1.Abandon Callback


i.Objective/Purpose


We select this disposition when a call has been abandoned because of the customer error or the system error


ii.Agent Actions -


There is a tracker that has been shared with the team which the agent needs to check for the abandoned calls and they need to call back the customer and assist them with the query and update the below mentioned tracker with the disposition and the UCID


https://docs.google.com/spreadsheets/d/1nP4Q1cwxCdGCaaHRvHFUjarS5hr4EuxKR1nKC_OZqC8/edit?usp=sharing_eil_m&ts=6163e7a3&urp=gmail_link


2. Acko Drive Related

    

i.Objective/Purpose


We selected this disposition when a person calls and says that he wants to buy a new vehicle


ii.Agent Actions -


The agent needs to transfer the call to the Auto team.


FAQ’s:-

I want to purchase a vehicle from Acko

I have heard that Acko sells cars as well

Can I purchase a car from Acko?

Does Acko have a Tie up with Car dealers ?



3. Agency or Marketing Related

    

i.Objective/Purpose


We select this disposition when a person calls and says that he has to sell the policies/ give policies to his staff


ii.Agent Actions -


The agent needs to get the basic details from the customer

Customer’s Name

Name of the Company

Official email address

Official Website

Official Number

Gather all the information and then send it to Chirag Mahajan and inform the customer that the Business Development Team will check the details and will contact you in case you are eligible.


Faq’s:-

I want to insure my staff with Acko 

Can you assist me with an offer for Corporate policies

How do Corporate policies work?

 


4. Auto Pre Sale Related


i.Objective/Purpose


We select this disposition when a person calls for Auto policy related


ii.Agent Actions -


The agent needs to transfer the call to the Auto team. 


5Auto Related

    i.Objective/Purpose


We select this disposition when a person calls for Auto policy related


ii.Agent Actions -


The agent needs to transfer the call to the Auto team. 


In case the customer has a policy from a different company and wants to take Acko policy then the calls need to be warm transferred to the sales team. PFB the steps for the same.



Image 3

>>Once the call is connected with the Sales department, provide the details to the advisor and click on the Unhold button so that the customer can speak with the sales' team advisor. 

>>Post Unholding the customer, the Auto team advisor can now drop the call by using the End Call button and then dispose of the call accordingly. 


Faq’s:-

    I want to renew my Insurance but it is with a different company

    I want to take a comprehensive Insurance for my vehicle, the one i got is third party


6. Blank Call


    i.Objective/Purpose


This disposition is selected when the call hits your terminal and you are not able to hear anything


ii.Agent Actions -


The agent needs to call back the customer and assist with the query. In case the call does not get connected the ticket needs to be disposed accordingly stating Blank call, tried calling the customer but RNR


If the call gets connected, then you can dispose of the first ticket as Blank call and the outbound calling ticket according to the issue.


7. Call Dropped


    i.Objective/Purpose


We selected this disposition when the call get disconnected while you are speaking with the customer for any reason


ii.Agent Actions -


The agent needs to call back the customer and assist with the query; the agent has to close the calling ticking ticket with the call dropped disposition and the outbound calling ticket according to the outcome of the call.


The other option would be to merge both the tickets and then dispose the call according to the outcome of the call


8. Cancellation

    i.Objective/Purpose

    We select this disposition when the customer calls to cancel the policy.

    

    ii.Agent Actions -

The agent needs to inform the customer that we can not cancel the policy and they need to contact the partner who has provided the policy and the refund can be processed by the partner if eligible.


The agent needs to provide the customer with the contact details of the partner, either email address or phone number from the below sheet and need to select the Partner Helpline Details Tab.


https://docs.google.com/spreadsheets/d/1GjDUkAf88F65TSnaqs758bCM3lEZ79Vcuq1dz89gc2Y/edit#gid=1757049469


Faq’s:-

I never asked for the policy

Why is there a policy under my name, I never asked for it(E.g. Ola Rides, Oyo, Rapido, Cred)

I have been charged for a policy i never asked for.(Cred, Kreditbee, HDB)

Return my money as i have never asked for a policy

Why have you charged me without my consent


9. Claim Registration


i.Objective/Purpose

    

We use the disposition when the customer calls for claim registration


    ii.Agent Actions -


The agent first needs to check the basic details of the customer and check whether he is eligible for the claim according to the policy TNC, 



If not eligible we can send him the policy copy through CX 360 and ask him to check the TNC.


