roof Tarp | !!IsTarpUsed!! |
Salvage | Salvage | !!IsSalvage!! |
Shock / Hot File | Shock / Hot File | !!IsShock!! |
SIU | SIU | !!IsSIU!! |
SIU - DIFS Report | SIU - DIFS Report | !!IsSIU-DIFSReport!! |
Steep / Special | Steep / Special | !!IsSteepRoof!! |
Subrogation | Subrogation | !!IsSubrogation!! |
Subrogation - Recovery | Subrogation - Recovery | !!IsSubrogation-Recovery!! |
Supplement | Supplement | !!IsSupplement!! |
Total Loss | Total Loss | !!IsTotalLoss!! |
Tree On Building | Tree On Building | !!IsTreeDamage!! |
Underwriting Referral | Underwriting Referral | !!IsUnderwritingReferral!! |
Wind - Excluded | Wind - Excluded | !!X-Wind!! |
Wind - Only | Wind - Only | !!IsWindOnly!! |
Withdrawn | Withdrawn | !!IsWithdraw!! |
COMPANY ADJUSTER INFORMATION: | ||
Employee ID | Employee ID | !!EmployeeID!! |
Adjuster First Name | First Name | !!Adj-First!! |
Adjuster Last Name | Last Name | !!Adj-Last!! |
Adjuster Title | Title | !!Adj-Title!! |
Adjuster Company | Company Name | !!Adj-Company!! |
Adjuster Home Address | Address 1 (Home) | !!AdjStreet(H)!! |
Adjuster Home City | City (Home) | !!AdjCity(H)!! |
Adjuster Home State | State (Home) | !!AdjState(H)!! |
Adjuster Home Zip | Zip Code (Home) | !!AdjZip(H)!! |
Adjuster Phone - Home | Phone Number (Home) | !!Adj-Ph(H)!! |
Adjuster Phone - Mobile | Phone Number (Mobile) | !!Adj-Ph(M)!! |
Adjuster Phone - Office | Phone Number (Office) | !!Adj-Ph(W)!! |
Adjuster Phone Ext. - Office | Extension (Office) | !!Adj-Ph(W)Ext!! |
Adjuster Phone - Other | Phone Number (Other) | !!Adj-Ph(O)!! |
Adjuster Phone - Fax | Phone Number (Fax) | !!Adj-Ph(F)!! |
Adjuster Email Address | Primary Email Address | !!Adj-Email!! |
Adjuster CAT Address | Address 1 (CAT) | !!AdjStreet(c)!! |
Adjuster CAT Address City | City (CAT) | !!AdjCity(c)!! |
Adjuster CAT Address State | State (CAT) (Abbreviation) | !!AdjState(c)!! |
Adjuster CAT Address Zip | Zip Code (CAT) | !!AdjZip(c)!! |
COMPANY ADJUSTER 2 INFORMATION: | ||
Adjuster 2 - Employee ID | Employee ID | !!Adj2-EmployeeID!! |
Adjuster 2 Role | Role | !!Adj2-Role!! |
Adjuster 2 First Name | First Name | !!Adj2-First!! |
Adjuster 2 Last Name | Last Name | !!Adj2-Last!! |
Adjuster 2 Title | Title | !!Adj2-Title!! |
Adjuster 2 Company | Company Name | !!Adj2-Company!! |
Adjuster 2 Home Address | Address 1 (Home) | !!Adj2-Street(H)!! |
Adjuster 2 Home City | City (Home) | !!Adj2-City(H)!! |
Adjuster 2 Home State | State (Home) (Abbreviation) | !!Adj2-State(H)!! |
Adjuster 2 Home Zip | Zip Code (Home) | !!Adj2-Zip(H)!! |
Adjuster 2 Phone - Home | Phone Number (Home) | !!Adj2-Ph(H)!! |
Adjuster 2 Phone - Mobile | Phone Number (Mobile) | !!Adj2-Ph(M)!! |
Adjuster 2 Phone - Office | Phone Number (Office) | !!Adj2-Ph(W)!! |
Adjuster 2 Phone Ext. - Office | Extension (Office) | !!Adj2-Ph(W)Ext!! |
Adjuster 2 Phone - Other | Phone Number (Other) | !!Adj2-Ph(O)!! |
Adjuster 2 Phone - Fax | Phone Number (Fax) | !!Adj2-Ph(F)!! |
Adjuster 2 Email Address | Primary Email Address | !!Adj2-Email!! |
Adjuster 2 CAT Address | Address 1 (CAT) | !!Adj2-Street(c)!! |
Adjuster 2 CAT Address City | City (CAT) | !!Adj2-City(c)!! |
Adjuster 2 CAT Address State | State (CAT) (Abbreviation) | !!Adj2-State(c)!! |
Adjuster 2 CAT Address Zip | Zip Code (CAT) | !!Adj2-Zip(c)!! |
COMPANY ADJUSTER 3 INFORMATION: | ||
Adjuster 3 - Employee ID | Employee ID | !!Adj3-EmployeeID!! |
Adjuster 3 Role | Role | !!Adj3-Role!! |
Adjuster 3 First Name | First Name | !!Adj3-First!! |
Adjuster 3 Last Name | Last Name | !!Adj3-Last!! |
Adjuster 3 Title | Title | !!Adj3-Title!! |
