Feature
Claims teams - the human face of insurance Claims is a people business, writes Dr. Dexter Morse, former Director Global Insurance & Risk Management at the International Air Transport Association (IATA). There are so many lessons to be learned from the claims department.
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he cost of claims is a major concern for insurers and reinsurers in all markets. Claims departments are faced with increasing demands and expectations from all stakeholders within their organization as insurers and reinsurers are being accused of failing to manage claims effectively and efficiently. Claims managers are constantly questioned about the accuracy of loss reserves. How does this headline loss impact our balance sheet? Are we paying too much? Are we properly supervising our claims management agents, loss adjusters and outside counsel? Are we compliant with local laws and regulations? As a result great emphasis is being placed on claims and claims practices. So how should a good claims operation look? It involves the following:
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September 2021
C – ommunication with the insured should be clear and open. The insured should be fully informed of the stages of the claims process and any investigations being made (such as instruction of loss adjusters or lawyers). L – iability. The claim should be investigated swiftly and thoroughly and a decision taken on liability early on. A – ctive and attentive. The claims team should respond swiftly to all correspondence received and verbal communication should be followed up with written confirmation to avoid misunderstandings. I – nvestigation. If there are policy issues or liability matters, the claims manager should deal with these promptly and professionally and have a definite action plan in mind.
M – oney. Payments should be made promptly (after all this is why insurance policies are incepted – to pay claims). In the event that the claim is not covered by the policy then the claims manager should advise the insured as soon as reasonably possible in writing. S – ubrogation. If there is the possibility to recover from a third party such actions should be pursued swiftly and zealously to ensure success and to avoid any time bar issues. Claims departments are a mine of valuable information that is frequently overlooked by the wider organization. The claims department is perfectly placed to see if the insurance policy responds in the way the underwriter actually intended (assuming the underwriter knew what he intended in the first place) or if the wording was too wide or obscure.
