1. Accident acceptance: including accepting reports, checking the documents copied from the bottom and registering.
2. On-site investigation: including on-site investigation, rescue and protection.
4. Loss verification: verify the property loss of the accident vehicle and the third party, formulate the repair plan, define the repair scope and items, determine the repair cost, and determine the repair manufacturer according to the principle of bidding for repair.
5. Making compensation case: including responsibility audit, cost verification, compensation calculation, comprehensive report and compensation case approval.
A, the classification of traffic accident scene
According to the changes of the scene after the accident, the scene of the traffic accident can be divided into the original scene and the changed scene.
1. Original site: refers to that after the accident, vehicles, people, livestock and all objects related to the accident remain in their original state after the accident.
2. Changing the scene: it means that the original state of the accident is partially or mostly changed for some reason. There are many reasons for changing the original state of the accident, usually in the following situations:
(1) Rescue the wounded. In order to rescue the injured in the accident, move the position of related objects or change the original position of the deceased.
(2) improper protection. Because the site was not closed in time, the traces were trampled by passing vehicles and pedestrians, resulting in unclear or disappearing traces.
(3) Natural destruction. Due to natural factors such as rain and snow, the accident traces are unclear or disappear.
(4) Allow changes. Vehicles carrying out special tasks such as fire fighting, security and rescue are allowed to leave the scene after the accident, or to move vehicles or related objects in order to avoid traffic jams.
(5) The vehicle leaves. After the accident, the driver left the scene unintentionally (unwittingly) or intentionally (shirking responsibility).
According to the requirements of on-site investigation, the original site was kept after the accident, which is convenient for the original site to obtain reliable information. Under normal circumstances, the accident should be kept as original as possible. Even if the injured are rescued, attention should be paid to try not to touch objects or traces unrelated to the rescue.
Second, confirm the target vehicle.
1. Check the insurance policy or insurance card: confirm whether the vehicle in danger is underwritten by our company; Confirm whether it is within the insurance period; Confirm whether to insure the insurance that meets the insurance liability of this case.
2. Check the driver's driving license and motor vehicle driving license, including temporary mobile license plate and temporary number plate. Check whether the driver has a qualified driving license, whether the driving license is within the validity period, whether it is consistent with the quasi-driving model, and whether the driving license photo is consistent with the driver. Whether the driver drives the vehicle according to the insurance policy; Whether the driver has an operation certificate issued by the relevant department when the special vehicle is in danger. Check whether the driving license has passed the annual inspection.
3. Find out the situation of the vehicles in danger and the nature of their use, including: checking that the insured vehicles include three vehicles, models, license plates, frame numbers and engine numbers, and checking them with insurance policies and driving licenses one by one. If the license plate is the same, but the frame number, VIN code and engine number are completely different, make a record to the customer immediately, understand the actual situation, prevent fraudulent insurance, and check whether the vehicle carries dangerous goods and is overloaded; Check whether the vehicle structure has been modified or added; For the trailer, it is necessary to check whether the two license plates of the front and trailer are insured in our company.
4. If the customer does not carry the insurance policy or insurance card, he can contact 95569 to inquire about the vehicle information.
5. If the driver's license and driving license are detained by the traffic police, the withholding certificate shall be checked.
Third, verify the authenticity of the accident.
1. Guide customers to fill in the simple claim processing form of motor vehicle insurance, and ask drivers to fill in the detailed accident handling procedures. Understand the time, place, cause, process and result of the accident.
2. Field investigation:
(1) investigation point
After the accident, whether it is between motor vehicles, between vehicles and fixed objects, between vehicles and pedestrians, or even the vehicle itself, there will be traces on the car body more or less.
After arriving at the scene, the surveyors must carefully investigate the vehicles, ground, casualties and collision objects on the scene. Find and determine the contact part of the accident. Carefully observe the shape and characteristics of accident traces and physical evidence. Pay attention to the following marks:
A road signs-dragging, trampling and rubbing vehicle tires on the road; The car body and some objects are smashed, squeezed, scraped and scratched on the road, and the human body is hit, rolled, rubbed and beaten.