Adjuster 3 Company | Company Name | !!Adj3-Company!! |
Adjuster 3 Home Address | Address 1 (Home) | !!Adj3-Street(H)!! |
Adjuster 3 Home City | City (Home) | !!Adj3-City(H)!! |
Adjuster 3 Home State | State (Home) (Abbreviation) | !!Adj3-State(H)!! |
Adjuster 3 Home Zip | Zip Code (Home) | !!Adj3-Zip(H)!! |
Adjuster 3 Phone - Home | Phone Number (Home) | !!Adj3-Ph(H)!! |
Adjuster 3 Phone - Mobile | Phone Number (Mobile) | !!Adj3-Ph(M)!! |
Adjuster 3 Phone - Office | Phone Number (Office) | !!Adj3-Ph(W)!! |
Adjuster 3 Phone Ext. - Office | Extension (Office) | !!Adj3-Ph(W)Ext!! |
Adjuster 3 Phone - Other | Phone Number (Other) | !!Adj3-Ph(O)!! |
Adjuster 3 Phone - Fax | Phone Number (Fax) | !!Adj3-Ph(F)!! |
Adjuster 3 Email Address | Primary Email Address | !!Adj3-Email!! |
Adjuster 3 CAT Address | Address 1 (CAT) | !!Adj3-Street(c)!! |
Adjuster 3 CAT Address City | City (CAT) | !!Adj3-City(c)!! |
Adjuster 3 CAT Address State | State (CAT) (Abbreviation) | !!Adj3-State(c)!! |
Adjuster 3 CAT Address Zip | Zip Code (CAT) | !!Adj3-Zip(c)!! |
COMPANY EXAMINER INFORMATION: | ||
Company Examiner First Name | First Name | !!CoExam-First!! |
Company Examiner Last Name | Last Name | !!CoExam-Last!! |
Company Examiner Home Address | Address 1 (Home) | !!CoExam-Street(H)!! |
Company Examiner Home City | City (Home) | !!CoExam-City(H)!! |
Company Examiner Home State | State (Home) (Abbreviation) | !!CoExam-State(H)!! |
Company Examiner Home Zip | Zip Code (Home) | !!CoExam-Zip(H)!! |
Company Examiner Phone - Home | Phone Number (Home) | !!CoExam-Ph(H)!! |
Company Examiner Phone - Mobile | Phone Number (Mobile) | !!CoExam-Ph(M)!! |
Company Examiner Phone - Office | Phone Number (Office) | !!CoExam-Ph(W)!! |
Company Examiner Phone Ext. - Office | Extension (Office) | !!CoExam-Ph(W)Ext!! |
Company Examiner Phone - Other | Phone Number (Other) | !!CoExam-Ph(O)!! |
Company Examiner Phone - Fax | Phone Number (Fax) | !!CoExam-Ph(F)!! |
Company Examiner Email Address | Primary Email Address | !!CoExam-Email!! |
Company Examiner CAT Address | Address 1 (CAT) | !!CoExam-Street(c)!! |
Company Examiner CAT Address City | City (CAT) | !!CoExam-City(c)!! |
Company Examiner CAT Address State | State (CAT) (Abbreviation) | !!CoExam-State(c)!! |
Company Examiner CAT Address Zip | Zip Code (CAT) | !!CoExam-Zip(c)!! |
SUPERVISING ADJUSTER INFORMATION: | ||
Supervising Adjuster First Name | First Name | !!SupAdj-First!! |
Supervising Adjuster Last Name | Last Name | !!SupAdj-Last!! |
Supervising Adjuster Home Address | Address 1 (Home) | !!SupAdj-Street(H)!! |
Supervising Adjuster Home City | City (Home) | !!SupAdj-City(H)!! |
Supervising Adjuster Home State | State (Home) (Abbreviation) | !!SupAdj-State(H)!! |
Supervising Adjuster Home Zip | Zip Code (Home) | !!SupAdj-Zip(H)!! |
Supervising Adjuster Phone - Home | Phone Number (Home) | !!SupAdj-Ph(H)!! |
Supervising Adjuster Phone - Mobile | Phone Number (Mobile) | !!SupAdj-Ph(M)!! |
Supervising Adjuster Phone - Office | Phone Number (Office) | !!SupAdj-Ph(W)!! |
Supervising Adjuster Phone Ext. - Office | Extension (Office) | !!SupAdj-Ph(W)Ext!! |
Supervising Adjuster Phone - Other | Phone Number (Other) | !!SupAdj-Ph(O)!! |
Supervising Adjuster Phone - Fax | Phone Number (Fax) | !!SupAdj-Ph(F)!! |
Supervising Adjuster Email Address | Primary Email Address | !!SupAdj-Email!! |
Supervising Adjuster CAT Address | Address 1 (CAT) | !!SupAdj-Street(c)!! |
Supervising Adjuster CAT Address City | City (CAT) | !!SupAdj-City(c)!! |
Supervising Adjuster CAT Address State | State (CAT) (Abbreviation) | !!SupAdj-State(c)!! |