If he is eligible, then need to send him the self-care option from CX 360 and ask him to register a claim. (Death/Electronic/Helmet have exception and a different flow has to be followed, Please click here to view that)



Note:- The only method to raise a claim is through self care, the customer has to raise it himself, unfortunately we cannot do it on his behalf, Display empathy and politely decline the request, if the customer insists to raise the claim. 


Alternatively 


In case the customer is requesting for a walkthrough then assist him with the steps.



The customer needs to login to our website i.e. www.acko.com  or use our application. 


He needs to login with his registered mobile number, he will receive an OTP by which he will be able to see all his policies.


image

He has to select the policy through which he wants to register the claim





On selecting the policy he will get two options, policy download and claim, he needs to click on claim.



After clicking on the claim button he will get an option which say’s “Tell us what happened”, where the customer has to mention in brief about the incident.



Then the customer will be asked to select the date of the incident and he will get the options to select the type of the claim to be registered i.e. OPD, Overnight Hospitalization, Accidental reimbursement, Loss of Pay, Permanent\Temporary Disability, Flight Delay, Flight Cancellation, Delay of checked in baggage, vector borne disease, Accidental damage, Hospicash.



Depending upon the option he has selected we will ask him to submit the documents required for the processing of the claims.



Post uploading all the documents the customer will be asked to enter the payment details, either his bank details or his UPI Id wherever he wants the payment to be done. Post entering the details he will receive an OTP, post entering the OPT the claim will be registered.



The agent has to inform the customer about the TAT that it will take 5-7 Business days for the verification of the document once we receive all the documents post which it will take another 

5-7 business days for processing of the payment. In case any documents are required for the verification process we will communicate the same to the customer.


The claim registration process for Urban clap Appliance protection plan differs from the above process, the customer can register the claim from the Urban company app. PFB the process to register the claim and the documents required:-




In case of claim registration of vehicle damage in DRIVEU policies, the claim needs to be registered from the DRIVEU app.


PFB the screenshots for the same:-



 



We can check the status of these claims in Karmator


Claim registration for Cred Customers:-



For all claim registration for international travel policies the agent needs to provide the details of Allianz


Email:- Acko@allianz.com 

Contact Number:- +91 8061617799


Death Claim/ Electronic Equipment Cover/ Helmet Cover are offline claims


In case the customer is calling for Death Claim, the agent has to take the email address for the person who is calling and needs to send the death claim format as the claim is offline and the TAT for the same is 1 month.


Dear **

 

Greetings from Acko General Insurance!

 

As per our telephonic conversation / Thank you for your email. We are sorry to hear about the sad demise of "CUSTOMER NAME". We express our deepest condolences & extend our support to the deceased’s family.

 

We request you to help us with the below-mentioned claim intimation details and the required documents, in order to process the claim. PFB the format.

 

 

 

Questions

Response to Be Noted

Date & Time of Call

(29th August 2021)

Policy Type/ Entity Name 

Zomato

Customer Name

Full Name

Customer Contact Number & Alternate number 

**

FE ID (mandatory)

 **

Customer Email ID

**

Date & Time of Accident -

26/07/2021

*Claim Type:

(Death Claim)

Vehicle Make/Model

Eg: (Honda CB Shine)

Vehicle Registration number - (optional)

Eg: (MH04XX1234)

Incident details (Cause of Loss) :

How it occurred / description of nature, cause & extent of loss

Incident Location: 

The exact place where loss has occurred

Whether FIR/Police Complaint lodged?

Yes/No

 

 

 

Documents required at the time of claim:

1. Duly filled up a claim form

2. Copy of death certificate attested by issuing authority.

3. Copy of Post Mortem report

4. Copy of F.I.R/Panchnama

5. Legal heir certificate & NOC from any other legal heir(s) if so exists (in absence nomination)

6. KYC and account details of the nominee/legal heir/claimant.

 

If there are any questions on your mind, just hit reply and we will be happy to assist you.


The claimant has to submit the form filled with the relevant details along with the documents mentioned below on (partner’s name)care@acko.


Once with receive the form duly filled with all the documents, the same has to be sent to 

Mohit Srivastava and M Sai Chiranjeevi  CC to cattravel- cattravel@acko.com.




In case of Electronic Equipment cover and Helmet Damage another form needs to be sent to the customer as it is also an offline claim, PFB the format for the same


 

Dear xxxxx,

 

Greetings from Acko General Insurance!

 

We request you to help us with the below-mentioned claim intimation details and the required documents, in order to process the claim.

 

Questions

Response to Be Noted

Date & Time of Call

(dd/mm/yyyy hh:mm)

Policy Type/ Entity Name 

(Swiggy / Rapido/ Urbanclap/ Zomato etc....)

