Get Smart with Underwriting and Claims

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Get Smart with Underwriting and Claims

• Jane Wild
• Risk Management Expertise

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Content

• How to Get Smart
• Out with the old.in with the new
• ABI Application Form Guidance
• Claims Guidance

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How to Get Smart

• Swift
• Medical
• Assessment
• Results in
• Treating Customers Fairly

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Out with the Old

• Traditional underwriting methods
• Paper based
• Medical evidence
• Long delays
• Underwriting gets in the way

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In with the New

• Straight through processing (STP)
• Automated UW
• Tele-Interviewing
• Tele Claims
• Targeted GPRs
• Post issue sampling
• Monitoring standards

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In with the new - STP

• Faster submission of applications
• Applications always complete gtsignificant
  reduction in end 2 end processing times
• Interactive risk assessment questions
• Instant decisions

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In with the new - Automated Underwriting

• Expert UW systems covering all protection
  products
• Rules covering all aspects of risk assessment,
  medical, occupation, financial, sports hobbies
• A robust rule set can result in majority of cases
  proceeding straight through
• Philosophy and culture shift

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In with the new - Tele-Interviewing

• Is revolutionising risk assessment
• Improved disclosure
• Better quality information
• Reduced disputes at claim stage
• Faster completion
• Reduced costs
• Improved reinsurance terms

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In with the new - TI or GPR

• TI
• Improved disclosure
• Faster completion
• Reduced costs
• Enhanced customer experience
• Improved risk management

• GPR
• Quality questionable
• Delays
• Costs increasing
• Impact on customer
• Impact on risk management

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In with the new - Change in Culture

• Moving away from traditional methods
• Underwriters need to change mind set
• Confidence in the process
• GPR is not the panacea, but still has its place

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In with the new - The Panacea?

• Tele- Interviewing has secured its place as a
  valuable risk assessment tool and in streamlining
  the sales process
• The GPR still has a place when used in
  appropriate circumstances

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In with the new - Tele-Claims

• Improved risk management
• Enhanced customer experience
• Improved quality of information
• Management of expectations
• Swifter claims decisions

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In with the new - Targeted GPRs

• Focus on key information
• Improved quality of reports
• Better turnaround
• Cost effective
• Wheat from the chaff

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In with the new - Post Issue Sampling

• Sample of cases should be subject to verification
• Obtain GPRs to ensure full disclosure made
• To verify that the tele-interview has obtained
  all the relevant information
• Feedback

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In with the new - Monitoring Standards

• Regular reviews to ensure that underwriters and
  claims assessors are adapting to the new culture
• Balance between too much or too little
• Learning process
• Risk Committees and Reassurers require this

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In with the new Psycho - Social

• Psycho social approach
• What they say they have is not always the cause
  of.
• Attitude
• Motivation
• Time off work is a powerful predictor

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In with the new - Application Form Design

• ABI guidance introduced in February 2006
• To address the concerns associated with
  non-disclosure
• Poor form design invites non-disclosure
• Good form design everyones a winner

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In with the new - Application Form Design

• Avoid technical terms, use plain English, refer
  to high blood pressure rather than hypertension
• Highlight important text
• Avoid long questions with multiple parts
• Avoid memory test questions

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In with the new - Application Form Design

• Put yourself in the customers shoes
• Could you reasonably answer the questions?
• If you havent done this already.time to get
  SMART

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In with the new ABI Claims Guidance

• ABI Claims Guidance Non-Disclosure
• Introduced in January 2008
• Objective to provide a framework for a fairer
  level playing field in the claims management
  process
• Expectation that more claims will be paid

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In with the new ABI Claims Guidance

• Key changes
• Medical information obtained
• Providing opportunity to explain non-disclosure
• Audit trail
• Increased customer confidence
• Early days

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In with the new..

• Are you SMART?

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Contact details for Jane Wildtele 01483
527072mobile [phone]email
jane_at_janewild.com