B body marks-marks of different degrees of damage, such as impact or scraping, formed on the surface of the vehicle when the vehicle contacts other objects in traffic accidents. The scratches are mostly strip-shaped, which are characterized by depression or damage, and are also characterized by the phenomenon that the dust and soil of the car body are wiped off or the paint skin is scraped off. Similar to collision accidents, scratches may leave traces of paint, wood fibers or other objects of other vehicles.
C. Other related marks-adhesion marks of vehicles, human bodies, roads and other related objects due to splashing, pollution and smearing. The shape, color and size of these marks often reflect some aspects of the accident process, and even completely reflect the whole process of the accident.
(2) Requirements for on-site photo shooting (including retest)
First, accurately reflect the whole scene of the accident;
B, accurately reflect the geographical location of dangerous places. For example: landmark buildings, road signs, building signs, traffic signs, etc. ;
C, accurately reflect the accident route and key reasons. Requirements: shoot in the direction of the vehicle;
D. Compare the height, area and shape of the damaged part of the vehicle and the part in contact with the outside.
E, accurately reflect the rescue situation;
F, record the site traces in detail. For example: impact point, scattered objects, tire running marks, brake marks, road scratch marks, car body marks and adhesion marks.
(3) draw a sketch of the scene. The site sketch should basically reflect the road, orientation, vehicle position, driving route and external factors at the scene of the accident.
3. Judgment of the authenticity of the accident: According to the description of the parties and the details of the scene, comprehensively judge the authenticity of the case and exclude the losses other than this accident. Focus on investigating suspicious or inconsistent matters; When necessary, make an inquiry record for the parties or witnesses.
4. Identification of insurance liability: According to the principle of proximate cause and the conclusion after case investigation, determine whether the accident belongs to insurance liability and what kind of insurance coverage it belongs to.
I. Post-damage identification management
1. Evaluate the qualification of the position.
(1) Honest, fair and conscientious. The loss assessor has a wide range of contacts in the usual loss assessment work, and has to deal directly with the insured and the repair shop. In the contact with different objects, it is often a test of the ideological consciousness and work style of the claim adjuster. Therefore, the loss assessor must first love the insurance business, cherish the reputation of the insurance company, be decent, seek truth from facts and adhere to the truth; Secondly, we should love the work of motor vehicle insurance claims, have practical experience in motor vehicle technical work and have certain working ability; Consciously obey the leadership, abide by the law, and work hard with dedication.
(2) Be good at clauses. The basis for handling compensation cases lies in the terms of the insurance contract, and the contents of the terms must be carefully understood and mastered. When conducting on-site investigation, conduct objective and realistic research and analysis on the accident site. After finding out the cause of the accident and determining whether it belongs to insurance liability, reasonably identify the degree of loss, identify the scope of repair in detail, formulate corresponding maintenance plans, especially the losses involving third parties, and handle them carefully in the spirit of seeking truth from facts.
(3) Be familiar with and master relevant professional knowledge. There are many kinds of motor vehicles with complex models. In order to achieve a reasonable and accurate damage assessment, it is required that the claimant master the essentials of accident investigation and damage assessment, master and understand China's road traffic regulations and road traffic accident handling methods, be familiar with the structure and working principle of motor vehicles, understand the repair technology of accident vehicles, and accurately formulate repair methods. In addition, road traffic accidents often involve the loss of third-party objects and the loss of goods on board. Therefore, it is necessary to know and master a lot of relevant knowledge and the standard of damages.
2. Damage the qualification of appraisers
(1) All loss adjusters must undergo professional training and pass the qualification examination specified by the company before taking up their posts.
(2) At work, you must accept the inspection and audit stipulated by the company.
3, determine the damage job responsibilities
(1) Accept dispatching: the dispatching center of the head office or the dispatcher of the branch company will dispatch workers to the scene of the case as soon as possible after receiving the case;
(2) Determine the accident loss: according to the principles of on-site investigation and damage assessment, determine the loss items of vehicles in danger, determine the maintenance mode and price, determine the residual value discount, and determine the rescue cost; Personal injury cases need to confirm the identity of the injured, ask about medical conditions, estimate medical expenses and fill in relevant documents;
(3) Claim data collection: according to the case, collect relevant claim data to know that the customer has gone through the claim procedures;
(4) Data uploading system: upload the damaged articles, photos and related documents to E-insurance system as required;
(5) Working time limit: strictly follow the time limit for handling cases set by the company, and the timely and effective handling of cases shall not be delayed due to personal reasons;
(6) Be responsible for the accuracy of damage identification;
(7) Complete other tasks assigned by the head of claims department.
