CHAPTER 10 - A Flashcards
What is often referred to as the shop window of an insurer?
Claims
This term reflects the critical role claims play in shaping the client’s perception of the insurer.
What is the primary impression left by an insurer’s claims team?
A positive impression leading to a happy client and renewed business.
What role does the claims team play beyond client interaction?
Interfacing with other departments within the organization.
What should the claims team report to underwriting?
Wordings that are causing problems in interpretation.
How does the claims team assist underwriting with new wordings?
Advise on clarity (or not) of new wordings before they are put into use.
What type of data should claims provide to underwriters?
Up-to-date claims data for risk performance review at renewal.
Why must claims liaise with underwriting regarding claims outside coverage?
To discuss intent if a claim appears to be outside the scope of coverage.
What should underwriting communicate to claims?
Commercial pressures to settle certain claims.
What must claims know about reinsurances?
Which reinsurances contain claims control or co-op clauses.
What is essential for claims to provide to reinsurers?
Adequate data for clear advice.
What must claims ensure about loss coding?
That losses are coded accurately for reinsurance recoverable aggregation.
Why is it important to keep claims data up to date?
To effect reinsurance renewals on accurate loss data.
How can claims assist complaints handling?
Provide clear information about handling any claim.
What should complaints provide to both Claims and Underwriters?
Advice on regulatory information.
What role does Management Information (MI) play with Claims?
Liaise for input on system designs or changes.
What should MI review with Claims?
Reports to ensure proper data reporting.
What is the role of Legal in relation to claims?
Liaise over outsourcing and litigation issues.
What should Legal work on with Underwriting and Claims?
Advise on problems with wordings.
What is a key responsibility of Compliance regarding claims handlers?
Ensure they are appropriately trained and authorized.
What should the claims manager ensure regarding staff?
All staff are aware of regulatory requirements.
How can Marketing utilize Claims?
As a publicity tool.
What should be reported to Senior Management/Board?
Large claims and matters of wider importance.
What is essential for Finance regarding large individual payments?
Ensure early warning is given.
What must Finance do in cases of high volumes of claims?
Liaise to ensure no cash flow issues.
