Insurance claim log for NEMT fleets: every claim, its status, and what your loss runs will show

This log tracks the money and the insurer’s side of every incident. The incident report records the event and the accident review form decides whether it was preventable. This log follows each one into the insurer’s file: who is handling it, what has been paid, what you got back, and whether the insurer’s own report agrees with yours. That last check is what you want on hand before a renewal, because the loss run is the version an underwriter reads, and the renewal plan starts by ordering it.

How to use the log

Open a row the day an incident happens, whether or not you expect a claim, and update it whenever an adjuster tells you something. Weekly is enough for most fleets, and the person who keeps it should not be the driver involved.

• One incident, several claims. A single crash can open a collision claim on your own policy, a liability claim for the other driver’s damage, and a workers’ compensation claim for your driver. The accident guide explains that one crash can open several claims, each on its own deadline. Each gets its own row in Part B and its own line in Part C, tied together by the incident number.
• Log incidents with no claim. An incident you paid for yourself stays in Part A with its cost. The policy still wants prompt notice of the accident, so the minor accident guide tells you when paying yourself is reasonable.
• Copy what the policy asks for. The standard business auto form (CA 00 01 10 13) wants prompt notice with how, when, and where the accident happened, plus the names and addresses of any injured persons and witnesses. It says to pass along to the insurer at once any demand, notice, summons, or other legal paper you receive about the claim, and, when the van is damaged, to keep a record of your expenses. Parts B and C have a column for each.
• Write the valuation date. Reserves and paid amounts change. A figure with no date cannot be compared with a loss run later.

The log

Part A: Incidents (one row per event)

Part B: Claims opened (one row per claim)

Coverage labels to use: auto liability, collision or comprehensive, general liability, workers’ compensation (medical only or lost time), and other.

Part C: Money and status (one row per claim, with the valuation date)

Status words: open, closed with payment, closed with no payment, denied, in subrogation. Use the insurer’s words, so the log matches its report.

Example (made-up numbers and names, for illustration only). On March 3, another driver hits Van 4 in a clinic lot and is cited. The repair costs $7,150 and the collision deductible is $1,000. The insurer pays $6,150, then recovers the deductible from the other driver’s insurer and returns it. Van 4’s driver strains a wrist, which becomes a medical-only workers’ compensation claim. On June 18, Van 2 scuffs a bollard, and the owner pays the $420 repair without a claim.

Part D: Summary by van and policy year

Fill this in once a year, from Part C. The net cost is what you paid minus what you recovered.

Example (same made-up incidents): Van 4 shows 2 claims from the one crash (collision and workers’ compensation), $6,790 paid by insurers ($6,150 plus $640), $1,000 paid by you, $1,000 recovered, and a net cost of $0. Van 2 shows no claims and a net cost of $420, the repair you paid yourself. That net cost is the figure to compare across vans. The accident rate guide turns incident counts into a rate per million miles.

Setting the follow-up date

The Next follow-up column holds the day an insurer’s own deadline runs out, so you ask before the claim goes quiet. Deadlines are set by state. California’s Fair Claims Settlement Practices Regulations are one example, and they apply to claimants who are third parties as well as policyholders:

• 15 calendar days from a notice of claim for the insurer to acknowledge it, send the forms it needs, and begin investigating (10 CCR 2695.5(e)).
• 15 calendar days to give a complete response to any communication from a claimant that expects an answer (10 CCR 2695.5(b)).
• 40 calendar days after the insurer receives proof of claim to accept or deny it, in whole or in part (10 CCR 2695.7(b)). The rule does not apply to automobile repair bills under collision and comprehensive coverage (2695.7(b)(4)).
• Every 30 days after that, a written notice, if the insurer needs more time and says why (10 CCR 2695.7(c)).

If a California insurer receives your loss of use claim and its documents on July 10, the 40-day mark falls on August 19. Put that date in the column, and add the next dates as they arrive. Ask your state’s insurance department which rule reaches each claim. In Texas, for example, the insurance department says the prompt payment law does not apply when another driver’s insurance company is paying, and the not-at-fault guide explains how that changes the clock.

Check the log against each loss run

Before a renewal, match every line of each insurer’s loss run to your log by claim number, then explain every difference in writing to the adjuster. A claim belongs to the policy period in which the loss happened, as the business auto form covers accidents and losses occurring during the policy period shown in the declarations. Order the runs early: Florida’s statute gives an insurer 15 calendar days after a written request, and the loss runs entry lists the other states.

Part E: Loss run check

Example (made-up numbers, Insurer A’s auto policy loss run valued September 15):

Most differences fall into five kinds:

• On the loss run, not in your log. Someone claimed directly: a rider, a lawyer, or another driver’s insurer. Add the row and ask what the claim is.
• In your log, not on the loss run. The insurer was never told, or was told under another policy. The policy asks for prompt notice of an accident, so call your agent the same day.
• Open on the run, finished in your log. Send the adjuster the closing documents and ask for the claim to be closed. California’s insurance department tells business owners that claims history feeds the rating formula and moves the premium directly, so a stale open claim costs money.
• Different amounts. Compare the valuation dates first. Then ask the adjuster whether a later payment or a recovery from the other side has been applied.
• The wrong policy year. A loss that happened on December 30 and was reported in January belongs to the policy in force on December 30.

Then add one line per claim for the underwriter: what happened, whether your driver was at fault, and what you changed. The renewal guide explains why those notes help.

How long to keep it

Keep the log for as long as the company operates and keep at least five policy years of loss runs next to it. RLI’s NEMT program asks for four years of loss runs valued in the 90 days before the policy starts, and it may request a fifth year, so a log that reaches back five years answers the question the first time. Keep each claim’s backup folder (the incident report, review form, photos, estimates, and letters) until the claim is closed and the longest deadline that could still reach it has passed. Suit deadlines differ by state and by who is claiming, and the vehicle accident guide gives examples from Florida and California. Workers’ compensation claims stay in the experience mod calculation for years, as the experience mod entry explains.

Filling the log from your trip records

Most of Parts A and C come from facts you already record. In HealthRide, each trip leg keeps its van, driver, planned and actual times, and GPS-recorded miles, and the trip log in reports exports to CSV or PDF. Vehicle insurance and registration are kept as vehicle credentials with expiration dates, and reminders go out before they lapse, so a renewal date does not slip while you reconcile the last year. See fleet and credentials.