CLIENT NAME

ACCIDENT DATE

ORDERED

LOR SENT TO/ INSURANCE INFO RECEIVED

LOR SENT TO/ INSURANCE INFO RECEIVED
LOR SENT TO/ INSURANCE INFO RECEIVED
TICKLE STATUTE: (4 yrs from the FILE OPENING DATE)
MEDICAL BILLING ORDERED
MEDICAL NARRATIVE ORDERED
MEDICAL RECORDS ORDERED
MEDICAL BILLING ORDERED
MEDICAL NARRATIVE ORDERED
MEDICAL RECORDS ORDERED
MEDICAL BILLING ORDERED
MEDICAL NARRATIVE ORDERED
MEDICAL RECORDS ORDERED
E R BILLS
DR. BILLS
DR. BILLS
DR. BILLS
DR. BILLS
DR. BILLS
PIP CARRIER (.005)
UM CARRIER (.002)
BI CARRIER (.007)
BI CARRIER
LETTER TO DEFENDANT NOTIFY INSURANCE (.006)
CRASH REPORT (RESPONDING AGENCY)
TICKET ISSUED TO
LOP AND REP TO DR. (.021)
PHOTOS ______CLIENT AND/OR

VEHICLE

TICKLE TWO WEEKS:

Insurance Investigation Dec Page and Application,
Wage & Salary Form, Attending Physician Forms from
PIP carrier; call treating physician (check trmnt status)
TICKLE ONE MONTH:
Insurance Investigation for Declaration page of Defendants
carrier; threshold letter (015A), call treating physician
(check trmnt status)
TICKLE TWO MONTHS:
CSR to client (042), call treating physician (check trmnt status)
TICKLE THREE MONTHS:
Narrative letters to both client (008B) and doctors (008),
PIP payout ordered
TICKLE FOUR MONTHS:
Review for Demand posture
TICKLE FIVE MONTHS:
Review for Demand posture. CSR to client at needed
TICKLE SIX MONTHS:
Review for Demand Posture::

RECEIVED

CLIENT NAME
INSURANCE CO NAME
CLAIM NUMBER

File Start Date: ______________

PHASE 1
Date of accident
Retainer Agreement
Medical Release signed
Interview Questionaire completed
Clients Rights signed
client statement of what happened
mileage form provided to client
Initial Treatment (providers)
Submit LOR to/via
Submit LOR to/via
Submit LOR to/via
Order Police Report
Evidence received from client (photos)
Arrange recorded statement if needed
Who received ticket
Liens W/
Liens W/
Medicaid Lien
Insurance Lien
Send Client Status Letter (30 days)

COMMENTS

ORDERED

RECEIVED

PHASE 2
Client treatment Status (call client)
Review Policy Limits
PIP Carrier (our client)
UM carrier (our client)
BI carrier (at fault)
Fax LOP
Order PIP Log
IME notices received/scheduled
Send Client Status Letter (60 days)

COMMENTS

ORDERED

RECEIVED

PHASE 3
Client treatment Status (call client)
Order Medical Records ER/PP
Order Medical Bills ER/PP
Order Medical Records
Order Medical Bills
Order Narrative
Order Medical Records
Order Medical Bills
Order Narrative
Order Medical Records
Order Medical Bills
Order PIP Log
EMC Achieved
Send Client Status Letter (90 days)

COMMENTS

ORDERED

RECEIVED

PHASE 4
Verify all information received
Draft Demand
Submit Demand
Demand Tracking number
Send Client Status Letter (120 days)
Send Request for Status to Ins. Co. (30 days)
Send Request for Status to Ins. Co. (45 days)

COMMENTS

SUBMITED

COMPLETED

COMMENTS

OWED

PAID

PHASE 5
Offer Received
Send Client Status Letter (150 days)
Atty Fees
ER/PP Negotiations
Other Negotiations
Other Negotiations
Other Negotiations
Other Negotiations
Prepare Settlement Statement
Client Settlement Amount
Funds to client
Date bills paid
Send Client Copies of all bills paid

AMOUNT