Customer Name

Full Name

Customer Contact Number & Alternate number 

913XXXXXXX

FE ID (mandatory)


Customer Email ID

r*****@****.com

Date & Time of Accident -

dd/mm/yyyy

*Claim Type:

(Hospitalization less than 24 hours, Hospitalization more than 24 hours, Loss of Baggage & Personal belongings etc etc etc) 

*See Coverages

Vehicle Make/Model

Eg: (Honda CB Shine)

Vehicle Registration number - (optional)

Eg: (MH04XX1234)

Incident details (Cause of Loss) :

How it occurred / description of the nature, cause & extent of loss

Incident Location: 

The exact place where loss has occurred

Whether FIR/Police Complaint lodged?

Yes/No

Electronic Equipment Cover

·         Duly completed Claim Form with your signature

·         Proof of ownership and or invoice

Repair invoice

·         FIR copy

The form needs to be sent to us on (partner’s name)care@acko.com. The agent needs to send the same to Kiran.hm@acko.com.


FAQ’s:- 

Can i raise a claim via your app

I have taken a treatment and want the money

what documents are required to raise a claim

How can i claim for my expenses incurred

How can i claim for my vehicle damage

How can i claim for my accidental damage to my appliances

How can I claim for missed flight, flight delay, flight cancellation?

How can i claim for Hospital Daily allowance

How can i claim for Loss of pass

How can i claim for Disability/Death

How can i claim for Vehicle Damage





10. Claim Settlement


i.Objective/Purpose

    

The customer calls for claim status and if we have settled the claim


    ii.Agent Actions -


The customer calls for the claim status and after checking in the respective application you find that we have settled the claim; you need to dispose the call as claim settlement









11. Claim Status


    i.Objective/Purpose

    

We use the disposition when the customer calls for claim status.


    ii.Agent Actions -


The agent has to ask some probing questions to determine where to search for the claim, probing questions should be like, what was the claim about and when did he register the claim.


Upon probing if we understand that the claim was for OPD, Flight canx, Flight Delay, Accidental medical Reimbursement, Loss of pay or Disability, we have to check Jarvis with his registered mobile number or with the claim ID if the customer provides it.


If we see multiple claims under the customer’s name, we have to select the one he is talking about and the one which has not been withdrawn.






If the status shows as pending document, the same has to be communicated to the customer and if there is an option to upload the document in Jarvis, we have to ask him to upload the same, if not then we have to ask him to email the documents to us through (partner’s name)care@acko.com. Post receiving the documents the TAT would be 5-7 business days for verification and then 5-7 days for processing the payment. PFB the screenshot for the same.



Once you click on the pending documents, it shows what documents are pending, PFB the screenshot.





If the status shows as admissibility deviation, then the same has to be communicated to the customer and also guide the customer to the website to check the policy TNC. PFB the screenshot for the same.



Once you click on the Admissibility deviation, it will show the reason for the same, PFB the screenshot for the same.






If the customer is calling for Death claim status, the agent can check the status in the Death claim Register


https://drive.google.com/file/d/1H9N1t7F9hgYiOL55akT8rRbCXKQsHmXJ/view 


And can also check in FD for any tickets and any communication from the claims team.


For Electronics equipment cover status the agent needs to check in FD for existing ticket and assist with the status accordingly


In some scenarios when the customer calls for the claim status and there is no update in Jarvis and the claim is not assigned to any claim handler then the agent needs to escalate the same to the Tech team as it is due to some technical error.


An email needs to be sent to sanket@acko.tech


In case of the status of Drive U policies, the agent needs to check in Karmatoor.


PFA the screenshots of the different stages of claim status in Jarvis:-


The first check that is performed when the claim is registered is admissibility check, to make sure whether the claim is admissible



Then there is customer contacted which is done to confirm that we have received the documents and they communicate the TAT and pending documents if any to the customer.



Claim under process is mentioned when all the documents are received.



Documents pending will be mentioned when there are some documents pending to process the claim once you click on the note it will display the pending documents.



If it shows, Claim rejected due to non submission of documents then it will specify the documents that were not submitted. In these scenarios. The agent needs to inform the same to the customer and ask him to email the pending documents to us so that they can reopen the same claim.



Once the customer sends the pending documents, the claim will be reopened and in notes it will be mentioned additional documents received.



If it is mentioned Medical Expert Flow initiated, it means that the claim documents have been sent to a medical expert for opinion. This is usually done in the case of Loss of Pass and Disability wherein the experts will suggest the number of days the customer is eligible for rest depending upon the injury. 