4, assessment work discipline
(1) obeys the scheduling, and shall not entrust an extension;
(2) timely identify the damage within the prescribed time limit, and shall not authorize others to identify the damage;
(3) In the process of loss identification, assist customers to take effective rescue and protection measures in time to prevent the loss from expanding;
(4) Take lost photos according to relevant regulations and requirements, and the photos shall not be lost;
(5) According to the specification requirements, the insured must sign for confirmation;
(6) Use the working time standard stipulated by the company;
(7) Inquire about accessories according to company regulations;
(8) Accurately identify the quantity and amount of losses;
(9) According to the prescription, timely input and upload the loss-fixing data, and timely handle the cases dispatched to the loss-fixing platform;
(10) After the preliminary damage identification is completed, report it to the damage identification audit in time, and reply and upload it immediately after completion;
(1 1) Be sure to use civilized language when facing customers;
(12) Don't engage in any behavior unrelated to work. Do not engage in any behavior that damages the company's image and interests. No meals, no money, no gifts.
Second, the principle of damage identification
1, adhere to the principle of insurance claims, fulfill the obligation of fixed loss, observe the company discipline and maintain the company image.
2. Carefully define the vehicle losses caused by this accident and the damaged parts unrelated to this accident. All losses caused by vehicle storage, paid rescue, failure to take timely measures and extra increase are not within the scope of compensation.
3, accident vehicle damage projects should adhere to the principle of "repair first, supplemented by replacement".
4. Where local parts can be replaced separately, assembly parts cannot be replaced. It is a special case and must be submitted for approval in advance.
5, in strict accordance with the damaged parts replacement standard to determine the replacement parts, according to the provisions of the repair process to determine the working hours.
6. Strictly implement the price standard of accessories specified by the company, which shall not exceed the specified price range.
7. Accurate, reasonable and boundary-based residual value identification of damaged materials, rescue expenses, etc. , determine the overall price.
8. Check and verify the total loss amount.
9. Strictly distinguish between accidents and losses caused by vehicle functional parts.
Third, the principle of parts replacement
1. Damaged accessories can only be replaced in the following three situations:
(1) Irreparability;
(2) after the repair, the use function is affected, the appearance is seriously affected, and the safety is affected;
(3) The repair price exceeds 90% of the replacement part price.
2, the replacement project must have accurate replacement basis, provide documentary evidence or diagnostic process data when necessary;
3. For the assembly parts that do not provide a single piece and the parts with complicated subordinate relationship that need to be replaced, the written description of the maintenance station and the data of the standard parts diagram must be provided.
Four, the accident vehicle damage identification method
1, on-site investigation and determination of damage scope
(1) Check the target vehicle, verify the loss position and confirm the loss degree.
(2) Distinguish the loss caused by this accident and the damaged part not caused by this accident.
(3) Strictly control the occurrence of repeated reporting and fraudulent compensation cases.
(4) Take the method of vehicle inspection and loss verification.
(5) Adopt the method of core recovery.
2. Technical basis of damage identification and confirmation
(1) Understand the overall structure and performance of vehicles in danger.
(2) Master the disassembly difficulty procedure of damaged parts and related disassembly workload.
(3) Master the detection technology of damaged parts.
(4) Master the auxiliary materials and dosage required in the repair process.
(5) To master and understand the technical standards for inspection and appraisal of dangerous vehicles after completion.
3. Basic methods and steps
(1) Accurately confirm the damaged parts and parts of the accident vehicle;
Confirm the losses caused by this accident according to the on-site investigation or double-car comparison traces.
