Transcript ECF & Market Reform

Electronic Claims File Update
The Old Library, Lloyd’s
4th September 2006
Agenda
• Introduction and Welcome
Trevor Maddison
• A Broker’s View
Trevor Maddison
• ECF and Market Reform
Andy Brookes
• ECF Underwriter View point
Carl Phillips
• Electronic Claims Files
Steven Matthews
• Questions and Close
Trevor Maddison
A Broker’s View
Trevor Maddison
Marsh and BEFIT
Electronic Claims Trading is Simple
• Electronic transfer of data and documents, broker
desktop to underwriter desktop.
• Claims workflow managed from the desktop
electronically.
• Removal of the paper claim file.
• Simple claims – straight through processing, no broker
involvement.
• Claims advocacy – broking where it matters.
• Delivery of a quality client and underwriter service.
ECF – Key Messages
• Market reform is no longer a set of words. This project is
real, ECF is real.
• In one weeks time the potential to trade new claims
electronically with Lloyds syndicates (day 1 in-scope)
will become a reality.
• The IUA are catching up fast, pilots have commenced
and the commitment is there – we expect them to be live
mid 2007.
• Reform of the claims process is happening, ECF is the
catalyst to a modern market place.
• The London market is changing, market reform and
electronic trading will work this time.
• Are you preparing for change?
Key criteria for ECF success
• Full commitment of all syndicates to trade claims
electronically.
• Full commitment of IUA carriers to trade claims
electronically.
• Full commitment of brokers to move to electronic claims
trading within a reasonable timeframe.
• All new claims received in the 4th Qtr 2007 traded
electronically, all brokers, all underwriters.
• Underwriters are making a commitment, brokers need to
respond.
• There will be issues, this is not Big Bang brokers need
to work in partnership with Underwriters to make ECF a
London market success.
Market Reform
ECF & Market Reform
Andy Brookes
Market Reform Programme Office
Page 7
ECF: Key part of the London process reform programme
Market Reform
• Overall aim:
Page 8
– A framework of standards for business processes that
enables firms to deliver services efficiently to customers at a
cost and level of risk comparable with other platforms
• Note:
– Any costs inherent in a subscription market must be offset to
deliver this comparability.
– Any changes in business process must be managed in such a way
as to avoid undermining the unique qualities/competitive
advantages of the London Market.
ECF is not happening in isolation
Market Reform
• Claims beyond ECF
– Change requests – no system stays put
– Claims infrastructure to include IUA
– Protocols (LMP2001); Lloyd’s Claims Scheme
– Support Claims Strategy & Minimum Standards
• Integration with other reform workstreams
– Accounting & Settlement
– Repository use; DRI standards; P2P strategy and claims
– Contract Certainty
– Roles and responsibilities clearly defined
– Repositories……..again
Page 9
Implementation approach
Market Reform
• Lead implementers
Page 10
• Prepare to follow
– Commercial
– Lloyd’s performance standards
– Regulatory
• Sponsors; project managers
Market Reform
E.C.F.
Underwriter
Viewpoint
Carl Phillips
Amlin & LMA Systems Delivery Group
Page 11
Why Do Underwriters Need A Claim File?
• Good Business Practice -
Market Reform
Easy way of supporting / evidencing decisions
• Justify Reserves and Payments to Shareholders
• FSA Requirements
• Lloyd’s Claims Management Principles and Minimum
Standards
• Claims Agreement for Followers (CAF) Consistency of information
• Goshawk / Tysers
Page 12
Market Reform
Why An Electronic Claim File (E.C.F.)?
Page 13
•
Concurrent/Contemporaneous Access
•
Transparent and Auditable Process
•
Improve service levels to customers
•
Removal of dead time (transporting files)
•
Worldwide access to the file 24/7
•
Data Integrity and Backup
•
Collaborative Agreement Lloyd’s Claims Scheme/ Claims Agreement for Followers
•
The Technology Exists in everyday use by all London Market Practitioners
•
Storage and filing requirements
LMA ECF Objective
Market Reform
• To replicate today’s file electronically
– Not a Blue Sky Claims System development
• Based on existing products
– No changes to CLASS at this stage
– Seamless access to CLASS information and documents through an
Integrated Repository using Windows
• Provide a base product in September 06
– To be evolved once experience gained
• Post implementation of base product
– Strategic review of on-going development
– e.g. Third Party Access / Leader Reserves/Web Services etc.