We attach the certificate that we get from the Medical expert under Medical expert Onboarding and we can download it. PFB the certificate which shows the period for which they have approved the rest. 


The customer can say that his doctor has advised him rest for a longer period but the agent needs to inform that we will settle the claim according to the approval from the medical expert


When the status shows as partner confirmation request, it means that we have sent the request to the partner for confirmation that the customer has not done any deliveries during the rest period and once we receive it, it will be mentioned  partner confirmation received.



There is tab which says Vendor payment, it is related to the payment done to the vendor for the opinion and the information should never be conveyed to the customer



Claim Payment will be mentioned when we have processed the payment and it will have the UTR number which we can share with the customer.


  

Faq’s:-

I have not received the payment yet

When will i get the payment

What is the status of my claim 

How long does it take for the payment to be processed



        

12. CSAT Calling


i.Objective/Purpose


We select the disposition when there is an outcall done to the customer after receiving a survey from the customer and he has given a D-Sat 


    ii.Agent Actions -


The agent needs to call and check with the customer the reason for the D-sat and if there is any scope for changing the customer experience


13. Electronics Related


i.Objective/Purpose


We select the disposition when the customer is calling in relation to the Electronic product coverage like home appliances.



    ii.Agent Actions -

    The agent needs to transfer the call to the Electronics department.

FAQ’s :-

a) Wants to confirm the extended warranty status

b) want to claim for my faulty device



 14. Endorsement


i.Objective/Purpose


We use the disposition when the customer calls to make changes on the policy like change of name, DOB, change of address, Marital status, Gender change, Email address and Multiple changes, also adding Dependants and Nominee 


    ii.Agent Actions -

    The agent needs to ask the customer to email us the documents depending on his request

  1. For a change of Name /DOB /Gender change he needs to send Adhar card or any Govt authorised ID card

  2. For Relationship change the customer needs to send us any Govt authorised proof like Ration card and Marriage certificate.

  3. For changes in International travel policies like Name correction, date correction, etc, the agent needs to get the basic details from the customer like :- 

(i) Customer contact number,

(ii) Full Name

(iii) Passport number.

And the same needs to be sent to international escalations@acko.com with the details of the changes to be made and a TAT of 5 working days to be informed to the customer.


For Endorsement related to MMT(Make MY Trip)the customer needs to be directed to the MMT customer service


In case the customer says that they are not getting support from the MMT team then it can be escalated to the Goibibo team


For any cancellation and extension of the policy the customer should be directed to the partners customer service.

     Faq’s:-

    My name needs to be updated on the policy

    I want to extend the policy for a week

    I want the travel dated to be changed as the flight has been rescheduled



8. Cancellation


    i.Objective/Purpose

    

The customer calls for the cancellation of the policy


    ii.Agent Actions -


The agent has to politely decline & redirect the customer to the source partner (OYO, Rapido, MMT, etc..) to place the cancellation request. 


The agent needs to help the customer with the helpline/customer care number of the partner & also with the email id if available.


FAQ’s:-

I want to cancel the policy

I never asked for the policy

You have charged me for a policy that i never asked for


16. Enquiry


i.Objective/Purpose


We use the disposition when the customer calls related to any enquiry related to the policy


    ii.Agent Actions -


The agent needs to open the policy in CX 360 and assist with the TNC, the query can be anything like Is my policy active, when does my policy expire, what is the SI in the policy, who is covered in the policy, what benefits are there in the policy, what the option to claim, is cashless available, Network hospitals, procedure for claiming.


Faq’s :-

What things are covered under my policy

When does my policy start



    


17. FHPL Cashless Escalation


i.Objective/Purpose


We use the disposition when a customer calls and states that he has been admitted in the hospital and he has not received the approval.



    ii.Agent Actions -


 The agent first needs to do some basic check, whether the policy is valid, and the DE is active, upon confirming the same he needs to check in Spectra whether the claim ID has been generated and whether there is anything pending from the Hospitals end, In case there are no details available in Spectra the agent needs to call the Cashless Team Spoc on the numbers mentioned below


Praveen 6309670505/ 9951255501

Rasheeda 9959577910

Narsimha 9866690234


The TAT for the same is 1 Hour.


In case the case is not resolved within the TAT then the same needs to be escalated to 


First level of escalation(FHPL)

Dr Koila Krishna 9246240020

Dr Mallesh 9246240006


First level of escalation(Acko)

Dr Kamal Kalita 9899401336


For any cashless hospital related issue the TAT remains the same 1 hour


First level of escalation (FHPL)

Dr Stella 8340878889 Email :- stella.susanne@fhpl.net

Dr Balkrishna 8142844998 Email:- balakrishna.b@fhpl.net


First level of escalation(Acko)

Dr Ashwini 9538903216 Email :- ashiwini.mushrif@acko.com



Level 1: TAT - 1hr

Step1: Check the DE status in Karmatoor if Active or Not.