(2) According to the severity of damaged parts in each part, issue a maintenance plan. Determine replacement items, repair items and repair processes, and determine working hours and labor costs;
(3) Report the replacement details of spare parts listed in the loss confirmation, and prepare a complete loss confirmation;
(4) The damage assessment of the accident vehicle shall be jointly conducted by the insured, the third party and the insurance company. If damage identification is carried out in a repair enterprise, the business personnel of the repair party shall also participate.
4. Problems existing in damage identification and measures to be taken.
(1) timeliness of damage identification
(2) Give full play to the role of fixed-point dismantling and inspection plants and cooperative manufacturers.
(3) Adhere to the principle of parts replacement and the working hours standard issued by our company.
(4) identification of special vehicles and spare parts scarce vehicle damage treatment methods.
(five) the problems that should be paid attention to in the identification of accident vehicle damage exceeding the current actual value.
(6) Handling the contradiction of customers' request to repair accident vehicles in 4S shops recommended by non-insurance companies.
(7) The shooting method of damaged photos and the problems that should be paid attention to.
(8) Disposal of damaged materials
Verb (abbreviation of verb) Standard for repair and replacement of damaged parts of accident vehicles
1, repair and replacement standard for body and sheet metal parts.
(1) Conditions for replacing body assembly parts
If the car body is severely deformed, it can't be corrected to the standard data by using repair tools, or the car body can be replaced only by providing the car body assembly because of the serious lack of individual parts;
When the floor deformation is serious, the bearing type and the non-bearing type should be distinguished. If it is a load-bearing body structure, the body assembly should be replaced, otherwise only the floor beam frame should be replaced.
The cost of repairing the damaged car body is greater than that of replacing the car body;
There are obvious differences between replacing the car body: the car body assembly and the car shell. If it is necessary to replace the car body assembly or car shell, it must be reported to the Claims Department of the Head Office for instructions, and it can only be replaced after approval.
(2) Replace the body reference drawing.
(The bottom plate is severely deformed-replace the body shell)
(The whole body is severely deformed-replace the body shell)
(The body main frame is not deformed-the body shell cannot be replaced)
(2) Local sheet metal parts
Replacement conditions: sheet metal parts can not be repaired after serious loss, or can not be restored to their original state after repair, which obviously affects the appearance, or can not be assembled according to the original standard after repair, and can be replaced;
Repair method: according to the degree of damage, it can be divided into three grades: severe, moderate and mild, and the working time of sheet metal can be considered separately. Severe damage refers to serious deformation and dead pleats, with the damage area reaching more than 50%, which is difficult to repair; Moderate damage degree means that the concave-convex area of the part is large, the part is wrinkled but the deformation is small, and it can be completely repaired; The degree of slight damage refers to the elastic deformation or abrasion of the parts, depression at the abraded place and slight damage. Slight bumps are not considered as sheet metal working hours, only as painting.
(3) Loss division diagram of sheet metal parts
Mudguard: The fender should be repaired if it is light, medium or heavy, and replaced if it is serious.
Hood: If the damage is mild, moderate or severe, it must be repaired, and if it is more serious, it should be replaced.
Front frame: If the damage degree is mild, moderate or severe, it must be repaired, and if it is more serious, it should be replaced.
Front frame: If the damage degree is mild, moderate or severe, it must be repaired, and if it is more serious, it should be replaced.
Bumper: The front and rear bumpers are easily damaged parts. It should be noted that the bumpers can be repaired by plastic welding, heating, shaping, etc. under the condition that the damage is not serious.
(Small area fracture-can be repaired by plastic welding) (Large area fracture-replaceable)
(Dent-can be heated for plastic repair)
Door: It should be repaired if the damage is light, medium or heavy, and replaced if it is serious.
(The left front door was moderately damaged-repaired) (The left rear door was deformed as a whole with multiple dead folds-replaced)
Car beam: the replacement of car beam must be reported to the Claims Department of the Head Office for instructions, and can only be replaced after approval.
2, electrical appliances, lighting parts repair, replacement standards
(1) Motor: If no surface damage is observed, the motors such as generator, starter, wiper motor and water tank motor should not be replaced.