Page 14
Features
Market Reform
• Broker submits claim electronically
– Enables parallel presentation to insurers
– Reduces data transcription errors
– Allow brokers to concentrate on complex claims
– Facilitates improvements in claims settlement time
– Improves Customer Service
• Improved insurer access to information
– It’s the insurers’ file
– Concurrent access to all subscribing insurers
– 24/7 access, worldwide
Page 15
Market Reform
Overview
ECF Screens
Data
CLASS
Broker
Input
Documents
Repository
· References
· Paid / Outstanding
Amounts
· Claim Status /
Agreement
· Reports
· Correspondence
· Bordereau
· Placing Documents
Agreement Parties Can Review All Claim Details, Perform
Updates & Record Agreement in One Place
(Without a Broker?)
Page 16
Insurer
Access &
Input
Status today
Key Enhancements in 5 Phases
Market Reform
Phase 1 - See all documents in one view
Phase 2 - Leader control of file/improved searching
Phase 3 - ACORD DRI (receipt of documents)
Completed 2005
Phases 4/5 – Merged into a single phase CLASS @ Lloyd’s data through GUI, full DRI and
Seamless link with documents in repository
Page 17
On target for
September Roll out
Go/No Go Decision 7 Sept
Systems Processes & Procedures
Market Reform
•
Systems Processes and Procedures Guide
– Broker & Underwriter Collaborative Approach
– High-level guide
– NOT a systems user manual or adjusting manual
– Focuses on process
•
Workshops have been convened to review generic process
and class of business variations
– Confirmed generic process
– Confirmed little variation by class of business
– Many Issues identified and documented for resolution.
Page 18
Types of claim
Market Reform
The majority of all new claims can be processed via ECF. However there are
certain circumstances that ECF has not been required to support and some other
instances where system change or further definition of market processes is required
to enable full support.
• Business or Claims types that ECF has never been required to support
–Claims on unsigned risks
–General Average
–Proportional treaties
–Scheme Canada
–Direct Livestock
• Business or Claims types excluded from the current implementation
of ECF
Solution is currently being developed
Require further analysis
– Delegated Lead to XCS (other than 100%
Delegation, which is in scope)
– Political Risk
– Binding Authorities, Cover Collections and
other Bordereaux Claims
Page 19
–Claims Payable Abroad
–Letters of credit, loss
reserves and Outstanding
Cash Advance (OCAs)
–Bulk Settlements
– Aviation verticals
– Certain Multiple OSND claims
– Third Party Access to ECF
– Existing paper claims files
Next Steps
Market Reform
• GO LIVE – September 2006
• Delivers first version
– of an integrated electronic claims service for Lloyd’s
– replicating existing file electronically
– with improvements where possible
– companies and syndicates can see the same claim
– BUT a step-change for the London Market
• There will be more issues and enhancements
– Legacy claims
– Issues recorded and initial plan for resolution
• Things change and we won’t have thought of everything
Page 20
ECF is here and we’re ready
Market Reform
• MAT approaching completion
• Staff training underway
•
16 Managing Agents participating from next month
– Representing about 60% of Lloyd’s Market Capacity
•
5 Brokers submitting ECFs next month
– Representing about 40% of Lloyd’s Market Capacity
– There won’t be a paper file!
• Increasing commitment every week
A Partnership Approach that Benefits all - But not least the Policy
Holder.
Page 21
Amlin’s Approach
Experience and extracting maximum benefit
• Have built experience in ECF through 7 pilots across
7 classes of business with 7 brokers over 2 years
• All claims teams have been engaged in ECF, some
since April 2004; claims handlers now looking forward
to going live with Electronic Claims.
• Implemented new repository workflow system
specifically to handle all claims electronically
• It works!
Amlin’s Approach
Preparedness
• Amlin have begun internal training in
preparation for live date.
• Little change for those that have used CLASS before
• Amlin confident that 80% of their new claims
can be handled through ECF now without
impediment.
• There will be pain to get the gain!
Electronic Claim Flies
Stephen Matthews
Tim Lovick
Date: 4 September 2006
© Xchanging 2006, no part of this document may be circulated, quoted or reproduced without prior written approval of Xchanging.