Step2:

Mail to: cashless@fhpl.net

CC: Kruthika kruthika.r_ext@acko.com

Subject: Cashless Request_Acko_Corp Name: <Swiggy DE/Zomato>

Body:

Dear Cashless Team,

PFB the details. Request you to coordinate with the hospital and kindly process the cashless request.


Customer name :

Mobile number :

Attenter contact number :

Uhid number :

Active status : Yes / no


Level 2: TAT - 30min

Call: +91 6309670505

Mail: loop - narasimulu@fhpl.net, kamal.kalita@acko.com

Body:

Hi All,

PF the mail thread. The delivery executive is Active. Kindly help in processing the cashless request.


Customer name :

Mobile number :

Attenter contact number :

Uhid number :

Active status : Yes / no


Level 3: TAT - 30min

Call: +91 9951255501

Mail: loop - koila.krishna@fhpl.net, pritam.choudhari@acko.com, tarun.pagadala@acko.com

Body:

Hi All,

PF the mail thread. The delivery executive is Active. Kindly help in processing the cashless request.


Customer name :

Mobile number :

Attenter contact number :

Uhid number :

Active status : Yes / no


In case the hospital calls stating that they have not received the payment and the customer has been discharged long back, the agent needs to call on 9121315672 and also escalate to the FHPL team.


Faq’s:-

When will i get the approval

The hospital is not doing any treatment as there is no approval

Why do i have to pay when it is cashless

Why is the hospital asking for deposit




18. FHPL Cashless Query


i.Objective/Purpose


We use the disposition when the customer calls for the cashless claim procedure


    ii.Agent Actions -


The agent needs to perform the basic check first like whether the policy and the DE are active, upon confirming the same he needs to check in Spectra whether a claim ID has been generated.


If no, advise the customer about the cashless claim registration process -

Please follow the steps below to avail cashless service only from the network hospital:

  1. Reach out to the TPA/ Insurance help desk of the hospital and present your E-card. If the e-card is not available at the time of hospitalisation, please share your Employee ID and company name. 


  1. Our team will send an approval to the TPA within 2 hours and you will receive an SMS confirming cashless claim registration. If you don’t receive any SMS, we suggest that you follow up with the admin at the insurance desk to ensure that the request was sent correctly.



If yes, check the status and if it shows pending from the Hospital, inform the same to the customer

If the status shows as under process than inform about the TAT


If there is no update in Spectra then the agent needs to call the FHPL numbers mentioned below and check the status as sometimes if the portal at the Hospital is not working they might email the details to the Cashless team and then there is an excel ID which starts with HYD


Praveen 6309670505/ 9951255501

Rasheeda 9959577910

Narsimha 9866690234


There are 3 phases in the FHPL cashless claim:-

  1. First phase is the Pre authorization request

  2. Cashless Enhancement in case the estimated bill is going to be higher than the pre auth approval

  3. Final approval when the hospital send the final bill

    

While checking the status in Spectra if the agent finds that it is pending CI from the Hospital then it is the clinical Investigation report which is pending from the FHPL person and not the Hospital.


Faq’s:- 

How long does it take for the approval

Do i have to pay anything

What is the room rent limit

What things are covered 


19. FHPL  Helpline number


i.Objective/Purpose


We use the disposition when the customer calls regarding query related to cashless and reimbursement



    ii.Agent Actions -


The agent needs to check the status in Spectra first and assist accordingly and if the customer insists on speaking with the FHPL team, we can assist with the number ie 1800 102 1213


In case the customer says that he had taken a cashless treatment and had been discharged as well and the hospital people are calling for the payment, the agent needs to ask the customer to call on 9121315672 and ask the hospital to email on pmt@fhpl.net


20. FHPL Reimbursement Escalation


i.Objective/Purpose


We use the disposition when the customer calls for the FHPL reimbursement status and it has exceeded the TAT.


    ii.Agent Actions -


The agent first needs to check the status in Spectra and assist the customer if there is anything pending from his end because FHPL does not call the customer for pending document, they only send a text stating that there are some documents pending


If you see that there is a query to the member, it means that some documents are pending, hence we have to click on view and it will show the documents pending.


If documents are pending then the agent has to email the customer requesting the documents, the format for the same is as follows:-


Dear


Greetings from Acko General Insurance!


