, Continued (continued) If a PCR cannot answer an inquiry (by phone or IRIS), he/she will initiate a VAI based on these rules. As previously stated, these rules are not all- inclusive and do not cover every possible scenario. In all cases where there is a question as to the appropriateness of the initiation of a VAI, PCRs should seek their supervisor’s guidance. f. Brokered If a claim has been brokered, VAIs should only be sent to the station of Claims jurisdiction (SOJ), and not to the brokered station. The SOJ will maintain responsibility for the VAI response. PCRs will identify the SOJ using MAP-D. If a claim has been temporarily transferred, they will use the SOJ that existed prior to the temporary transfer. g. Consolidated For consolidated claims (i.e., pension claims), if after a thorough review of Claims all available systems (Share, MAP-D, etc.), there is inadequate information to answer an inquiry, a VAI should be forwarded to the appropriate SOJ or PMC for reply. If the caller alleges he/she submitted a claim, but no pending claim exists in h. Claims Control/Share Share (and after review of MAP-D notes, , and the “Claims/Denials” screen in the Corporate record): A VAI should be initiated when there is no claim pending in Share 21 days (or more) after the claim was submitted by the claimant. In addition, a , should be completed to secure the date of claim. Note: This includes rating and non-rating issues. both Continued on next page , Continued For claims showing as in MAP-D, the following table should be i. Claims in an ”Open” Status used to determine the VAI initiation time frames to be used for the following “Open” end product series (110, 010, 020, 140, 120, 180, and 190).
, Continued (continued) If a PCR cannot answer an inquiry (by phone or IRIS), he/she will initiate a VAI based on these rules. As previously stated, these rules are not all- inclusive and do not cover every possible scenario. In all cases where there is a question as to the appropriateness of the initiation of a VAI, PCRs should seek their supervisor’s guidance. f. Brokered Claims If a claim has been brokered, VAIs should only be sent to the station of jurisdiction (SOJ), and not to the brokered station. The SOJ will maintain responsibility for the VAI response. PCRs will identify the SOJ using MAP-D. If a claim has been temporarily transferred, they will use the SOJ that existed prior to the temporary transfer. g. Consolidated Claims For consolidated claims (i.e., pension claims), if after a thorough review of all available systems (Share, MAP-D, etc.), there is inadequate information to answer an inquiry, a VAI should be forwarded to the appropriate SOJ or PMC for reply. h. Claims Control/Share If the caller alleges he/she submitted a claim, but no pending claim exists in Share (and after review of MAP-D notes, , and the “Claims/Denials” screen in the Corporate record): A VAI should be initiated when there is no claim pending in Share 21 days (or more) after the claim was submitted by the claimant. In addition, a , should be completed to secure the date of claim. Note: This includes both rating and non-rating issues. Continued on next page , Continued i. Claims in an “Open” Status For claims showing as ”Open” in MAP-D, the following table should be used to determine the VAI initiation time frames to be used for the following end product series (110, 010, 020, 140, 120, 180, and 190).