Agenda
What is ECF?
Process Overview
Roles and Responsibilities
Validation Checks
Mandatory Rules
Roll Outs
Lessons Learnt
System Overview
Practical Help
25
© Xchanging 2006, no part of this document may be circulated, quoted or reproduced without prior written approval of Xchanging.
What is ECF?
Market
Repository
Converged
CLASS
C@L
ECF
Tracker
Workflow
26
…combination of new systems and procedures
© Xchanging 2006, no part of this document may be circulated, quoted or reproduced without prior written approval of Xchanging.
ECF Process Overview
ECF System
XCS CLASS
(XCS Internal System)
Once all agreement
Parties ‘Accept’ claim
Document storage
system
Supplement
claim details e.g.
i. FIL
ii. NAIC
iii. TF codes
Broker
4. CLASS
CLASS
Database
Agreement Party
MARKET
SCM &
BSM
27
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XCS
Roles & Responsibilities of ECF Parties
Lead Lloyd’s Underwriter
Broker
Role
XCS
•
Agent of the (Re)Insured
•
Review claims information provided by broker and other parties
•
Review claims information provided by broker and other parties
•
Collate and present claims data / information to Insurers will include first and subsequent claim advices
•
Represent the interest of Leading Lloyd’s Syndicate in any claims
handling decisions, including coverage, recovery, litigation etc
•
•
Collection of claim monies on behalf of (Re)Insured
Represent the interest of Following Lloyd’s Syndicates (if CAF or
Peer Review, will include claims handling decisions including
coverage, recovery, litigation)
•
Advise claim details to Lloyd’s Syndicates and process claims,
recoveries and/or fees via Lloyd’s Market claims system
•
Confirm broker has uploaded correct claim documents and review same.
Will include:– Slip with OSND and policy, if available and all relevant
endorsements (including AP/RP and Non Premium)
– Cover Note / Certificate / Declaration, where applicable
– Expert reports, invoices, receipts, shipping documents etc
Check coverage details and confirm:– Certificate / Insured / interest / declaration attaches to policy and
sum insured
– DOL / DCM falls within policy / certificate period
– Claim falls within available policy / certificate limits
– Applicable coverage type
– Deductible / excess / franchise correctly applied
– Loss location
Review and assess claim documentation. Will include (but not limited to):– Identity of Insured / Coverholder / Cedant / Reinsured
– Preliminary and subsequent loss details
– Expert reports
– Release Form / Proof of Loss Form etc
Review broker loaded financials
Update XCS comments on CLASS @ Lloyd’s entry
Route claim to other agreement parties, as necessary
Instruct and manage experts
Manage disputes with insured in conjunction with Leader. Will include:– Arbitration hearings or court cases
– Depositions etc
Manage “Direct Report” claims files and agree and process any applicable
“Direct Settlements”
Determine and execute claims handling strategy in conjunction with
Leader
Provide Technical Processing or CAF service, as required
Process corrections
Determine and create XCS CLASS entries in line with:– Regulatory requirements
– CAT code splits
– NAIC splits
– Trust Fund
– State Code requirements
Create XCS CLASS entries and send SCM / USMs to Syndicates
Offer an Enhanced Claims Review service
Pursue recoveries, where appropriate
•
•
•
•
Responsibilities
•
•
Create / update claims data in CLASS @ Lloyd’s in a
timely fashion. Will include:– Claims
– Refunds
– Fees, if included in indemnity amount (optional for
brokers if not))
Upload correct supporting claims documentation onto
Market Repository. Will include (but not limited to):– Slip with OSND and policy, if available and all
relevant endorsements (including AP/RP and Non
Premium)
– Cover Note / Certificate / Declaration, where
applicable
– Preliminary and subsequent loss details
– Expert reports
– Release Form / Proof of Loss
– Correspondence from (Re)Insured
– Supporting claim documents (e.g. bordereau,
shipping documents, invoices receipts, etc)
Convey instructions to experts on behalf of Insurers
Calculate claim adjustments, including application of any
applicable deductibles, orders, reinstatements - where
applicable etc
Arrange payment of claim funds to (Re)Insured on behalf
of Lloyd’s syndicates
Arrange payment of expert’s fees on behalf of Lloyd’s
syndicates, if included in indemnity amount (or broker
elects to collect fees if not)
•
•
•
•
•
•
•
•
•
•
Confirm broker has uploaded correct claim documents and review same.
