Claims management is often more complicated than what first meets the eye. From complexity and severity to turnaround times, litigation, recoveries, fraud detection and claims leakage, the factors that influence a claims lifecycle are limitless.

John White, Partnership Manager at Gallagher Bassett Australia discusses Gallagher Bassett’s unparalleled experience and approach to supporting insurers with complex claims portfolios.

Q: GB has a proven track record of reducing the average cost of liability claims for clients. Can you tell us the approach GB takes to reduce average claims costs?

John White (JW): Claims management should be a relatively straightforward process, but due to the many moving parts and potential for claims cost blowouts, it is always best to engage an expert TPA.

The approach adopted by GB’s Specialist Liability team is quite simple and can be summarised as ‘early everything.’ This foundation applies to every stage of the claims management cycle from notification, early proactive client contact, fast track triage, investigation and resolution. Our approach is also one of a true partnership with an appreciation and shared understanding of desired outcomes.

Q: What is GB’s approach to supporting insurers who transition their complex claims portfolios?

JW: There are several factors that should be considered when engaging a TPA.

GB has more than 25 years’ experience in Australia supporting insurers with complex claims management which means our team is well versed in considering the specific needs of our clients. While our support for each client is designed to solve their particular challenges, our approach always encompasses these six elements:

1. Implementation / Transition

The process of implementing a new portfolio or transitioning an existing program from legacy systems is supported by the entire GB business, coupled with extensive experience using robust project management governance. GB’s Risk Management framework is embedded in the process, which has been developed over many years of consistently performing and refining these projects for our extensive range of clients.

2. Claims Service Review Meetings

These regularly scheduled meetings cover operational issues such as claims reviews, suggested system, process and service enhancements, training, education and other functions as required.

3. Program Steering Committee Meetings

The GB management team will meet with their client at scheduled intervals to plan, review and approve initiatives and to implement continual program improvements.

4. Comprehensive Plans of Action

Our Luminos® claims management RMIS system allows for the development of a comprehensive action plan. All relevant information is captured and forms the basis for the proactive resolution approach our claims experts use for each claim.

5. GB Expertise

Our claims experts have an inbuilt approach to proactive claims resolution, and this is constantly reinforced via our structured claim strategies.

6. Issues Register and Dispute Handling

A live issues registers allow us to document issues in real time as they arise to then assign ownership to track and monitor actions for resolution.

GB has a proven complaint management process to ensure that remedial steps are undertaken and managed by our Quality and Compliance team in consultation with the relevant claims expert, and to ensure timeframes for dispute resolution are adhered to, monitored and reported on regularly.

Q: What are the most critical aspects when managing liability claims that insurers should be aware of?

JW: Our claims specialists are accountable for independent thought and do not blindly follow the opinions of others. This level of accountability, combined with a case managed ownership approach ensures that claims are proactively driven to settlement, reducing delays and cost leakage.

While various liability classes have their individual nuances in terms of complexity that need a particularly high level of regular focus (i.e Malpractice, Construction and Complex Economic Loss claims), one of the most critical aspects for Underwriters at any stage of the life of the claim is the accuracy of the claims reserve.

A large variation between the reserve and the ultimate total incurred amount obviously affects an organisation’s profitability, so accurate reserve management on each claim file is a critical factor for actuaries to correctly validate total reserves against individual policies. The long tail nature of some classes and the lack of detailed information can make the reserving process a little subjective in the early days. However, ensuring a collaborative peer review approach to more complex claims on a regular basis can avoid the need for stepped reserving and bring a greater level of accuracy to the early assessments of claims.

GB’s experienced claims professional specialty team has decades of experience managing complex claims across a range of business lines.

Connect with Gallagher Bassett Australia Partnerships Manager John White or speak with the GB team to explore how Gallagher Bassett can support you with superior liability claims management.

Blog Author

John White

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