Delegated Claims programme of work

In collaboration with the LMACC & Lloyd’s claims team, the LMA has put together a delegated claims model, encompassing a long term delegated claims strategy addressing both business process and underlying systems to support that change. A program of work has been designed to help to address both of these and in response to the Lloyd’s delegated authority (DA) claims thematic review undertaken in 2017.

The main aims of the program are to provide an improved and more consistent DA experience for TPAs, improved service for customers and increased indemnity accuracy. This will be achieved by providing the market with guidance, tools, model wordings and frameworks to assist in moving towards a common market approach in managing delegated claims.

For an executive summary of the programme, click the document link below, or download the detailed guidance on the side panel.

Our progress

LMA21-30-TB | June 2021 – Delegated Claims Standards

The DACG has been working collaboratively with Lloyd’s, brokers and DCAs to enhance the delegated claims business model by addressing the key areas of friction to provide improved outcomes for all. These Delegated Claims Standards (DCS) are outlined in the attached guidance document. The initial launch of the standards can be found at LMA20-036-TB-DCS.

DCS managing agent alignment  : This alignment document outlines how each managing agent aligns to the various Delegated Claims Standards. The intention here is to provide clarity to brokers and DCAs on the approach of the various Lloyd’s managing agents, which will make their lives easier, by understanding the stance each managing agent is taking.

DCS Guidance  : The guidance, initially published in July 2020, outlines in more detail the actual standards, including the deliverable and associated benefits for each, then links to any supporting material for each standard. It also links to the supporting material for each standard.

Delegated Claims Standards Table: The DCS guidance document supports the delivery of these new standards, and includes links to enabling and supporting material previously published.

 

LMA20-036-TB | 30 July 2020 - Delegated Claims Administrator Agreement (LMA9188) & Market Standard SLAs

The new DCAA template, LMA9188, is now ready for use and can be accessed HERE  or via the Lloyd’s Wordings Repository. The market-led SLAs and SLEs have been incorporated into the schedules of the new LMA9188 and can be easily extracted by those who wish to use them separately to LMA9188. We have also produced a FAQ document to support the delivery of the new DCAA, which can be found at Delegated_Claims_Administrator Agreement_FAQ.

LMA20-016-LE | 07 April 2020 – LMA9186 Co-Lead Claims Agreement

LMA9186 CLCA  Delivery of a model agreement that will wrap around a number of co-lead arrangements to a specific coverholder, replicating the processes within the Lloyd’s Claims scheme to ensure efficient claims agreement processes.

LMA19-030-TB | 08 November 2019 - DCA & Coverholder Audit Framework & Scope

Following feedback from the Lloyd’s Thematic Review in to DA Claims Management in 2017, work commenced to enhance the existing audit process, specifically for DCAs. The already embedded Coverholder audit scope was reviewed and refreshed to include a greater focus on claims controls and claims testing (technical file audits), with a DCA specific version being made available with the same (and consistent) claims controls and testing. The deliverables are:

  • DCA specific audit scope , allowing managing agents to propose some or all of the following components, depending on previous audits and risk appetite;
  • a Guidance Document  to support the auditors use of the DCA audit scope, with much greater clarity on expectation of the claims controls expected; • an updated Claims Testing Sheet for use as a technical file audit question set (from 38 questions to 61 questions), including an aggregation and reporting tool to group and analyse audit findings;
  • an updated coverholder audit scope  and guidance document  , refreshed to include any new material developed as part of the DCA audit scope creation.

Should you have any queries about the program or would like to get involved, please contact either Carla Wise or Tim Bowling.

Contact us

Carla Wise
Delegated Authorities & Claims Operations Manager

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Tim Bowling
Senior Executive, Claims

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Strategy document

Download Strategy Document


Activity tracker

Click here for timelines