As per our telephonic conversation. We would like to inform you that,

we have received an update from the FHPL team on 6th of January 2022,

that they required the below mention documents, in order to process

the claim further.


Documents Required:


1.

2.

3.

4.


Post receiving all relevant documents, your claim will be reviewed

within 5-7 working days. Post-approval, you will receive the payment

within 5-7 working days.


If there are any questions on your mind, just hit reply and we will be

happy to assist you.



If FHPL has received all the documents, then it will be displayed in the following manner:-





In case the customer says that he has already sent the document to FHPL, confirm the email address and also ask them to send it to us on (partner’s name)care@acko.com so we can forward the same to FHPL.


The agent also needs to check in Freshdesk to see whether there is any existing ticket related to the same claim, if yes and the customer has already submitted the same documents earlier than the same needs to be sent to acko.crm@fhpl.net and eclaims@fhpl.net and in CC kruthika.r@acko.com and ashraf.unnisa@acko.com


If we have already sent the documents to the above mentioned emails and there is no response within 24hrs(note the FHPL team does not work on Sundays and National Holidays), then the escalation matrix needs to be followed


First level of Escalation (FHPL)

Dr Premrao 707504774 Email :- premrao.gudise@fhpl.net

Dr Jyoti Reddy 9010087555 Email :- jyoti.reddy@fhpl.net 

Acko.crm@fhpl.net  email is managed by Kiranmayee and her contact number is 9121315672


First level of Escalation(Acko)

Dr. Yogesh Bhise 9850780661 Email yogesh.bhise@acko.com

Dr. Kamal Kalita 9899401336 Email kamal.kalita@acko.com


Acko second level of escalations for all matters

Dr. Pritam Choudhari 7709047964 Email pritam.choudhari@acko.com

Dr. Vidyadhar Dhaware 7709197966 Email vidyadhar.dhaware@acko.com


Faq’s:-

How long will it take to get my payment

What documents are required 

I haven't got any update related to my claim

I have submitted all the documents i had



21. FHPL Reimbursement Query


i.Objective/Purpose


We use the disposition when the customer calls for query related to FHPL Reimbursement


    ii.Agent Actions -


The agent first needs to check the basic details whether the policy and the DE are active and then ask the customer about the treatment that he has taken, to claim for the reimbursement that customer needs to be hospitalised for at least 24 hours(Day care treatment’s like Piles, Fissures, cataract etc are also covered provided the customer needs to get the discharge summary for the same).


The agent needs to ask the customer about the date of the incident and then check whether he was active, if yes then he can register a claim through our website www.acko.com, if no then inform the same that he won't be eligible for the claim.


If the customer insists that he had informed the partner about the treatment then we need to ask him to speak with the partner and ask them to send us the updated login details.


The customer’s also have an option of emailing all the documents to FHPL on acko.crm@fhpl.net


If the customer has already registered the claim, then we need to check for the status in Jarvis with his Emp ID or claim ID if he has it.


If the status shows as pending from the customer, the same needs to be informed to the customer and an email needs to be mentioning the pending documents, before sending the email the subject line needs to be changed. It should be in the format of 


//Partners Name// Customer’s Name//Phone Number// Emp ID // Claim ID //


We should change the from option of the email to the partners name


The format in which we request the pending documents is :-


Dear 


Greetings from Acko General Insurance!


As per our telephonic conversation. We would like to inform you that, we have received an update from the FHPL team on 6th of January 2022, that they required the below mention documents, in order to process the claim further.


Documents Required:


1. 

2. 

3. 

4. 


Post receiving all relevant documents, your claim will be reviewed within 5-7 working days. Post-approval, you will receive the payment within 5-7 working days.


If there are any questions on your mind, just hit reply and we will be happy to assist you.


If the customer says that he has already sent the documents then we need check in Freshdesk with his number and email address, in case we are able to find them, the same needs to be sent to FHPL team on acko.crm@fhpl.neteclaims@fhpl.net CC to Kruthika.r@acko.com and Ashraf.unnisa@acko.com


After sending the documents to FHPL an acknowledgement email needs to be sent to the customer as follows


Greetings from ACKO General Insurance!

 

Thank you for your email. We want to inform you that we have already forwarded your details to our FHPL  team and they/we will get back to you at the earliest.

 

Post receiving all relevant documents, your claim will be reviewed within 5-7 working days. Post-approval, you will receive the payment within 5-7 working days


Your patience here is much appreciated.

 

If there are any questions on your mind just hit reply and we will be happy to assist you.


The major confusion we come across is that when the FHPL mentions that they want the payment receipt of the final bill and the customer are only sending the final bill where there is no mention of the payment or a stamp/seal and sign.


