claims quarterly newsletter > modernisation initiatives
April 2019

Gemini expert hub solution

Following the approval to proceed with the Claims Expert Management Hub by the LMA Claims Committee (LMACC) in 2017, a tender process was undertaken from June to October 2017, with Advent Insurance Management Limited being selected by the market and endorsed by the LMACC on 1 November 2017 to deliver the Gemini expert hub solution to the market.

Benefits

The Gemini expert hub will deliver the following benefits:

  • Data: taking an enhanced mandatory data feed from ECF on claims transactions that will allow carriers to understand what their true fee spend is, who they are spending it with, and where fees are being incurred. This allows carriers to make informed decisions on who they use, how they are used, and the value they bring.  
  • Performance: an oversight of performance of claims experts, with the ability to track fee budget erosion, real time dashboards on data captured through the GEMINI platform, and an optional set of monthly or quarterly customer/service KPIs for lawyers and loss adjusters.  
  • Management: allowing a carrier to manage their relationship with their regularly used experts (not TPAs), including the on-boarding of that expert with a market centralised due diligence exercise, and the ongoing oversight of performance. It will also act as a searchable database of experts used by the market, to allow a claims adjuster to identify a suitable expert for a given class of business/territory, and make an informed decision on their suitability.

Current Status

The initial delivery was released to the market on 30 November 2018, and enables MAs to manage their relationship with experts, capture due diligence, securely store and access fee agreements and contracts, and obtain via Gemini regular SLA oversight reports. Approximately 600 Experts have already been registered within Gemini, and 30 MAs have signed up to utilise the hub. The registration process of Experts will continue throughout 2019.

The delivery of a data feed from DXC (allowing additional expert spend data to be captured and analysed within the expert hub) is still under discussion, but progress has stalled following a lack of engagement from DXC, and delivery in 2019 now looks remote.

An alternative solution is being explored within Gemini which moves the burden away from MA claims adjusters to add the structured fee data, and thus negates the need for any changes to ECF, and at the same time accelerates delivery to the market in 2019.

Relevance to Future Claims Model

Whilst this project was instigated before the current wave of activity on TOM Claims, the TOM team have been consulted to ensure the delivery is aligned with the TOM programme. The solution is a stand alone and transportable solution that deals with a specific area of focus. Data is being captured in a structured way so that it is more reliable, and capable of being reused. We have partnered with an agile vendor using easily configurable technology with easy integration points to other systems/platforms. There is no dependency on any legacy system or platform.

DA claims data is undergoing some major transformation at present with the delivery of DA SATS. The transition from bordereau to straight through processing will make it possible to extract fee spend data from delegated claims entities (TPAs and coverholders), and that is certainly something GEMINI can take full advantage of in the near future to give a clear view of ALL expert spend data, i.e. open market and DA claims data.

 

Gemini update
(Adobe PDF File)

Bulletins

DA SATS Endorsements
[LMA19-012-TH3/21/2019] DA SATS was launched in late 2018 as a platform to assist the market to manage bordereaux information and data gathered under binding authorities.

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Delegated Claims Oversight Strategy - Consultation on Core Deliverables
[LMA19-011-TH3/20/2019] The LMA are now in a position to publish the deliverables within a consultation phase for Delegated Claims which is scheduled to end on 5 April 2019.

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Blogs

A Satellite View of Enhanced Claims Service
[A satellite view of enhanced claims service11/26/2018] LMA's James Wilson explains how the satellite service used during recent wildfires and hurricanes enabled Lloyd’s insurers to make early part or full settlement of claims. He also talks about potential future service enhancements.

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LMA action on delegated claims
[LMA action on delegated claims9/19/2018] LMA's Claims Director, Lee Elliston discusses the LMA's programe of work in relation to delegated claims in the Lloyd's market.

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