how will your policy respond when you need to make a claim n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
How will your policy respond when you need to make a claim? PowerPoint Presentation
Download Presentation
How will your policy respond when you need to make a claim?

Loading in 2 Seconds...

play fullscreen
1 / 22

How will your policy respond when you need to make a claim? - PowerPoint PPT Presentation


  • 111 Views
  • Uploaded on

How will your policy respond when you need to make a claim?. Candy Holland ACILA, ACII, BA (Hons) & Nick E ntwistle ACILA, ACII, BA ( Hons). FCA Claims thematic review.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'How will your policy respond when you need to make a claim?' - erma


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
how will your policy respond when you need to make a claim

How will your policy respond when you need to make a claim?

Candy Holland ACILA, ACII, BA (Hons) & Nick Entwistle ACILA, ACII, BA ( Hons)

fca claims thematic review
FCA Claims thematic review

“It was felt by the group that if we could educate the customer on how the claims process will work, then that might actually increase the satisfaction numbers the FCA is seeing”

Andrew Gibbons

Chairman of BIBA claims working group

Post Magazine 17th April 2014

typical claim challenges1
Typical claim challenges

Communication

and interfaces

how prepared are you
How prepared are you?

Level 1

Broker wording review

Independent coverage review

Level 2

  • Meet insurers claims team &
  • agreeclaims procedures

Level 3

Level 4

Internal claims plan

  • Explore hypothetical loss scenarios

Level 5

developing a joined up approach
Developing a joined up approach

Create a claim plan which defines and maps your internal processes

Stress test your policy coverage to find out how it will operate when a claim arises

Develop a claim protocol with your insurers to agree how they will deal with your claim

create a claim plan
Create a claim plan
  • Identify the possible parties who would be involved
    • Nominate a claims project team
    • High level sponsor
    • Immediate response, who does what
  • Loss quantification and preparation
    • What data & information is held and where
    • How you will record and capture it
  • Communication planning
    • Lines of reporting and timescales
    • Stakeholders, internal management and external parties
    • Regular and frequent meetings/ calls/ reporting updates
claims and bcp
Claims and BCP

“There are different schools of thought about how the relationship between the claims process and the business continuity management and associated recovery process should operate. For me they are inextricably linked, although the link should be forged much earlier in the management process than after a claim.

It never ceases to surprise me how any recovery time objective can be forged by business continuity managers and business interruption insurance solutions designed by risk managers without these being simultaneous and fully engaged processes”

Julia Graham

President of FERMA

where problems arise
Where problems arise
  • Limits, sums insured, indemnity periods
  • Deductibles
  • Policy language
    • Trigger
    • Exclusions
    • Warranties
    • Conditions
    • Definitions
  • Disclosure

Unexpected Policy

Response

claims conditions
Claims Conditions
  • Claims Notification – some examples

“as soon as possible”

“as soon as practicable”

“as soon as reasonably practicable”

“as soon as is reasonably practicable but not later that 30 (thirty) days after the Information Holder is advised of the event.”

“as soon as is reasonably possible but no later than 45 days after the occurrence of said loss or damage”

slide17

Gaps in cover

  • Ambiguities in interpretation
  • Uninsured exposures
  • Queries
  • More information
  • Changes in practice
  • What is the deliverable?
  • When to do it?
  • Who to involve?
  • Agree terms of reference
  • Business risk or exposure
  • Recent near miss
  • Coverage uncertainty
  • Previous claims experience
  • High profile event
  • Quantification & evidence
  • Assumptions
  • Identify & test heads of loss
  • Loss mitigation
  • Evaluate the financial impact
  • Analyse the policy wording
  • Apply coverage to loss scenario
developing a claim protocol
Developing a claim protocol
  • How insurers deal with claims
  • Agree key elements of the claims process
  • Minimise potential for dispute at the point of claim
  • Expedite the claims process
  • Practical working document
  • Binding when incorporated into the wording
  • Tripartite agreement - Client, Broker, Insurer
  • Timing
  • Reinsurance?
the content
The content
    • Pre agree advisers and experts
    • Deal with any confidentiality issues
  • Reservation of rights
  • Claim notification procedures and timescales
  • Interim payments and information requirements
  • Clarify any ambiguities in the policy wording
  • Pre-agree a basis for valuation of claims
  • Master and local policies
in conclusion
In conclusion...
  • Some issues are unavoidable
  • Some issues can be anticipated and prepared for!
  • No single correct approach
  • 3 part plan
    • Claim plan
    • Stress test
    • Claim protocol
thank you visit us at stand 73

Thank youVisit us at stand 73

Candy Holland ACILA, ACII, BA (Hons) & Nick Entwistle ACILA, ACII, BA ( Hons)