Clarity, consistency and certainty key to claims success

Claims is a hot topic in Spain following IGREA’s publication of its claims charter. Adrian Ladbury asked José Ramon Morales – country manager Iberia, insurance at insurance at XL Catlin, AXA XL, a division of AXA – how he believes claims could, and should, be more efficiently and professionally handled in today’s complex global market. AL: What is your strategy for ensuring that valid claims are paid rapidly and effectively? JM: Paying claims in good time is always important, but for many claims the monetary payouts are only one part of the story. Equally important is how we work with the client to get them back to where they were before. There are three elements to delivering effective claims management consistently and efficiently. First, people. You need to have the right professionals who can understand both the needs of the client as well as the wording of the insurance contract. Also, you need to have a team that is resourced adequately. Second is technology. World-class IT tools and processes are paramount. Third, you need to have a strong relationship with a variety of external service providers, including recovery/cleanup specialists, attorneys, IT professionals and so on. The fact is that with large, complex claims, our role often includes us mobilising and managing an assortment of third-party specialists to undertake specific activities to support the client in responding to, and rebounding from, the incident. That’s why we put considerable emphasis on continually reviewing our networks of outside resources. When an incident occurs, you want to be able to call a technical specialist that you have worked with before. This needs to be someone you know is capable of addressing the particular problem at hand, and who understands our expectations for delivering consistently superior customer service. AL: What are the main causes of dispute and delay with corporate and commercial insurance claims? JM: The main cause of dispute is coverage. This is because of a lack of clarity over certain wordings, especially triggers in some specialty lines that are difficult to precisely define. That is why communication between client, broker and underwriter is such an important part of the underwriting process. AL: Which lines of business lead to the most complex and difficult claims? JM: While all lines of business can bring complex claims, D&O is generally the most complex, especially when it comes to determining the trigger. Also, product liability, construction or global programmes can become quite complex. Resolving claims in other countries, for example, can be challenging. This is where good communication, collaboration and the strength of our local network partner are essential. AL: How could and should risk managers work with their brokers and insurers to minimise claims disputes and delays? JM: A good way is managing and setting expectations at the beginning of the relationship and aiming to set up a collaborative approach, with transparency as a key principle. This needs to be underpinned by agile communications and processes. Also, I would encourage risk managers to spend more and more time trying to understand how insurance companies can adapt to their programmes and needs. They need to understand how they will resolve an international claim, how they are staffed, who is authorised within the company to decide, and what IT tools and platforms they have. Specialist insurers may look alike but we are all different, and understanding these differences is important. Brokers are also in a good position to help risk managers better understand the attributes of an insurer’s claims practices. AL: How can the latest technology be used to make the claims process more effective and efficient? Does blockchain offer a radical solution? How are you investing in technology to improve the way you manage claims? JM: Here, our digital team is working with startups and various service companies to understand emerging technologies and how they can be applied to transform our internal operations into a truly digital business. We have many initiatives underway, in addition to various blockchain-related efforts, focusing on new technologies and data sources. Our overarching aim is to positively impact how we underwrite new and emerging risks, support global programmes and captives, and settle claims. Blockchain technology offers the possibility of simplifying transactions between multiple parties in insurance. The potential benefits include shorter turnaround times as well as increased data quality, transparency and security.

Clarity, consistency and certainty key to claims success

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