Supervising Adjuster CAT Address Zip | Zip Code (CAT) | !!SupAdj-Zip(c)!! |
FILE REVIEWER INFORMATION: | ||
File Reviewer - Employee ID | Employee ID | !!FileReviewer-EmployeeID!! |
File Reviewer First Name | First Name | !!FileReviewer-First!! |
File Reviewer Last Name | Last Name | !!FileReviewer-Last!! |
File Reviewer Title | Title | !!FileReviewer-Title!! |
File Reviewer Company | Company Name | !!FileReviewer-Company!! |
File Reviewer Home Address | Address 1 (Home) | !!FileReviewer-Street(H)!! |
File Reviewer Home City | City (Home) | !!FileReviewer-City(H)!! |
File Reviewer Home State | State (Home) (Abbreviation) | !!FileReviewer-State(H)!! |
File Reviewer Home Zip | Zip Code (Home) | !!FileReviewer-Zip(H)!! |
File Reviewer Phone - Home | Phone Number (Home) | !!FileReviewer-Ph(H)!! |
File Reviewer Phone - Mobile | Phone Number (Mobile) | !!FileReviewer-Ph(M)!! |
File Reviewer Phone - Office | Phone Number (Office) | !!FileReviewer-Ph(W)!! |
File Reviewer Phone Ext. - Office | Extension (Office) | !!FileReviewer-Ph(W)Ext!! |
File Reviewer Phone - Other | Phone Number (Other) | !!FileReviewer-Ph(O)!! |
File Reviewer Phone - Fax | Phone Number (Fax) | !!FileReviewer-Ph(F)!! |
File Reviewer Email Address | Primary Email Address | !!FileReviewer-Email!! |
File Reviewer CAT Address | Address 1 (CAT) | !!FileReviewer-Street(c)!! |
File Reviewer CAT Address City | City (CAT) | !!FileReviewer-City(c)!! |
File Reviewer CAT Address State | State (CAT) (Abbreviation) | !!FileReviewer-State(c)!! |
File Reviewer CAT Address Zip | Zip Code (CAT) | !!FileReviewer-Zip(c)!! |
TEAM LEAD INFORMATION: | ||
Team Lead First Name | First Name | !!TL-First!! |
Team Lead Last Name | Last Name | !!TL-Last!! |
Team Lead Home Address | Address 1 (Home) | !!TL-Street(H)!! |
Team Lead Home City | City (Home) | !!TL-City(H)!! |
Team Lead Home State | State (Home) (Abbreviation) | !!TL-State(H)!! |
Team Lead Home Zip | Zip Code (Home) | !!TL-Zip(H)!! |
Team Lead Phone - Home | Phone Number (Home) | !!TL-Ph(H)!! |
Team Lead Phone - Mobile | Phone Number (Mobile) | !!TL-Ph(M)!! |
Team Lead Phone - Office | Phone Number (Office) | !!TL-Ph(W)!! |
Team Lead Phone Ext. - Office | Extension (Office) | !!TL-Ph(W)Ext!! |
Team Lead Phone - Other | Phone Number (Other) | !!TL-Ph(O)!! |
Team Lead Phone - Fax | Phone Number (Fax) | !!TL-Ph(F)!! |
Team Lead Email Address | Primary Email Address | !!TL-Email!! |
Team Lead CAT Address | Address 1 (CAT) | !!TL-Street(c)!! |
Team Lead CAT Address City | City (CAT) | !!TL-City(c)!! |
Team Lead CAT Address State | State (CAT) (Abbreviation) | !!TL-State(c)!! |
Team Lead CAT Address Zip | Zip Code (CAT) | !!TL-Zip(c)!! |
CARRIER / CLIENT INFORMATION: | ||
Carrier/Client Name | Client Name | !!ClientName!! |
Carrier/Client Display Name | Client Display Name | !!ClientDisplayName!! |
Carrier/Client Address1 | Main Office Address 1 | !!ClientAdd1!! |
Carrier/Client Address2 | Main Office Address 2 | !!ClientAdd2!! |
Carrier/Client City | Main Office City | !!ClientCity!! |
Carrier/Client State | Main Office State (Abbreviation) | !!ClientState!! |
Carrier/Client Zip | Main Office Zip | !!ClientZip!! |
Carrier/Client Phone - Main | Main Office Primary Phone | !!Client-Ph(1)!! |
Carrier/Client Phone - Alternate | Main Office Alternate Phone | !!Client-Ph(2)!! |
Carrier/Client Phone - Fax | Main Office Fax | !!Client-Ph(F)!! |
Carrier/Client Email Address | Main Office Email | !!Client-Email!! |
Carrier/Client Threshold Value | Reserves Threshold | !!Client-$MAX$!! |
Carrier/Client Invoice Address1 | Invoice Office Address 1 | !!ClientInvAdd1!! |
