What Does Your Claim Rejection Message Really Mean?

Does this scenario sound familiar?

Caller: “Your wait time is 12 minutes, please hold for the next available agent”.

Manufacturer: (16 min later) “Good Morning, this is Katie, Can I help you”?

Caller: “Hi Katie, this is Janice from ABC Appliance. My claim #12345 rejected for commercial application-no labor warranty applies but the unit was in my customer’s home not a business?”

Manufacturer: “Hi Janice, can you give me the product model number?”

Caller: “Sure, the model number is TR4005”

Manufacturer: “This is a residential unit, not sure why your claim rejected. Let me transfer you to the warranty department?”

Manufacturer: (10 min later) “Hi this is the warranty department. How can I help you?”

Caller: “The previous department confirmed that I have residential unit that rejected for commercial application-no labor warranty applies. Can you fix my rejected claim #12345?”

Manufacturer: “Your serial number is registered to a different unit not a TR4005, which is a commercial unit. Can you please check the tag for the correct serial number?”

Caller: “Why didn’t the error message say Serial number not valid on that model number?”

Total Time Spent: 45 minutes

This is a typical conversation about a rejected claim where the error message (reject reason) to the user is confusing or misleading. If you file 100 warranty claims a month, on average approximately 20% of the claims will reject while 10% of them may require a phone call to the manufacturer. 10 claims @ 45 minutes per claim means one day out of the month, an entire 8-hour day will be spent on those 10 claims.

Let's look at some other interesting Claim Error Messages

There is no standard for warranty claim rejection descriptions. Therefore, we have to read between the lines to understand what each manufacturer means by the error message. Have you received this error message yet? spCreateRepInfo Error. Sounds to us like the error message is an error!!!

For this error message refile listing part info to be paid also the manufacturer is requesting a part needs to be added to your claim. The Service Performed verbiage included in the claim led the manufacturer’s processing system to believe a part was required. So maybe the correction is not adding a part but rewording the Service Performed details. Could be that you want Labor Only, either way it’s an investigation on your behalf and possibly a call to the manufacturer.

When a job in warranty is sent you by the manufacturer you receive a dispatch or call number in advance which needs to be in the claim data when submitted. What does this error message mean Authorization/Call # Not On File? If you were dispatched the job with the call number assigned, how can it not be on file? Another call to the manufacturer.

MUST SELECT REPAIR LEVEL OF ‘PARTS ONLY Another very strange error message which you can receive when you submit a claim for parts only. What is a Repair Level? Another call to the manufacturer.

Stay tuned for ClaimWorks™ a software connection portal that will eliminate the claims processing issues you may be faced with today. If you need help trying to determine what the manufacturer claims requirements are in order to get paid, we may be able to help. Call us at 877-535-WORK and watch the video