(2) Lamps and lanterns: Ensure that the replaced lamps and lanterns fittings must be damaged beyond repair. The basis of replacement is: the surface damage of lampshade and the damage of lamp shell; Bondable corners of the lamp housing must be repaired. For lamps with damaged shell, it is necessary to pay attention to whether a separate lamp shell is provided; When replacing the headlight assembly, be sure to pay attention to the accessories contained in the assembly, and do not list them repeatedly.
3, engine parts repair and replacement standards
(1) If it is necessary to replace the engine assembly and the middle cylinder assembly, it must be reported to the Claims Department of the Head Office for instructions, and the replacement can only be carried out after approval.
(2) No damaged maintenance parts shall be included in the replacement project.
(3) Parts that have been damaged and cannot be repaired or affect the function after repair should be replaced.
(4) Damaged electrical components must be accessories that are seriously damaged and affect their functions after repair, and can be classified as replacement items. No obvious damage to the accessories, must provide proof of measurement of special instruments.
(5) determine the replacement, such as; Starter, generator, booster pump, oil pump and other assembly parts must obtain written documents from professional enterprises. Used for crankshaft, camshaft fittings, etc. If there is no obvious damage, it is necessary to obtain a measurement certificate from a professional enterprise when confirming the replacement, which proves that it is beyond the scope of maintenance and cannot be repaired.
(6) Confirm that the standard for replacing the engine bracket is that the position deviation between the bracket bolt mounting hole and the vehicle cross beam bolt hole is more than 5mm and cannot be repaired.
4, transmission parts repair and replacement standards
(1) The replacement of the gearbox assembly and the reduction/transfer box assembly must be approved by the audit department in advance.
(2) Parts that are damaged beyond repair or affect the function after repair shall be classified as replacement parts.
(3) Damaged electrical components must be accessories that are seriously damaged and affect their functions after repair, and can be classified as replacement items. No obvious damage to the accessories, must provide proof of measurement of special instruments.
(4) If the shell is seriously damaged, just confirm to replace the damaged shell part. When there is a slight crack in the shell, it should be confirmed as a repair process.
(5) For the damaged automatic gearbox, it is recommended that the 4S shop send it to the professional automatic gearbox enterprise designated by the brand for maintenance.
5, suspension parts repair and replacement standards
(1) Confirm that the standard for replacing the suspension arm \ rod must be that the wheel and suspension arm \ rod are severely deformed. If there is no obvious deformation of the suspension arm \ rod, the measurement results of the four-wheel alignment instrument and the supporting documents beyond the adjustment range must be provided.
(2) Confirm that the standard for replacing the shock absorber is that the surface of the shock absorber has serious damage marks, or the mandrel is extended and rotated, and the swing difference is greater than 0.5 mm. ..
(3) When the transmission shaft is confirmed to be replaced, it must be seriously damaged or bent.
6, seat parts repair and replacement standards
(1) In the case of seat deformation, the technology of repairing the seat frame must be adhered to.
(2) If it is confirmed that the seat is damaged or the surface is damaged, and the assembly needs to be replaced, a written certificate without separate accessories provided by the brand manufacturer must be provided.
(3) The scratches on the seat surface must be repaired.
7, interior decoration accessories repair and replacement standards
(1) The interior part is scratched and must be repaired.
(2) Determine the replacement standard: severely damaged parts with irreparably torn surfaces.
8. Maintenance and replacement standards for safety components
(1) Make sure that the purpose of repairing and replacing safety accessories must be to ensure the recovery of functions and reliability.
(2) Confirm that the replaced parts must have surface damage and electrical damage caused by accidents.
(3) Determine the electrical components of the braking and safety system. If the fault warning light is on;
Obtain the static fault code from the diagnostic instrument to confirm whether it is a gas component fault.
Use the diagnostic instrument to eliminate the fault code or cut off the power supply for 5 minutes, and then remove and check the faulty components and restore them.
Start the engine and run the braking conditions.
Then use the diagnostic instrument for functional diagnosis, when the indicated fault is consistent with the initial indicated fault. Confirm that the component is really invalid, otherwise it should not be recorded as a damaged item.