Carrier/Client Invoice Address2 | Invoice Office Address 2 | !!ClientInvAdd2!! |
Carrier/Client Invoice City | Invoice Office City | !!ClientInvCity!! |
Carrier/Client Invoice State | Invoice Office State (Abbreviation) | !!ClientInvState!! |
Carrier/Client Invoice Zip | Invoice Office Zip | !!ClientInvZip!! |
CARRIER / CLIENT INFORMATION - CLIENT EXAMINER: | ||
Examiner First Name | First Name | !!Exam-First!! |
Examiner Last Name | Last Name | !!Exam-Last!! |
Examiner Title | Title | !!Exam-Title!! |
Examiner Phone - Home | Phone Number (Home) | !!Exam-Ph(H)!! |
Examiner Phone - Mobile | Phone Number (Mobile) | !!Exam-Ph(M)!! |
Examiner Phone - Office | Phone Number (Office) | !!Exam-Ph(W)!! |
Examiner Phone Ext. - Office | Extension (Office) | !!Exam-Ph(W)Ext!! |
Examiner Phone - Other | Phone Number (Other) | !!Exam-Ph(O)!! |
Examiner Phone - Fax | Phone Number (Fax) | !!Exam-Ph(F)!! |
Examiner Email Address | Primary Email Address | !!Exam-Email!! |
INSURED INFORMATION: | ||
Insured First Name | Insured First Name (Named Insured) | !!Ins-First!! |
Insured Last Name | Insured Last Name (Name Insured) | !!Ins-Last!! |
Insured Home Phone | Insured Home Phone (Named Insured) | !!Ins-Ph(H)!! |
Insured Business Phone | Insured Office Phone (Named Insured) | !!Ins-Ph(W)!! |
Insured Mobile Phone | Insured Other Phone (Named Insured) | !!Ins-Ph(M)!! |
Insured Email | Insured Primary Email (Named Insured) | !!Ins-Email!! |
Co-Insured Name | Co-Insured First and Last Name | !!Co-Insured!! |
INSURED INFORMATION - LOSS ADDRESS: | ||
Loss Address1 | Insured Loss Location Address 1 | !!LossAdd1!! |
Loss Address2 | Insured Loss Location Address 2 | !!LossAdd2!! |
Loss City | Insured Loss Location City | !!LossCity!! |
Loss State | Insured Loss Location State (Abbreviation) | !!LossState!! |
Loss Zip | Insured Loss Location Zip | !!LossZip!! |
Loss County | Insured Loss Location County/Parish | !!LossCounty!! |
INSURED INFORMATION - MAILING ADDRESS: | ||
Insured Mailing Address1 | Insured Mailing Address 1 | !!MailAdd1!! |
Insured Mailing Address2 | Insured Mailing Address 2 | !!MailAdd2!! |
Insured Mailing Address City | Insured Mailing City | !!MailCity!! |
Insured Mailing Address State | Insured Mailing State (Abbreviation) | !!MailState!! |
Insured Mailing Address Zip | Insured Mailing Zip | !!MailZip!! |
MORTGAGE INFORMATION: | ||
Mortgage Company Name | Mortgage Company Name | !!MortCo!! |
Mortgage Contact First Name | Mortgage Contact First Name | !!Mort-ContactFirstName!! |
Mortgage Contact Last Name | Mortgage Contact Last Name | !!Mort-ContactLastName!! |
Mortgage Company Address1 | Mortgage Address 1 | !!Mort-Add1!! |
Mortgage Company Address2 | Mortgage Address 2 | !!Mort-Add2!! |
Mortgage Company City | Mortgage City | !!Mort-City!! |
Mortgage Company State | Mortgage State (Abbreviation) | !!Mort-State!! |
Mortgage Company Zip | Mortgage Zip | !!Mort-Zip!! |
Mortgage Company Phone - Office | Mortgage Phone (Office) | !!Mort-Ph!! |
Mortgage Company Fax | Mortgage Phone (Fax) | !!Mort-Fax!! |
Mortgage Email | Mortgage Email | !!Mort-Email!! |
SECOND MORTGAGE INFORMATION: | ||
Second Mortgage Company Name | Second Mortgage Company Name | !!2nd-MortCo!! |
Second Mortgage Contact First Name | Second Mortgage Contact First Name | !!2nd-Mort-ContactFirstName!! |
Second Mortgage Contact Last Name | Second Mortgage Contact Last Name | !!2nd-Mort-ContactLastName!! |
Second Mortgage Company Address1 | Second Mortgage Address 1 | !!2nd-Mort-Add1!! |
Second Mortgage Company Address2 | Second Mortgage Address 2 | !!2nd-Mort-Add2!! |