Will include:– Slip with OSND and policy, if available and all relevant
endorsements (including AP/RP and Non Premium)
– Cover Note / Certificate / Declaration, where applicable
– Expert reports, invoices, receipts, shipping documents etc
Check coverage details and confirm:– Certificate / Insured / interest / declaration attaches to policy and
sum insured
– DOL / DCM falls within policy / certificate period
– Claim falls within available policy / certificate limits
– Applicable coverage type
– Deductible / excess / franchise correctly applied
– Loss location
Review and assess claim documentation. Will include (but not limited to):– Identity of Insured / Coverholder / Cedant / Reinsured
– Preliminary and subsequent loss details
– Expert reports
– Release Form / Proof of Loss Form etc
Review broker loaded financials
Update Lead Underwriter comments on CLASS @ Lloyd’s entry
Route claim to other agreement parties, as necessary
Instruct and manage experts in conjunction with XCS
Manage disputes with insured in conjunction with XCS. Will include:– Arbitration hearings or court cases
– Depositions etc
Manage “Direct Report” claims files and agree any
applicable “Direct Settlements”
Determine and execute claims handling strategy in conjunction with XCS
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
System Validation
Broker
Lead Lloyd’s Underwriter
Broker loads C@L
Class @ Lloyds
XCS
Lead agrees C@L
Class @ Lloyds
XCS release XCS CLASS
and send SCM / USM
to market
XCS agrees C@L
Class @ Lloyds
XCS CLASS
Mandatory Fields in C@L - 25
(Entered by Broker)
Editable & Updateable Fields in C@L - 5
(Data originally entered by Broker)
Editable & Updateable Fields in C@L - 5
(Data originally entered by Broker)
Non-Editable Fields in XCS CLASS - 17
(Data originally entered by Broker)
- UCR (includes Original Broker)
- TR (includes Payee Broker)
- Bureau
- LMP Indicator
- First Advice Indicator
- Advice to include Settlement
- UMR
- Broker Phone No.
- Bureau Lead
- Insured
- Policy Period or Period Narrative
- Slip Order 1 or Narrative
- Loss Name
- Loss Date From
- Loss Details (Narrative)
- Original Currency
- O/S amt or O/S Qualifier
- Order Settlement (if Settlement)
- Settlement Currency (if Settlement)
- Settlement Amount (if Settlement)
- Original Signing No. & Date
- Settlement Exchange Rate
- Risk Code
- CAT Code
- PCS Code
- Further Agreement Parties
- Cause Codes (not used at the moment)
- Risk Code
- CAT Code
- PCS Code
- Further Agreement Parties
- Cause Codes (not used at the moment)
- UCR
- TR
- Advice / Settlement
- UMR
- Syndicates on Risk (including Bureau Lead)
- Slip Order
- Original Currency
- O/S Amount or O/S Qualifier
- Settlement Currency
- Settlement Amount
- Original Broker (Calculated from UCR)
- Payee Broker No. & Pseud (Calculated from TR)
- Original Signing No. & Date
- Settlement Exchange Rate
- Broker Claim Reference 1 & 2
- Interest
- VAT amount
Editable Fields in XCS CLASS – 16
(Data originally entered by Broker)
- Broker Phone No.
- Insured
- Pol / Cert Period From & To
- Loss Name
- Date of Loss From & To
- Loss Details (Narrative)
- Reinsured
- Original Insured
- Perils
- SI Limits
- SI Currency
- Excess
- Loss Location
- Vessel / Aircraft
- Lawyer
- Adjuster
NB. Editing these fields will cause discrepancies
between C@L and SCM/USMs sent to Syndicates
Optional Fields in C@L - 42
(Entered by Broker)
- Broker Claim Reference 1 & 2
- Reinsured
- Interest
- Perils
- Location / Voyage
- SI Limits
- Excess
- Loss Location
- Vessel / Aircraft
- Lawyer
- Adjuster
- Previously Paid
- VAT amount etc
Additional Fields in XCS CLASS - 72
(Entered by XCS on XCS CLASS)
- Presentation Date
- Charge Type
- Peer Review Indicator
- Market Code etc
Getting the data right first time
Claims
Data
SCM & USMs
Contractual Framework – Mandatory Rules
• Licence to use and access to Documents
• Unintentional disclosure of Documents and Privilege
• True, fair and complete copies
• Use of ECF and A&S
• Response Buttons/Response Codes (for Lloyd’s only)
• Recording Transactions (ECF and A&S)
• Authentication of Users
• Governance
• Compliance
• Law and Jurisdiction
30
© Xchanging 2006, no part of this document may be circulated, quoted or reproduced without prior written approval of Xchanging.
