Customer Inquiry Checklist

Steps a CSR or account manager runs when fielding an inbound policyholder inquiry, from intake and policy verification through resolution, documentation, and follow-up.

4 sections 15 steps Collects data
1

Intake and Caller Verification

  1. Capture caller name and callback details

    • Record full legal name, preferred phone, and email. If the caller is not the named insured, capture their relationship to the policy — spouse, additional named insured, broker of record, or third-party claimant — before discussing any policy detail.

    Collects phone
  2. Authenticate the caller against AMS records

    • Pull the account in Applied Epic, AMS360, or HawkSoft and verify two identifiers — typically policy number plus DOB or mailing ZIP. Releasing NPI to an unverified caller is a GLBA Safeguards Rule violation.

  3. Classify the inquiry type

    • Classification drives routing. FNOL goes to the carrier's claims line within statutory acknowledgement windows (e.g., Texas Insurance Code Chapter 542 — 15 business days). Coverage and billing inquiries stay with the agency.

    Collects list
  4. Review prior interactions in the activity log

    • Scan the AMS activity log and ImageRight (or equivalent) for open suspenses, pending endorsements, or unresolved escalations. Repeat callers on the same issue often signal a service breakdown that should escalate to the account manager.

2

Policy and Coverage Verification

  1. Pull the current dec page and endorsements

    • Confirm policy period, named insured, limits, deductibles or SIR, and any scheduled items. Do not rely on the AMS summary screen — open the carrier-issued dec page in the document repository, since AMS data drifts from carrier records over multiple renewals.

  2. Check for mid-term endorsements not yet on the dec

    • Look for pending endorsement requests, premium-bearing changes awaiting carrier issuance, and any audit results in process. A caller asking about a recently-added vehicle or location may be looking at a change the carrier has not yet endorsed.

  3. Review exclusions and special conditions

    • Read the actual form language — not the AMS coverage summary — for exclusions, sublimits, and conditions precedent. Common gotchas: claims-made retroactive dates, water damage sublimits, anti-concurrent causation language, named-driver exclusions on personal auto.

  4. Confirm whether coverage applies to the inquiry

    • Make a coverage determination in writing only after reading the form. If uncertain, escalate to the account underwriter or the carrier — never give a coverage opinion off-the-cuff. Verbal misstatements about coverage are a frequent source of agency E&O claims.

    Collects list
3

FNOL Handling

  1. Capture loss date, location, and description

    • Get loss date and time, location, parties involved, injuries, police or fire report numbers, and a brief narrative. Do not coach the insured or speculate about coverage on the call — record what they report.

    Collects date Collects paragraph Collects file
  2. Report the FNOL to the carrier claims line

    • Most carriers expect FNOL within 24 hours. State unfair claim settlement practices acts (e.g., Texas Chapter 542) start the acknowledgement clock from carrier receipt — delays at the agency burn the carrier's statutory window.

  3. Send the carrier-assigned claim number to the insured

    • Email the claim number, assigned adjuster contact, and what to expect next. If a recorded statement may be requested, remind the insured that they should know the consent rules in their state — some are one-party, some two-party.

4

Resolution and Documentation

  1. Deliver the response in writing

    • Even when the inquiry is resolved verbally, send a follow-up email summarizing the question, the answer, and any action items. The written record protects both the insured and the agency at the next E&O audit.

  2. Issue updated COIs or endorsement requests

    • If the inquiry produced a certificate request, generate the ACORD 25 with the correct certificate holder and additional insured fields — these are separate boxes and confusing them is the most common COI error. Endorsement requests go to the carrier with effective dates the insured confirmed.

  3. Log the activity in the AMS

    • Create an activity record in Applied Epic / AMS360 / HawkSoft with the inquiry classification, the resolution, attached correspondence, and time spent. Carrier market-conduct examiners and E&O auditors both read activity logs as the file's source of truth.

    Collects list Collects paragraph
  4. Schedule a follow-up suspense

    • Set a suspense in the AMS for any open item — carrier response on a coverage question, return of signed endorsement request, receipt of supporting documents. Open suspenses without owners are how inquiries become E&O claims.

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Sections 4
Steps 15
Category Insurance
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