Second Mortgage Company City | Second Mortgage City | !!2nd-Mort-City!! |
Second Mortgage Company State | Second Mortgage State (Abbreviation) | !!2nd-Mort-State!! |
Second Mortgage Company Zip | Second Mortgage Zip | !!2nd-Mort-Zip!! |
Second Mortgage Company Phone - Office | Second Mortgage Company Phone (Office) | !!2nd-Mort-Ph!! |
Second Mortgage Company Fax | Second Mortgage Company Phone (Fax) | !!2nd-Mort-Fax!! |
Second Mortgage Email | Second Mortgage Email | !!2nd-Mort-Email!! |
POLICY INFORMATION: | ||
Policy Number | Policy # | !!Pol#!! |
Policy Type | Policy Type | !!PolType!! |
Coverage Template | Coverage Template | !!CovType!! |
Deductible | Deductible Amount | !!Deductible!! |
Policy Start Date | Policy Start Date | !!PolStart!! |
Policy End Date | Policy End Date | !!PolEnd!! |
Endorsements | Endorsements | !!Endorsements!! |
Policy Program | Policy Program | !!PolicyProgram!! |
POLICY INFORMATION - LIMITS (PROPERTY): | ||
Dwelling | Limit Dwelling Amount | !!Limits-Prop-Dwelling!! |
Appurtenant Structures | Limit Appurtenant Structures Amount | !!Limits-Prop-APS!! |
Contents | Limit Contents Amount | !!Limits-Prop-Contents!! |
Additional Living Expense | Limit Additional Living Expense Amount | !!Limits-Prop-ALE!! |
Loss of Rent | Limit Loss Of Rent Amount | !!Limits-Prop-LossOfRent!! |
Business Interruption | Limit Business Interruption Amount | !!Limits-Prop-BI!! |
Code Upgrade | Limit Code Upgrade Amount | !!Limits-Prop-CodeUpgrade!! |
Medical Payments | Limit Medical Payments Amount | !!Limits-Prop-MedPay!! |
Liability | Limit Liability Amount | !!Limits-Prop-Liability!! |
Other | Limit Other Amount | !!Limits-Prop-Other!! |
Other Description | Limit Other Description | !!Limits-Prop-OtherDesc!! |
Loss Adjustment Expense | Limit Loss Adjustment Expense Amount | !!Limits-Prop-LAE!! |
Defense Cost Containment | Limit Defense Cost Containment Amount | !!Limits-Prop-DCC!! |
Adjuster Expense | Limit Property Expense 1 Amount (Dynamic) | !!Limits-Prop-AdjExp!! |
Attorney Coverage Expense | Limit Property Expense 2 Amount (Dynamic) | !!Limits-Prop-AttyCovExp!! |
Expert Cost | Limit Property Expense 3 Amount (Dynamic) | !!Limits-Prop-ExpertCost!! |
TPA Expense | Limit Property Expense 4 Amount (Dynamic) | !!Limits-Prop-TPAExpense!! |
POLICY INFORMATION - LIMITS (AUTO): | ||
Property Damage | Vehicle Limit Property Damage Amount | !!Cov-Auto-PD!! |
Bodily Injury (Per Person) | Vehicle Limit Bodily Injury Limit Per Person Amount | !!Cov-Auto-BIPerPerson!! |
Bodily Injury (Per Accident) | Vehicle Limit Bodily Injury Limit Per Accident Amount | !!Cov-Auto-BIPerAccident!! |
Collision | Vehicle Limit Collision Deductible Amount | !!Cov-Auto-COLL!! |
Comprehensive | Vehicle Limit Comprehensive Deductible Amount | !!Cov-Auto-COMP!! |
Collision Damage Waiver | Vehicle Limit Collision Damage Waiver Deductible Amount | !!Cov-Auto-CDW!! |
Uninsured Motorist Property Damage | Vehicle Limit Uninsured Motorist Property Damage Amount | !!Cov-Auto-UMPD!! |
Uninsured Motorist Bodily Injury (Per Person) | Vehicle Limit Uninsured Motorist Bodily Injury Limit Per Person Amount | !!Cov-Auto-UMBIPerPerson!! |
Uninsured Motorist Bodily Injury (Per Accident) | Vehicle Limit Uninsured Motorist Bodily Injury Limit Per Accident Amount | !!Cov-Auto-UMBIPerAccident!! |
Under-Insured Motorist Bodily Injury (Per Person) | Vehicle Limit Under-Insured Motorist Bodily Injury Limit Per Person Amount | !!Cov-Auto-UIMBIPerPerson!! |
Under-Insured Motorist Bodily Injury (Per Accident) | Vehicle Limit Under-Insured Motorist Bodily Injury Limit Per Accident Amount | !!Cov-Auto-UIMBIPerAccident!! |
