Chapter 6 (actually 5) Flashcards
IT relates to:
Storage
Production and
Communication
Of information
Digital strategies are used for:
Underwriting, selling and marketing products
Claims systems are designed with reference to:
Companies corporate philosophy
Claims management procedures
What else are claims systems used for:
Recording appropriate info
Compatible with Company’s overall objectives
Insurers use online servicing through:
Electronic portals
Characteristics of insurance claims are:
Volume
Complexity
Volume is:
Claims reserving, estimating
Claims payments
Recoveries
Complexity is:
Processing large amounts of data
Processing it quickly
Processing it accurately
Delivering info in a meaningful manner
IT must be:
Accompanied by a review of present claims procedures
New methods operation
Effective IT strategy:
Balances the efficiency of comprehensive IT solution with the skills and talents of experience members of claims staff
Major components of general insurance claims are:
Structure of the company
Type of business written
Standard claims info:
The name of PH Policy number and claim ref Details of claim Contacts Payments
Additional info at u/w stage:
Description of risk
Description of cover
Supporting risk info
Whether there is more than one insurer
Using IT systems:
reduces the cost of claims admin
Improve the service provided to the insured
Benefits of IT systems:
Single data entry Reduced paper files Quicker claims settlement Electronic with of claims payments Increase in communication channels Ports and extranet services
Organisation structure:
Function - claims, u/w
Division- product, geographical area
Or a blend of both
Functional structure
Best suited for smaller companies CEO BOD OPERATIONAL HEAD OF DEPT HUMAN RESOURCES, FINANCE, IT, MARKETING, UW, CLAIMS
Divisional structures:
Most large multi product companies
Home country commercial division home country personal division
International division
Centralised structure:
Retain authority at the top with little delegation
Decentralised structure:
More delegation, divisional managers make more decisions
Choices of systems depend on:
Size of the company
Business written
Outsourcing companies
Cost benefits
Manage specific issue
Gain access to wider skills base
Loss adjusters:
Experts in processing claims start to finish
Deal with large complex claims
Investigate, negotiate, recommendation for settlement
Their function is to negotiation a settlement
Disaster recovery companies:
Ensuring business continuity for company in event of interruption to the business
Management analysis
Compiling recovery strategies
Trials to asses the effectiveness of plans
Surveyors :
Eyes and ears of u/w
Full description of risk
Level of risk
Solicitors:
Issue court proceedings where negotiations have reached an impasse,
Defend claims where proceedings have been issued against the insurers customer
Also help with policy wording and reinsurance disputes
Loss assessors:
Appointed by insured to prepare and negotiate claims on their behalf
Represent the insured to maximise recovery from the insurer
