“A claim is the defining moment in the relationship between an insurer and its customer. It’s the chance to show that the years spent paying premiums were worth the expense. If a claim is handled well, retention rates may rise. If handled poorly, the insurer may not only lose the customer, but also damage its wider reputation.”

Source: “Cutting the cost of insurance claims” – pwc

The speed and accuracy with which claims are handled are major drivers of service differentiation in an industry that is resolutely price-competitive. Because customer expectation is high and tolerance of poor performance is low, it is in a business’s own interests to make sure that it does all that it can to get things right first time and to respond quickly and efficiently when errors occur.

Also, insurance – by its nature – is open to abuse either through the actions of one-off opportunists, or from those who perpetrate organised crime. Fraud is the biggest area of concern and the UK insurance industry and its regulators are becoming increasingly successful at detecting it and punishing those responsible.

The Course Agenda

Claims handling – how it works

• Claims handling – the basic process
  • The claim form
  • Third Party Claims
  • Double Insurance
  • Claims settlement
• Rejecting a claim

Claims handling and regulation

• Claims handling and the FCA’s Principles for Businesses
• Insurance Conduct of Business Sourcebook (ICOBS) 8: Claims Handling
• Treating Customers Fairly
• FCA’s Thematic Reviews
• Lloyd’s minimum standards

Governance and controls

• Preventing claims fraud and the Fraud Act 2006
• Policies and procedures
• The use of Information Technology (IT) in claims handling and its benefits
• Management accountability
• Outsourcing claims handling
• Auditing claims
• Management reporting

Handing claims related complaints

• FCA & Lloyd’s requirements
• Financial Ombudsman Service (FOS)