Medical Payments | Vehicle Limit Medical Payments Amount | !!Cov-Auto-MP!! |
Rental Reimbursement | Vehicle Limit Rental Reimbursement Amount | !!Cov-Auto-RENT!! |
Towing and Labor | Vehicle Limit Towing And Labor Amount | !!Cov-Auto-TOW!! |
Roadside Assistance | Vehicle Limit Roadside Assistance Amount | !!Cov-Auto-ROADSIDE!! |
Additional Custom Parts or Equipment | Vehicle Limit Additional Custom Parts Or Equipment Amount | !!Cov-Auto-ACPE!! |
POLICY INFORMATION - RESERVES (PROPERTY): | ||
Dwelling | Reserve Dwelling Amount | !!Res-Prop-Dwelling!! |
Appurtenant Structures | Reserve Appurtenant Structures Amount | !!Res-Prop-APS!! |
Contents | Reserve Contents Amount | !!Res-Prop-Contents!! |
Additional Living Expense | Reserve Additional Living Expense Amount | !!Res-Prop-ALE!! |
Loss of Rent | Reserve Loss Of Rent Amount | !!Res-Prop-LossOfRent!! |
Business Interruption | Reserve Business Interruption Amount | !!Res-Prop-BI!! |
Code Upgrade | Reserve Code Upgrade Amount | !!Res-Prop-CodeUpgrade!! |
Medical Payments | Reserve Medical Payments Amount | !!Res-Prop-MedPay!! |
Liability | Reserve Liability Amount | !!Res-Prop-Liability!! |
Other | Reserve Other Amount | !!Res-Prop-Other!! |
Other Description | Reserve Other Description | !!Res-Prop-OtherDesc!! |
Loss Adjustment Expense | Reserve Loss Adjustment Expense Amount | !!Res-Prop-LAE!! |
Defense Cost Containment | Reserve Defense Cost Containment Amount | !!Res-Prop-DCC!! |
Adjuster Expense | Reserve Property Expense 1 Amount (Dynamic) | !!Res-Prop-AdjExp!! |
Attorney Coverage Expense | Reserve Property Expense 2 Amount (Dynamic) | !!Res-Prop-AttyCovExp!! |
Expert Cost | Reserve Property Expense 3 Amount (Dynamic) | !!Res-Prop-ExpertCost!! |
TPA Expense | Reserve Property Expense 4 Amount (Dynamic) | !!Res-Prop-TPAExpense!! |
Reserves Total | Reserve Total Amount | !!ResTot!! |
POLICY INFORMATION - RESERVES (AUTO): | ||
Property Damage | Vehicle Reserve Property Damage Amount | !!Res-Auto-PD!! |
Bodily Injury (Per Person) | Vehicle Reserve Bodily Injury Limit Per Person Amount | !!Res-Auto-BIPerPerson!! |
Bodily Injury (Per Accident) | Vehicle Reserve Bodily Injury Limit Per Accident Amount | !!Res-Auto-BIPerAccident!! |
Collision | Vehicle Reserve Collision Deductible Amount | !!Res-Auto-COLL!! |
Comprehensive | Vehicle Reserve Comprehensive Deductible Amount | !!Res-Auto-COMP!! |
Collision Damage Waiver | Vehicle Reserve Collision Damage Waiver Deductible Amount | !!Res-Auto-CDW!! |
Uninsured Motorist Property Damage | Vehicle Reserve Uninsured Motorist Property Damage Amount | !!Res-Auto-UMPD!! |
Uninsured Motorist Bodily Injury (Per Person) | Vehicle Reserve Uninsured Motorist Bodily Injury Limit Per Person Amount | !!Res-Auto-UMBIPerPerson!! |
Uninsured Motorist Bodily Injury (Per Accident) | Vehicle Reserve Uninsured Motorist Bodily Injury Limit Per Accident Amount | !!Res-Auto-UMBIPerAccident!! |
Under-Insured Motorist Bodily Injury (Per Person) | Vehicle Reserve Under-Insured Motorist Bodily Injury Limit Per Person Amount | !!Res-Auto-UIMBIPerPerson!! |
Under-Insured Motorist Bodily Injury (Per Accident) | Vehicle Reserve Under-Insured Motorist Bodily Injury Limit Per Accident Amount | !!Res-Auto-UIMBIPerAccident!! |
Medical Payments | Vehicle Reserve Medical Payments Amount | !!Res-Auto-MP!! |
Rental Reimbursement | Vehicle Reserve Rental Reimbursement Amount | !!Res-Auto-RENT!! |
Towing and Labor | Vehicle Reserve Towing And Labor Amount | !!Res-Auto-TOW!! |
Roadside Assistance | Vehicle Reserve Roadside Assistance Amount | !!Res-Auto-ROADSIDE!! |