(4) For example, for safety accessories that do not work in accidents; Passive safety generation, airbag, airbag curtain, connecting wire, etc. , shall not be included in the replacement project. In order to determine the computer controller, special diagnostic instruments must be used to reset, clear the fault, re-run and re-diagnose the program before confirmation.
Chapter III Operation Practice of Damage Identification
First, the identification of general car damage cases
1, carefully check the damaged objects, determine the damaged parts, loss items and loss degree, and confirm the vehicle after serious damage;
2, check the scene photo records, lost photo trace records, check whether the reason, process and loss are consistent, and whether the lost part has expanded;
3. Check the damage of vehicle parts systematically along the collision force transmission route until there are no traces of damage, so as to prevent the omission of indirect losses. Indirect losses are difficult to determine and analyze comprehensively. Damage appraisers must try their best to find out the traces of deformation of each part, and check whether all bolts, washers or other fasteners are moved or misplaced, whether unpainted metal surfaces are exposed, and whether internal coatings are cracked or cracked. At the same time, pay attention to distinguish between indirect losses and non-accident losses;
4. Determine whether the damage is limited to the car body, and whether it also includes functional parts, components or hidden parts (such as hidden parts in wheels, suspension, engine and instrument panel). ), and distinguish accident damage from disassembly damage according to the transmission range of collision force, damage deformation and lost photos of disassembled accessories;
5. Determine the repair items in strict accordance with the classification of disassembly, sheet metal repair, machine repair, electrician and painting, and determine the replacement items according to the collision line and collision force transmission line, and record the spare parts model, specifications and some spare parts codes reflected in the photos in time;
6, according to the provisions of the quotation management, to determine the replacement parts for quotation; Determine the hourly rate of maintenance workers according to the local hourly rate of maintenance.
7. Take photos of all the missing parts.
8. If the entrusted agency has completed the vehicle damage assessment, the entrusted agency shall negotiate with the insured, and the accident vehicle needs to be towed back to the place where the entrusted agency is located for repair. In principle, the results of re-assessment by the entrusted agency shall prevail, and the entrusted agency shall introduce new damage assessment information when compiling, and the original damage assessment information of the accepting agency shall not be modified.
9. For the accident vehicles with large losses, before the maintenance is completed and the customer picks up the car, the implementation of the maintenance plan, the quality of replacement parts and the maintenance quality should be checked; It can also take the form of random inspection during maintenance. The results of re-inspection shall be indicated on the damage appraisal form. If it is found that the damaged parts have not been replaced or the corresponding accessories have not been replaced at the damaged price, the corresponding price difference shall be deducted from the damage identification form.
65438+
1 1. Attention should be paid to the distinction between losses caused by this accident and those not caused by this accident, and the boundary between accident losses and normal maintenance, and the principle of repairing the parts identified as accident losses as much as possible should be adhered to;
12. The surplus value shall be transferred to the insured through negotiation and be disposed of by the insured;
13, pay attention to the damage appraisal authority, and report the cases beyond the authority in time.
9. Loss of working hours.
The man-hour cost of vehicle damage includes the maintenance man-hour cost. Refers to the man-hour expenses for repairing the accident vehicle within the scope stipulated by the insurance principle, including the expenses incurred in each link of each type of work during the maintenance process, such as disassembly expenses, sheet metal expenses, painting expenses, debugging expenses, inspection and diagnosis expenses, computer supporting expenses, etc. Working hour pricing is an important part of damage identification. In the process of vehicle damage identification, the following principles should be grasped when dealing with maintenance man-hour expenses.
1. According to the standard. The basis for determining the maintenance man-hour expense is the man-hour quota standard for automobile maintenance enterprises promulgated by the Ministry of Communications, and the implementation standard is the man-hour expense quota standard for Anbang auto insurance claims issued by our company.
2. Damage identification operation. When determining the loss, the working hours standard shall be determined according to the category of maintenance enterprises, and the contents not included in the project shall be converted in proportion with reference to similar projects.
3. Identification of damage disputes. In the actual operation process, the above standards should be strictly implemented. When there is a dispute with the repair enterprise, the repair enterprise must provide the working hours standard registered and recognized by the local maintenance industry management department, and submit it to the approval and attach the file.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.