2023-02-06 Referral Committee Meeting Minutes
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Public Page
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Date
Feb 6, 2023
ANTITRUST STATEMENT
As participants in this meeting, we need to be mindful of the constraints of antitrust laws. There shall be no discussions of agreements or concerted actions that may restrain competition. This prohibition includes the exchange of information concerning individual prices, rates, coverages, market practices, claims settlement practices, or any other competitive aspect of an individual company’s operation. Each participant is obligated to speak up immediately for the purpose of preventing any discussion falling outside these bounds.
Agenda
Welcome/Networking
Antitrust
This meeting is subject to the Antitrust Statement shown above and may be recorded.
Meeting Minutes Review
Review Kim’s example of Referral vs Assignment
Meeting Minutes
Antitrust Accepted
Meeting Minutes Reviewed/Accepted
Meeting minutes
Kim was feeling unwell and unable to attend the meeting.
Definitions
The assignment normally comes from who is paying the bill and the referral has no bill to information.
An OEM can make a referral to a body shop. The Customer will choose if they want to use the referral or wait for their carrier weigh in on the financial responsibility. An Assignment is approved by the carrier.
When Assignment message was created, it had a focus on insurance, and it was implied that the insurance company that sent the assignment would be paying for the claim. In reality the assignment could be broke into parts with referral and assignment information. But the break is the assignment was always insurance centric and assumed an adjuster was sending the assignment.
Where does the referral end up?
Will this information from the Referral show up in the estimate?
Party Types
OEM - See an OEM making referrals but not assignments with the existing terminology.
OEM with insurance, such as Tesla and OnStar, these would have to be separate entities, in essence they already are, but we would not keep them as the same actor.
Insurance Company can send a referral before they complete coverage and liability investigation to start the repair process or get a customer a renter. Then the assignment would be sent to approve the referral and assign bill to information after the insurance company agreed to pay the claim.
The Bill To and Party/Actors are critical in the difference between a referral and assignment.
Data may need to be stored to show who made the referral and then later there would be approval from someone else.
Is Referral and Assignment Different?
Do we have a referral and after so many boxes are checked off, it becomes an assignment?
The option with the referral is stating we do not know who is paying for this rental/estimate/repair/tow, it will be a clear message that the customer is accepting responsibility until the liable party approves.
Use Cases
For an insurance company, if a driver hits a deer, there is no investigation needed. The insurance carrier is clear coverage and liable because there is not second party being involved. This would be a simple example of the insurance company paying and sending an assignment. In this use case we can skip the referral.
For an insurance company, if there are 2 parties involved in an accident at an intersection, it is not clear who is at fault for the accident or who is going to be paying. Both of the insurance companies are going to gather information on the accident and the damage. Here the message to the body shop is we need you to identify the damage and to send us the documentation with photos and an estimate but hold off on the repairs itself. In today’s environment, the hold off on repairs is normally a note in the message that this is an estimate only.
For Owner, the owner hits a deer and it's not drivable, so they push the OnStar button or use an app to call a local shop with a tow truck that they have used for years, here there is no assignment, it's just the owner contacting a shop or tow. But if we use OnStar to make the call.
Most OEM only cover tow for mechanical issues and not for collision.
In the aspect of Tesla having Insurance and GM having OnStar, again that is not looking at it as the OEM, it's a different entity to what the insurance entity will pay for.
Review of Assignment
If we look at the data that is provided in an assignment, we can see Admin Info has many Actors (Insurance Company, Rental Company, Third Party Company, Sender, Receiver, Owner, etc. Remember, the BMS has all of these as optional, so none actually have to be sent on an assignment, it's the Use Cases and Test instances that show the best way to use the BMS data for a use case.
We need to look at the examples and see how these are used and can we add an element to say they are making a referral to each party, or do we simply add a new actor for Referral Sender and Referral Receiver, or do we use sender and receiver?
You can send insurance information on an Assignment, but it is optional data.
Could we control the Referral as an assignment message and have a new code list for document type to show it is a referral?
Great Meeting Everyone, Talk to you in 2 weeks.
Up Next
Welcome/Networking
Antitrust
Meeting Minutes Review
Review Kim’s example of Referral vs Assignment
Review the Comparision of Assignments in the Industry and the possible referral Message as an assignment or new message.
Action items
Decisions
Reference Material:
The Excel document to show the data based on the BMS test instances and possible referral messages can be found in the committee workdrive https://cieca.atlassian.net/l/cp/00ct5yCq
Assignment Vs Referral
Participants
@Paulette Reed
Stacey Phillips
David McCreight
Jason Kurutz
James Palmer
John Eck
Don Porter
Krysten Green
Paul Barry
Jeffery Hodge
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