Additional Custom Parts or Equipment | Vehicle Reserve Additional Custom Parts Or Equipment Amount | !!Res-Auto-ACPE!! |
Expense | Vehicle Reserve Expense Amount | !!Res-Auto-EXPENSE!! |
Adjuster Expense | Vehicle Reserve Expense 1 Amount (Dynamic) | !!Res-Auto-AdjExp!! |
Attorney Coverage Expense | Vehicle Reserve Expense 2 Amount (Dynamic) | !!Res-Auto-AttyCovExp!! |
Defense Cost Containment | Vehicle Reserve Expense 3 Amount (Dynamic) | !!Res-Auto-DCC!! |
Expert Cost | Vehicle Reserve Expense 4 Amount (Dynamic) | !!Res-Auto-ExpertCost!! |
TPA Expense | Vehicle Reserve Expense 5 Amount (Dynamic) | !!Res-Auto-TPAExpense!! |
Reserves Total | Reserve Total Amount | !!ResTot!! |
POLICY INFORMATION - INDEMNITY (PROPERTY): | ||
Dwelling | Indemnity Dwelling Amount | !!Ind-Prop-Dwelling!! |
Appurtenant Structures | Indemnity Appurtenant Structures Amount | !!Ind-Prop-APS!! |
Contents | Indemnity Contents Amount | !!Ind-Prop-Contents!! |
Additional Living Expense | Indemnity Additional Living Expense Amount | !!Ind-Prop-ALE!! |
Loss of Rent | Indemnity Loss Of Rent Amount | !!Ind-Prop-LossOfRent!! |
Business Interruption | Indemnity Business Interruption Amount | !!Ind-Prop-BI!! |
Code Upgrade | Indemnity Code Upgrade Amount | !!Ind-Prop-CodeUpgrade!! |
Medical Payments | Indemnity Medical Payments Amount | !!Ind-Prop-MedPay!! |
Liability | Indemnity Liability Amount | !!Ind-Prop-Liability!! |
Other | Indemnity Other Amount | !!Ind-Prop-Other!! |
Other Description | Indemnity Other Description | !!Ind-Prop-OtherDesc!! |
Loss Adjustment Expense | Indemnity Loss Adjustment Expense Amount | !!Ind-Prop-LAE!! |
Defense Cost Containment | Indemnity Defense Cost Containment Amount | !!Ind-Prop-DCC!! |
Adjuster Expense | Indemnity Property Expense 1 Amount (Dynamic) | !!Ind-Prop-AdjExp!! |
Attorney Coverage Expense | Indemnity Property Expense 2 Amount (Dynamic) | !!Ind-Prop-AttyCovExp!! |
Expert Cost | Indemnity Property Expense 3 Amount (Dynamic) | !!Ind-Prop-ExpertCost!! |
TPA Expense | Indemnity Property Expense 4 Amount (Dynamic) | !!Ind-Prop-TPAExpense!! |
Gross Loss | Gross Loss | !!Ind-GrossLoss!! |
Total Indemnity Paid | Paid Indemnity | !!Ind-TotalPaid!! |
POLICY INFORMATION - INDEMNITY (AUTO): | ||
Property Damage | Vehicle Indemnity Property Damage Amount | !!Ind-Auto-PD!! |
Bodily Injury (Per Person) | Vehicle Indemnity Bodily Injury Limit Per Person Amount | !!Ind-Auto-BIPerPerson!! |
Bodily Injury (Per Accident) | Vehicle Indemnity Bodily Injury Limit Per Accident Amount | !!Ind-Auto-BIPerAccident!! |
Collision | Vehicle Indemnity Collision Deductible Amount | !!Ind-Auto-COLL!! |
Comprehensive | Vehicle Indemnity Comprehensive Deductible Amount | !!Ind-Auto-COMP!! |
Collision Damage Waiver | Vehicle Indemnity Collision Damage Waiver Deductible Amount | !!Ind-Auto-CDW!! |
Uninsured Motorist Property Damage | Vehicle Indemnity Uninsured Motorist Property Damage Amount | !!Ind-Auto-UMPD!! |
Uninsured Motorist Bodily Injury (Per Person) | Vehicle Indemnity Uninsured Motorist Bodily Injury Limit Per Person Amount | !!Ind-Auto-UMBIPerPerson!! |
Uninsured Motorist Bodily Injury (Per Accident) | Vehicle Indemnity Uninsured Motorist Bodily Injury Limit Per Accident Amount | !!Ind-Auto-UMBIPerAccident!! |
Under-Insured Motorist Bodily Injury (Per Person) | Vehicle Indemnity Under-Insured Motorist Bodily Injury Limit Per Person Amount | !!Ind-Auto-UIMBIPerPerson!! |
Under-Insured Motorist Bodily Injury (Per Accident) | Vehicle Indemnity Under-Insured Motorist Bodily Injury Limit Per Accident Amount | !!Ind-Auto-UIMBIPerAccident!! |