Another import document required for the reimbursement claim is the ICP and the complete discharge summary on the hospital letterhead.


The other claim that we can see under the same category is pre and post, as it also covers the customer for 30/60 days, respectively. The customer can claim for the same even if he has availed the cashless treatment.


Faq’s:-

How long will it take for the payment to be processed

Will i get the payment

What documents are required

Do i have to fill the form



22. Health Related


i.Objective/Purpose


We use the disposition when the customer is calling for query related to Health policies


    ii.Agent Actions -


The agent needs to confirm with the customer about the policy he is referring to just to make sure that we are not transferring the call incorrectly to the Health team.


23. Helpline Number


i.Objective/Purpose


We use the disposition when the customer is calling for query related to the Partner and wants to speak with them


    ii.Agent Actions -


The agent needs to ask relevant questions to understand the query of the customer and in case there is something that needs to be addressed by the partner; we need to assist them with the helpline numbers or email addresses, Please find below the list of number that we have:-



x

Helpline Number

HDB Financial

Service

"Customer Care Email ID:

Customer Care Number: 044 4298 4541

Ola

Customer Care Email ID: support@olacabs.com

Customer Care Number: 46831009- with the STD code.

Rapido

Customer Care Email ID: shoutout@rapido.bike

Cred

support@cred.club

Redbus

1860 3001 0101 / 1860 121 2102

Customer Care Email ID: support@redbus.in

Abhibus

1860 108 6789 /040-61656789

Customer Care Email ID: support@abhibus.com

Urbanclap

1860-500-0020

Customer Care Email ID: help@urbancompany.com

Goibibo

1800 208 1060

Customer Care Email ID: travel@goibibo.com

Happay


Drive U

8880712345

Customer Care Email ID: care@driveu.in

Zomato


011 30806376

Religare

1800 102 4488 /1860 500 4488

Customer Care Email ID: zomato@religare.com

Zest Money

9343422556

Customer Care Email ID: help@zestmoney.in

OYO

93139 31393

Customer Care Email ID: bookings@oyorooms.com

Lendingkart

1800-572-0202

Customer Care Email ID: info@lendingkart.com

MMT

1800-103-8765

Customer Care Email Id: service@makemytrip.com

Zoomcar

18601239666

Customer Care Email ID: support@zoomcar.com

FHPL

1800 1001213 / 1800-102-4033 (or) 1800-425-4033

Customer Care Email ID: acko.crm@fhpl.net

EMT- EaseMy Trip

Customer Care Number: 011-43030303/011-43131313

Customer Care Email Id: Care@easemytrip.com

MoneyTap

Customer Care Email: hello@moneytap.com

Indifi


Allianze

Contact Number: +918061617799 Email Address: acko@allianz.com


Visit

011 4084 5566

Customer Care Email Id: corporate@getvisitapp.com

Kredit bee

080-44292200

help@KreditBee.in

Goibio/ EMT INternational Flight

Contact Number: +918061617799

Email Address: acko@allianz.com

Urgo

022-48918686

info@ugrocapital.com

HDB query

044 4298 4541

customer.support@hdbfs.com

Cred

support@cred.club.

KreditBEE

help@KreditBee.in

080-44292200

INDIFI

9696555444

cs@indifi.com

Trip Money

support@tripmoney.com

Happyness

Customer Care

+91 90440 52266


support@happyness.net

Happy Easy Go

cs@happyeasygo.com



    Faq’s:-

    My Id has been blocked

    I have made the payment but my ID is not working

    I have been charged twice

    I have been charged without my consent

    I have not received the payments for last week


24. Internet Related


i.Objective/Purpose



    ii.Agent Actions -


25. Language Barrier


i.Objective/Purpose


We use the disposition when a customer calls and says that he is not comfortable speaking in English or Hindi and wants to speak in a regional language,


    ii.Agent Actions -


The agent needs to confirm whether the customer is calling from his registered mobile number, if the agent sees any policies on his account related to Internet LOB then he can confirm the language that the customer is comfortable with and check in the tracker below to see whether we have any agent who is comfortable with the language the customer is asking for, if we have an agent who speak the language the agent has to check the team roaster to confirm whether that agent is scheduled today, if yes he has to assure a callback with a TAT of 1 hour and a request needs to be sent to the advisor for a callback with the customer’s details and the same needs to be updated in the tracker as well.


The callback won't be actioned if the details are not updated in the tracker


https://docs.google.com/spreadsheets/d/1V6FE2uIC4C4WywrlQYuXMGLdQdlVClqSevWv4j7MRYQ/edit#gid=0


 

In case we don't have anyone speaking the desired language then the same needs to be  communicated to the customer.



