Chartered Insurance Institute Claims Management

Assess_Saw

This is taken from the Claims Management Exam -

Give examples of statements that might be contained in an insurance claims philosophy -

Answers with my comments afterwards -

Quality of Service - invariable poor
All Claims will be paid fairly and promptly - Laughable assertion does not happen
Prompt and Courteous response to customers- try and get someone to call you back from a claims department or loss adjuster
Efficient claims investigation - plenty of investigation very little efficiency
Clear decision making - loss adjuster to incident manager to insurer and all the other links in the chain no one prepared to make a decision and always covering their backs in case of the dreaded audit
Fair claim negotiation - use our suppliers or lump it , vouchers , drag the claim out until the policyholder just gives in and accepts whatever he's offered
Awareness of total claims costs - may have a point here however has anyone measured what the flood restoration companies made last year and they are still drying properties now!
Prompt handling of complaints - ignore them , take the full amount of time legally available to respond in all instances so that the complainant gets fed up or suggest the ombudsman who takes at least six months before the papers are even looked at

The reality of the insurance claims process is not one the industry can be proud of.

raskazz

My opinion: Don't feed the troll.

Insco

How many moneysavers feel that their insurance claims have been paid fairly and promptly, were efficiently investigated, were treated promptly and couteously and were kept informed throughout?

mattymoo

Are you talking all sectors here or just household?

I work for a niche insurer in the commercial sector and we are justifiably proud of our claims settlement procedures.

I do however agree with some of your points re household / motor and have seen a steady deterioration since I left that area in 1994. I took out a policy with Hiscox this year on basis of their reputation.

Insco

Household / motor claims without a doubt.

As you say Hiscox, and Chubb and a few other HNW Insurers, and Co-op generally provide a good value for money service.

Pile it high sell it cheap Insurers - we all know the ones, are the ones that typify the summary by Assess Saw

Which just goes to show its not always about moneysaving! Because with household insurance, you really do get ( or not) what you pay for.

dunstonh

Pile it high sell it cheap Insurers - we all know the ones, are the ones that typify the summary by Assess Saw

Which just goes to show its not always about moneysaving! Because with household insurance, you really do get ( or not) what you pay for.

buy cheap, get cheap. Some people focus too much on the pennies they pay not realising the pounds they can miss out on later by that false economy.

This site used to be more about value for money but has been increasingly about getting something for nothing in recent times.

mattymoo

I did post in another thread recently about the erosion of policy cover and service levels in the race to reach the top of the comparison site tables (by having the lowest premiums).

The only way the companies can do this is to strip away the policy benefits until you have a no-frills product backed by an inadequately resourced back office / customer support team.

The consumer is in some ways getting what they deserve by treating insurance as a commodity purchase and the providers are not doing anything to prevent this view.

dunstonh

The consumer is in some ways getting what they deserve by treating insurance as a commodity purchase and the providers are not doing anything to prevent this view.

Its a bit of a ever decreasing circle and the internet doenst help. Quote portals continue to focus on premium and not benefits and I swear a good majority of those that buy the products online dont know what the actual features and options are that they should look out for.

One of the quote portals advertising on tv at the moment highlights how it scores insurers based on your criteria. Yet on the example screen they show, the top company on their list only gains 4 stars because it doesnt meet all the requirements but its top because its cheapest. So anyone buying that one is not buying what they need. Come claims time they will no doubt complain when they find they are not covered as well.

Martin's MPPI article highlighted a few insurers that are cheap. Yet when you look at their coverage and clauses, they are have a number of restrictions that are not present with providers who are not that much more expensive. Yet you dont see the better plans mentioned. Just the cheap ones.

Oscar_The_Grouch

OP, you seem to have an axe to grind. From the fact that you are quoting CII exams, can you confirm whether you are a qualified member of the CII yet? I assume not if you are reading past papers.

Whatever the answer, it's not too late for you to leave the industry. If you have that low an opinion of the companies out there, isn't it somewhat hypocritical to earn a living from them?

If it was your intention to start a debate over whether insurance claims handling departments were being given the resources to meet the expectations of the FSA and consumers, why not simply pose a question rather than your blanket insult to every claims handler in the UK (plus the various callcentres in far flung places)?

I have worked in the insurance industry now for over 20 years. I have made my fair share of mistakes for which I have had to apologise, but this is balanced by some very nice letters thanking me for my help and assistance. I've had my "day in court" to defend my decisions (twice and one of those was the high court) and met some very influential people.

I was at the CII dinner in Croydon in the 90's when in the middle of the main speach the guest speaker stopped and said to the table where some people from Direct Line were sitting; "Can you hear me at the back there, because I sure as hell can hear you up here".

All in all, I have had a great time so far. I started with the CU straight from school, so I am less than half way through my career. In my time, I have been a claims handler and although I am not one now, I am very pleased with the way the claims handlers where I work conduct themselves.

I can't speak for everyone in the industry and would not want to. I can, however, confirm that I am very satisfied with the way that the my employers deal with claims and confident that this will continue. If you are not so confident, become an accountant.

jessjess_2

OP, well done for showing you can use google. Now if you spend your time revising a bit more you might learn something. back to the textbooks little man.

mattymoo

jessjess wrote: »

OP, well done for showing you can use google. Now if you spend your time revising a bit more you might learn something. back to the textbooks little man.

While we might despise / knock the actions of loss assessors like Assess saw and Insco, I think we have to remember they are simply another part of the insurance / claims process and one that acts as an advocate for the customer.

I would hate it to appear that the insurance company people on this board are ganging up on people in a profession that acts as a policyholders advocate.

Perhaps we could just drop all the name calling / legal threats and just debate the various threads in the same way that we would do in our professional lives?

It would certainly be in the interests of the majority of board users.

Oh - Jessjess, I've got 21 years experience in the trade but no CII qualification to my name. I work in risk management and hold other professional qualifications. I've also been the president of my local CII institute. The lack of ACII / FCII is not a bar to posting here.