Download Claims handling costs and quality of experts

Claims handling costs and
quality of experts
Feedback for group discussion
Group One - insurers
• Q1
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Needed for reserves/costs/information
Separate representation should remain
Need to improve comms/collaboration process
Change may be forced by external regulators
Loss of control of claim
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Prime consideration individual and expertise
Price secondary with firm strength third (except big cases)
Relationship beneficial but claim specific
Personal recommendation rather than Yellow Pages
• Q2
Group One - insurers
• Q3
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SLA/TOE
Prelim assessment with reserve – update/realign
Budgets rare – usually block fee reserve
Managed process driven by reporting requirement
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Continuous/qualitative assessment
Monitor accuracy of reserves v settlements
Audits of TPAs in line with SLA
Triggered by unexpected movements
• Q4
– Recommendations
– Global SLA/TOE
– Revisit adjuster/surveyor issue at future conference
Group Two - insurers
• Appointment of experts
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Gathering facts
Coverage issues
Liability issues
Resource issues
Recovery issues
Objectivity
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Selection of expert
Panels
Location
Experience
E&O
Price
Group Two insurers
• Management of experts
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SLAs
TOE
Budget
Reporting criteria
– Assessment of experts
– Criteria?
– Timeliness/quality/reporting/price/accuracy of
reserving
– Open and closed file reviews
Group three - experts
• Q1
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• Q2
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Protect own and clients interests:cause nature and extent
Skills not in house
Independent sources of information
Resistance by owners to u/w surveyor adjusting the claim
Panels not resisted but not too narrow
Choose by personal knowledge or reference
Past record best advertising
Prompt payment in exchange for reduced rates
Location
U/W relationship with assured and types of expert dictates who chooses
Group Three - experts
• Q3
– Managing expectations
– Good instructions vital – as is clarification if unclear
– Estimates reasonable for fee
• Q4
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Few audited
Positive feedback is repeat business
Questionnaires well received by clients
Difficult to evaluate – which clients have the skills?
Group four - experts
• Q1
– How else are u/w going to service the claims properly?
– Experts who really are experts
– Avoid duplication of experts
• Q2
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Good experience in the past and reputation
Price – value for money and overall result than actual rates
Knowledge of clients and market procedures
Bad timing of appointment can impair expert performance and
affect result
Group Four - experts
• Q3
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• Q4
Communication
Deal direct. Talk direct
Record instructions
Give instructions to others in expert manner
Comms, comms, comms
– u/w experts in judging quality of work provided to them
– Every case different – objective criteria unrealistic
– Frequent dialogue between u/w and experts critical and would be
profitable for recap at end of case