Claims

Designing a world-leading, modern, flexible claims service

The Claims Board has agreed the strategy and vision for a flexible customer-centric claims model, which encompasses:

• Customer / 3^rd Party Access & Communication - a flexible  distribution model and direct access via customer and 3^rd party portals
• Reduced claims lifecycle - appropriate claims settlement and claims management processes to streamline all claims types = standard, SCAP, complex, CAT and DA Claims, reducing the claims lifecycle and simplifying the agreement / processing chain
• Flexible & enhanced settlement methods - optimised payments which reduces settlement times, including direct and local settlement (where appropriate)

This is to be delivered utilising modern and emerging technologies with the objective of enhancing the customer’s experience, via a London claims model that will deliver direct benefits to customers, carriers, our delegated agents and brokers.

An external claims survey managed by Haggie confirmed that 98% of Managing Agents (48 of 52) are supportive of the claims modernisation programme and vision.  

Objectives

To move to a new flexible customer centric model for optimised claims processing which encompasses;

• Flexible distribution and customer facing portals
• Appropriate claims settlement and claims management processes to streamline all claims types = standard, SCAP, complex, CAT and DA Claims
• Optimised payments which reduce settlement times and reduce credit risks, including direct settlement where appropriate
• Comprehensive market-wide claims reporting and MI suites
• Embracing all appropriate technologies to support the overall claims processing

Progress to date

A series of workshops have been held to engage the market and capture high and low level requirements that are needed to deliver the technology and services to support claims. Suppliers are being engaged to respond to the requirements and provide a range of estimates, a business case is being drafted to articulate how the claims model vision will be met, what would be delivered and at what cost to the market.

At the same time, DLT and Customer Portal prototypes have been assessed and have helped drive more detailed requirements.

SCAP:

• DXC selected by SCAP Working Group to remove follower effort
• DXC manual effort live 24/09
• Areas of automation have been agreed and robotics build is completed.  Pre go live testing is underway in February.
• Accelerated Claims agreement, processing and settlement for customers
• Administration and re-keying reduced freeing time for more value-add work

Strategic Claims:

• Claims vision created
• Project initiation document (PID) produced and signed off
• Selection of future architectural models produced to deliver the claims vision. These will now be assessed against the vision.
• High-level and detailed market requirements reviewed and approved by working groups
• Business Case updated and approved by governance forums
• Average claims settlement targets for different claims types agreed with senior stakeholders
• Claims Portal prototypes delivered and assessed by 30 claims professionals across 13 market firms
• DLT prototypes delivered and assessed by 57 claims professionals across 22 market firms
• RFP created
• Selection criteria proposed and agreed
• RFP structure and content agreed by RFP Working Group, Claims Board, LMACC and LM TOM Working Group
• The LM TOM Steering Board reaffirmed their commitment to claims transformation and have agreed a target date of end of March for it to be sent out.

Market Feedback

As part of claims consultation, we held four market-wide engagement sessions at the end of November and early December which saw around 150 market participants connected to claims attend. These sessions showed a strong demand for claims transformation with 100% saying the time is right or overdue, and 93% providing a score of three or more out of five on commitment – with 78% either committed or very committed to supporting it.

Attendees also highlighted the agreement process and customer experience as the highest priorities for claims transformation, which is very much in line with the proposals made.

Further updates will be given following the RFP process and more detailed solution design.