Medical Payments | Vehicle Indemnity Medical Payments Amount | !!Ind-Auto-MP!! |
Rental Reimbursement | Vehicle Indemnity Rental Reimbursement Amount | !!Ind-Auto-RENT!! |
Towing and Labor | Vehicle Indemnity Towing And Labor Amount | !!Ind-Auto-TOW!! |
Roadside Assistance | Vehicle Indemnity Roadside Assistance Amount | !!Ind-Auto-ROADSIDE!! |
Additional Custom Parts or Equipment | Vehicle Indemnity Additional Custom Parts Or Equipment Amount | !!Ind-Auto-ACPE!! |
Expense | Vehicle Indemnity Expense Amount | !!Ind-Auto-EXPENSE!! |
Adjuster Expense | Vehicle Indemnity Expense 1 Amount (Dynamic) | !!Ind-Auto-AdjExp!! |
Attorney Coverage Expense | Vehicle Indemnity Expense 2 Amount (Dynamic) | !!Ind-Auto-AttyCovExp!! |
Defense Cost Containment | Vehicle Indemnity Expense 3 Amount (Dynamic) | !!Ind-Auto-DCC!! |
Expert Cost | Vehicle Indemnity Expense 4 Amount (Dynamic) | !!Ind-Auto-ExpertCost!! |
TPA Expense | Vehicle Indemnity Expense 5 Amount (Dynamic) | !!Ind-Auto-TPAExpense!! |
Gross Loss | Gross Loss | !!Ind-GrossLoss!! |
Total Indemnity Paid | Paid Indemnity | !!Ind-TotalPaid!! |
POLICY INFORMATION - AGENT INFORMATION: | ||
Agent Company Name | Agent Company Name | !!AgtCo!! |
Agent First Name | Agent First Name | !!Agt-First!! |
Agent Last Name | Agent Last Name | !!Agt-Last!! |
Agent Address1 | Agent Address 1 | !!Agt-Add1!! |
Agent Address2 | Agent Address 2 | !!Agt-Add2!! |
Agent City | Agent City | !!Agt-City!! |
Agent State | Agent State (Abbreviation) | !!Agt-State!! |
Agent Zip | Agent Zip | !!Agt-Zip!! |
Agent Phone - Office | Agent Phone (Office) | !!Agt-Ph!! |
Agent Fax | Agent Phone (Fax) | !!Agt-Fax!! |
Agent Email | Agent Email | !!Agt-Email!! |
ACTIVITY LOG - HISTORY/CLAIM STATUS: | ||
File Created | Created (Age-Days) | !!Created!! |
Adjuster Assigned | Adjuster Assigned | !!AdjAssigned!! |
Adjuster Received | Adjuster Received | !!AdjReceived!! |
Pending Manager Review | Pending Manager Review (Last Date) | !!PendMgrReview!! |
Adjuster Action Required | Adjuster Action Required (Last Date) | !!AdjActionReq!! |
Approved for Closure | Approved for Closure (Last Date | !!ApprvClosure!! |
File Closed | Closed | !!Closed!! |
Date Reported | Reported | !!Reported!! |
ACTIVITY LOG - ADJUSTER ACTIONS: | ||
Diary Date | Diary | !!Diary!! |
Initial Contact | Initial Contact | !!1stContact!! |
Scheduled Appointment | Scheduled Appointment | !!SchAppt!! |
Loss Inspected | Loss Inspected | !!Inspected!! |
First Report Due | First Report Due | !!1stReport!! |
Subsequent Report Due | Subsequent Report Due | !!SubReport!! |
Adjustment Completed | Adjustment Completed | !!AdjCompleted!! |
ACTIVITY LOG - FILE REVIEW/ADMIN ACTIONS: | ||
File Reviewed | File Reviewed | !!Reviewed!! |
Manager Review | Manager Review | !!MgrReview!! |
Reassigned | Reassigned (Last Date) | !!Reassigned!! |
Reopened | Reopened (Last Date) | !!Reopened!! |
Archived | Archived (Last Date) | !!Archived!! |
Unarchived | Unarchived (Last Date) | !!Unarchived!! |
ACTIVITY LOG - CLIENT ACTIONS: | ||
Client Approved | Client Approved | !!Client-Apprv!! |
Client Rejected | Client Rejected | !!Client-Rejected!! |
INVOICE (Use for Invoice Summary Only): | ||
Invoice Number | Invoice Number | !!InvNo!! |
Invoice Notes | Invoice Note | !!InvoiceNotes!! |
Invoice Gross Loss | Invoice Gross Loss | !!InvoiceGrossLoss!! |
Invoice Type | Invoice Type | !!InvoiceType!! |
Invoice Date | Invoice Date | !!InvoiceDate!! |
Close Without Pay | Close Without Pay | !!CloseWithoutPay!! |
Billing Rate Sheet | Billing Rate Sheet | !!BillingRateSheet!! |
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