26. Nominee details


i.Objective/Purpose


We use the disposition when the customer calls to check his nominee details 


    ii.Agent Actions -


The agent should check the policy of the customer in CX 360 and inform whether they added the nominee on the account, in case it is added, inform the same and close the call


In case it is not added then we need to guide the customer to add the Nominee through the Acko website or the Application.




27. Non Acko Related


i.Objective/Purpose


We use the disposition in case the customer is calling for something which is not related to Acko.


    ii.Agent Actions -


The agent needs to probe the customer to understand what he is calling for to understand whether the query is related to Acko.


The different scenarios that can come under this category are :-

  1. Customer calls to pay his broadband subscription fees

  2. Customer called thinking it’s Dominoos to order Pizzas

  3. Customer calls thinking that he has called Zomato, Rapido Etc




28. Not Reachable


i.Objective/Purpose


We use the disposition when we are calling the customer, and the number is not reachable


    ii.Agent Actions -

    The agent tries calling the customer in case of a call drop then he can use the disposition


29. Other


i.Objective/Purpose


    ii.Agent Actions -


30. Partner Helpline


i.Objective/Purpose


We use the disposition when the customer calls for a query related to the partner or for policy cancellation and refunds


    ii.Agent Actions -


The agent needs to understand the query first and then assist the customer with the partner's helpline number or the email address from the below link:-


https://docs.google.com/spreadsheets/d/1GjDUkAf88F65TSnaqs758bCM3lEZ79Vcuq1dz89gc2Y/edit#gid=2112148674


The scenarios under which we can provide the number is:-

  1. Customer says that he has not requested for the policy and wants to cancel it

  2. Customer says that he has not received the payments from his company for the job he has done

  3. Customer is not happy with the policy coverage and wants to cancel it

  4. We have informed Customer that his claim is not admissible according to the policy, and he wants to cancel it.

        


31. Policy coverage


i.Objective/Purpose


We use the disposition when the customer calls for information about the policy


    ii.Agent Actions -


The agent needs to confirm the registered mobile number and open the policy in CX 360 and explain the details


In case the policy is not reflecting in Cx 360, we need to ask the customer to contact the partner

Eg:- Policies like Cred, HDB usually take some time to reflect in our system.


32. Test Call


i.Objective/Purpose


We use the disposition when there is a test call that is made for whatever reasons


    ii.Agent Actions -


The agent needs to write proper notes and the reason for the call


33. Unsubscribe Promotional Emails or SMS


i.Objective/Purpose


We use the disposition when the customer says that he has been getting emails or SMS from Acko and does not wish to receive them.


    ii.Agent Actions -


The agent needs to confirm the registered mobile number or the email address and Please mark all email blocking mails to Central team ( Kamlesh Suwarnkar ) sourabh.deokar@acko.tech


ssanket@acko.tech, kamlesh@acko.tech, sourabh.deokar@acko.tech


Email ID misuse


The format for the same is 


Hi Sourabh,


The below customer reached us stating that someone has misused his Email ID for (Oyo Stay, or-----)


Name:

Number:

Email ID:


For Marketing related or business related emails send email to

 Anujan Krishnamoorthy and Megha Jain and garima luthra   anujan.krishnamoorthy@acko.com,megha.jain@acko.com,garima@acko.com  





  


34. Visit App Or Opd Health


i.Objective/Purpose


We use the disposition when the customer calls for OPD claims related to Zomato policy


ii.Agent Actions -


The agent has to confirm the details of the incident, like the date of the incident and the treatment taken, we have to check whether the customer was active on the incident date and then assist with the claim registration process(Claims where the incident date is prior to 18th Dec 2021 are supposed to be registered on the Visit app)


Claim post the 18th of Dec 2021 need to be registered on Acko App or Acko website ie www.acko.com


The total amount allocated for the OPD claim in the Zomato policy is 5000 annually and it covers the DE, spouse and 2 children.


There are limits to the clam as well:’

Doctor's prescription limit is 1000 per prescription

Test per prescription limit is 1500 per prescription


To claim the same for the dependants of the customer, he first needs to add the dependants name from the app or the website


FYI :- Prior to 18th Dec, the customers had option of cashless OPD and the dependants covered were Spouse, 2 children, Mother, Father and Mother in Law and Father in Law

    FAQ’s:-

    My claim shows rejected

    I am not able to avail the cashless OPD treatment

    Visit app shows that i am not eligible for a claim

    Are my parents covered for OPD