Delegated Claims Oversight Strategy - Consultation on Core Deliverables
In September of 2018, we outlined a programme of work that we would be undertaking in relation to Delegated Claims (LMA18-043-TH), and provided an update on the programme in December 2018 (LMA18-052-TH) to carriers and third party administrators (TPAs).
We are now in a position to publish the deliverables within a consultation phase which is scheduled to end on 5 April 2019.
The key areas we are engaging the market on throughout that period are:
- Delegated Claims Administrator Agreement (replacing the TPA agreement LMA9008)
- SLA and MI (performance) measures
- TPA audit framework, plus changes to the coverholder framework for claims
- The core deliverable in relation to due diligence and compliance is being managed simultaneously by Lloyd’s. With their consultation for Risk Based Oversight underway we would strongly urge all market participants to engage with Lloyd’s consultation, which you can find here.
Click here to access an overview of the above deliverables, and to leave feedback via an online survey prior to 5 April 2019.
These core deliverables have been designed by the market following the output of Lloyd’s Claims DA Thematic Review, to which the LMA Claims Committee (LMACC) set clear objectives and priorities around due to the inconsistent, uncommon, and complex approach to managing delegated claims.
The objectives of the programme are to:
- provide an improved and consistent delegated claims experience between managing agents (MAs) and TPAs/coverholders
- improve the service delivered to policyholders via common and consistent delegated transactional and management methods.
The LMACC sponsors Nick Sinfield and Richard Foulger said:
“The importance of servicing our policyholders in key territories via our delegated network is critical to attract and retain profitable business in the Lloyd’s market, and the role that coverholders and TPAs play in providing that service is significant and increasing as our competitors adapt and respond to client needs. It is absolutely necessary to make the touchpoints and methods in managing the delegation as consistent and uncomplicated as possible across the whole Lloyd’s market to both enable coverholders and TPAs to be attracted to operate in our market and to provide service excellence.
"Our delegated agents are there to serve our policyholders and we must allow them to do so with authority and autonomy in a seamless and efficient manner, with effective, robust controls and oversight in place at the appropriate points that don’t negatively impact the delegated agents operation or claims transaction.”
The engagement and adoption level (of each of the deliverables) from MAs is critical to meeting the objectives above, your feedback and the re-shaping of any deliverables ahead of implementing at a market wide level is key.
The LMA Binding Authority Strategic Claims Group (BASCG), LMACC and Lloyd’s have played a key role in designing the proposed outputs that are part of this consultation, while Lloyd’s will be following up on the output of the DA Claims Thematic review to assess how MAs and the market have responded to trends identified in Q4 2017.
Should you have any questions on the consultation or want to understand more about the context of these deliverables, please get in touch with either Tom Hamill or Tim Bowling.
Tom Hamill
Manager, Claims and Delegated Authority Operations
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