How do claims handlers ensure that claims are resolved promptly and satisfactorily? 九色视频Claims Practice Leader, Cedric Declercq, highlights four elements of successful claims management.
Successfully resolving valid claims promptly and fairly should be at the heart of all insurers' value propositions; as I would say in French, it is their raison d'être. Nonetheless, experience suggests that claims functions and processes aren't always well understood or appreciated. What, exactly, happens during the lifetime of a claim? And what does "success" look like for the client and the insurer?
In my experience—which encompasses nearly 20-years handling claims across eight different lines-of-business—the answers to these questions often are relatively straightforward. Clients simply want to be compensated for their losses as quickly as possible. If payments are issued promptly, many clients aren't very interested in what we, as claims handlers, do to make that happen. After all, that is what clients expect—the prompt resolution of their claims.
At the same time, every client and claim is unique. As a result, claims handlers must continually adjust and adapt their resolution strategies based on myriad factors and considerations, one of the aspects of this work I most enjoy. Nonetheless, while the details vary from claim to claim, I've also found that successful claims management comprises the four broad elements I've outlined below. While these basic considerations may be familiar to some readers, clients and brokers can always benefit from an overview of how claims handlers approach their work. I also hope my observations are helpful to those new to commercial insurance, whether with an insurer, client or broker.
Technical knowledge
Whether the asset is a ship, an oil rig, a jewelry shop, a fish farm, a plane, a building or a cargo shipment, claims handlers must understand their clients' businesses and the insurance products they've bought. The opportunity to interact with and learn about diverse companies—from the largest multinational organizations to smaller family-owned firms—is for me an exciting and motivating aspect of commercial insurance.
For instance, I've always had a keen interest in marine claims. But when I first started my career, I struggled with engine-related claims because I wasn't very knowledgeable about the inner workings of ship engines. Accordingly, I spent a lot of time with AXA XL's risk engineers and external marine service providers to learn about different types of engines, how they function, why and how they can fail, and what can be done to repair them.
In sum, technical knowledge is central to delivering good claims services and promoting productive relationships with clients, whether that means understanding how a ship engine works, assessing mortality rates in fish farms, or recognizing the role provenance plays in valuing fine art and artifacts. That expertise also enables claims handlers to provide valuable feedback to underwriters on causation and lessons learned.
Coverage considerations
Claims handlers must also understand the details of the policies to determine how they would or wouldn't apply under different scenarios. This understanding is facilitated by clear policy wordings and enhanced by knowledge of the underwriting intent.
The challenge here is that more and more manuscripted policies are being issued. Larger clients in particular often prefer tailor-made policies that more closely fit their risk profiles than standard policies. However, great attention must be paid to ensuring that the policy language is unambiguous and clear.
Another challenge is comprehending the legal complexities and local market nuances in various jurisdictions. Underwriters must ensure that our policy wordings align with the laws, regulations, and market practices in each country or region. This is particularly relevant for people who cover the Asia-Pacific region, given the different jurisdictions and legal systems involved.
Regional support is invaluable. It enables the claim handler to service the client by asking the right questions to the right people and making more informed decisions about the coverage in a timely fashion, consistent with the requirements of the applicable jurisdiction. Also, AXA XL's network across the Asia-Pacific region and the breadth of experience our claims colleagues and external service providers (legal or otherwise) possess allow us to promptly enlist their assistance whenever needed.
Commercial considerations
In addition to understanding a clients' business and the policies they've bought, it also helps me as a claim handler if I've had prior interactions with a client's representatives and am at least somewhat familiar with their backgrounds and positions within the company, as well as with the organization's culture. Clients who have just experienced a claim, particularly if the losses are extensive, understandably can feel unsettled. However, if I've worked with them before, I'm more attuned to their needs and expectations, which lowers the anxiety threshold when initiating difficult conversations.
As a starting point for all claims, we strive to maintain a transparent dialogue with our clients. In most cases, open and transparent negotiations, albeit challenging, yield acceptable solutions. Ultimately, our goal is to work towards amicable resolutions. However, negotiations aren't always successful, and, on rare occasions, mediation, alternative dispute resolution or litigation is the only recourse.
Walking into that zone requires courage because I have to uphold AXA XL's standards and values while also managing the possibly divergent expectations of the client, subscription markets, re-insurers, and other stakeholders. While keeping that finely tuned balance, it's essential never to lose sight of the ultimate goal: resolving the issue at hand fairly.
Stakeholder management
A final dimension of claims management relates to engaging with various stakeholders, each of whom must be kept informed about the developments of the claim. Recognizing there may be a broader set of issues underpinning the successful resolution of the claim is important for the claims handler to understand, which is why good communication with those stakeholders is vital.
In these instances, a claims handler needs to recognize that the particulars of the claim aren't necessarily determinative, and that larger interests could influence the resolution. While claims handlers should always strive to maintain their professionalism and integrity—those are essential—the relationships between the various parties can be complex and nuanced, and unrelated issues may play a role in resolving claims.
In summary, while every claim has its own features and unique challenges, the four elements highlighted above invariably assist claims handlers as they endeavor to resolve covered claims promptly and satisfactorily.
Cedric Declercq is a Claims Practice Leader and Manager for Specialty lines supporting AXA XL's marine, aviation, energy, CMSR, ASB and A&H clients in the Asia-Pacific. He has almost two decades of experience handling marine claims in the London, French and Singapore markets. He holds a postgraduate law degree in Maritime Law from the University of Southampton in the UK. He is based in Singapore and can be contacted at cedric.declercq@axaxl.com.
