Spotlight: Claims - How a bespoke service can ensure a better experience for customers

In taking a ‘listen, solve and deliver’ approach, insurance claims specialists can gain a deep understanding of the client and that means their policy wordings, what in-house resources they have and also, importantly, their philosophy. They can identify existing pressure points, where they seek to improve services and save costs.

A third-party administrator may be able to provide an end-to-end service from first notification to settlement or focus on specific areas, such as providing a network of loss adjusters or the repairer network. There is now more emphasis on flexibility. A client may want to start small and see how the service benefits their business. They may want to take a ‘pick and mix’ approach and there may be a need to scale up at a later date or deal with surge conditions. 

The following factors will influence the need to appoint a TPA: the in-house claims department is struggling to cope with the workload and may also be held back by its systems; there is a need for greater specialism for certain claims that does not exist in-house; there is a requirement to save cost while maintaining or increasing customer service; current TPA arrangements are not meeting agreed service levels; there may also be different TPAs involved that are run separately, such as loss adjusters and repairer networks and this can result in delays and communication problems.

Those suppliers with a full suite of services under one umbrella are often able to eliminate these delays and communication problems and, ultimately, benefit from reduced lifecycles and an improved customer journey. This also allows the provision of better quality management information to insurers that can assist with the underwriting process.

The right fit

There are also a number of factors to consider when providing a solution to clients. Does the client want to fully outsource its claims? Do they want to outsource property claims up to a specified limit? TPAs can also step in when it comes to more complex claims that require validation or even if fraud is suspected.

Perhaps they wish to retain an in-house claims handling department but for the TPA to take on building repairs and home emergency call-outs. Some TPA providers have sought to offer a ‘one-size-fits-all approach’, but others will customise their offering to suit the insurer and then adapt as needs change.

When TPAs ‘deliver’ on property claims, this means working to agreed key performance indicators and service level agreements. The TPA might be focused on compliance, Financial Conduct Authority regulated and committed to customer care. This can also lead to a reduction in the client’s exposures and allow it to better manage in-house risks.

Insurers too can benefit from increased customer loyalty if claimants’ expectations are exceeded. 

Using a TPA is likely to be about ensuring efficiencies. They need to ensure clients can better manage their in-house claims resources and remove the ‘hassle factor’. Having highly experienced staff that can handle customer communication and automated systems for updates is key and ensures claimants are kept fully informed and any repair stays on track. Also producing detailed management information for the client will show claims values and trends.

The right people for the job

A team of adjusters will always attend where it is appropriate, such as with a liability claim or a validation that requires their expertise. Where it is not appropriate for a claim to be serviced by a loss adjuster it’s important to have a team of surveyors who have in-depth knowledge of insurance and property. By being connected to the TPAs repairer network and attending a claim promptly they will know what the issue is, if it can be approved and ensure that the most suitable contactor is appointed.

Having a large, vetted and established network of repairers matters and some claims may require a number of contractors. A severe escape of water claim, for example, would mean a drying team is dispatched to work, to be followed by other repairers as needed. It requires a joined-up approach and being able to bring in the right professionals in a co-ordinated way can both ensure the customer receives a high level of service with the claims process and costs are controlled.

Meanwhile, because of the pandemic, the past year has meant surveyors have also been able to handle some claims remotely if needed – many customers were able to film damage, allowing an assessment to be made and the work progressed.

The role of bespoke

All the while, the TPA needs to follow the requirements of the client and to the agreed standards. So, as an example, if the triggered policy has high sums insured or there could be damage to antique furniture or there is a thatched roof, for example, relevant specialists would need to be engaged for the work. Equally, if only a basic level of cover is taken out and the insurer has strict indemnity limits, then the TPA needs to make sure that these are adhered to, with any repairs and/or replacement goods sourced remaining within budget.

The field of cosmetic (also known as resilient) repairs – where an expert repair can be provided without the need for a replacement, can be a preferred route for the customer and also mean savings for the insurer. An example would be a damaged kitchen unit or work-surface can potentially be restored using  modern techniques, such as with resin and other materials. As with car windscreens, it is often not essential to replace the glass and so for property repairs, this option can appeal both on environment grounds and since there is no need to order in replacement goods.

Being focused on customer satisfaction with how a claim is handled and that the client is confident the agreed levels of service are being delivered is important. Taking a bespoke approach enables this and is key to making a TPA partnership effective and there for the long term.

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