74 Lloyd’s Early Implementers
Brokers
Carriers
Karl Ross
Dave Warren
Barbara Stuchberry
Robin Morgan
Joe Hayward
Claire Musson
Mark Harrison
Joy Lowry
Stephen Matthews
Sean Finneran
Rob Casserly
Darren McEwan
Ninette Fernandes
Matt Shelton
Simon Davies
Dean Gardiner
David Price
Matthew Nicholas
Bernard Levy
John Merrett
Heather Loane
Georgie Burrows
Kennedy Paryag
Clive Campbell
Tabir Shah
Tim Lovick
Matthew Taylor
Rob Pearce
Niall Wapshott
Darren Moles
Nick Miller
Shelley McCormack
31
© Xchanging 2006, no part of this document may be circulated, quoted or reproduced without prior written approval of Xchanging.
Lessons Learnt
To assist the efficient management of your ECF transactions and reduce rejections,
the following points are important:
• Check the risk/class of business is applicable for ECF
• Check the data listed in the ‘Validation Checks’ (see previous page) is included in
the presentation
• Ensure the correct signing number is presented
• Check a signed Slip is loaded on to the Repository (along with other relevant
policy documentation such as schedules, breakdowns, APs, Endorsements etc.)
• Correct Slip order
32
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Lessons Learnt
• Ensure both the currency of limits and SI/limit amounts are entered (e.g. either both fields
are completed or left blank)
• If a bordereau presentation includes a newly added US tax state or a Canadian province
which requires a payment, this needs to be loaded as an advice prior to the settlement
• Check the Settlement currency is the same as the first and subsequent advice
• When a first advice with settlement is presented, the advise must be loaded on the first
transaction then the settlement on the second transaction
33
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Practical Help
• XIS are running a number of familiarisation
sessions across September 06.
(Contact Graham Sheppard)
• XCS are planning a number of face-face
procedural workshops and demonstrations
with Brokers commencing September 06.
34
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System Overview
Tim Lovick
Date: 4 September 2006
© Xchanging 2006, no part of this document may be circulated, quoted or reproduced without prior written approval of Xchanging.
Homepage Search
36
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Awaiting Action List
37
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Transaction Summary
38
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Transaction Summary (cont…)
39
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Market Summary
40
© Xchanging 2006, no part of this document may be circulated, quoted or reproduced without prior written approval of Xchanging.
Market Response
41
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Market Response (cont…)
42
© Xchanging 2006, no part of this document may be circulated, quoted or reproduced without prior written approval of Xchanging.
Xchanging ECF Project Teams – Key Contacts
XIS Project
Team
Graham Sheppard
Email:
[email protected]
Tel: 07917 423 308
Stephen Matthews
Email:
[email protected]
Mob : 07789 273760
XCS Project
Team
Tabir Shah
Email:
[email protected]
Tel: 020 7780 5308
Mob: 07919 564 214
Kennedy Paryag
Email:
[email protected]
Tel: 020 7780 5353
Mob: 07748 761 977
43
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Questions
44
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Questions & Close
Trevor Maddison
Marsh and BEFIT
How Do I Get Involved – What Do I Need?
To submit claims electronically you must
have:
– Class @ Lloyds access either online or batch
– The ability to load scanned claims documents to the Xchanging
hosted market repository either via DRI auto load or direct load
– Both Class and the ability to put documents in the repository are
pre requisites to eclaims trading with underwriters
Key Contacts – Getting Started
• Market Reform Programme Office
– Ben Sayles:
– Claire Bulman:
[email protected]
[email protected]
• Xchanging
– Geoff Kennard:
– Graham Sheppard:
[email protected]
[email protected]
• LMBC
– Matthew Bateson:
[email protected]
Market Reform Website
• The website for all market reform matters is:
www.marketreform.co.uk
• Please pay a visit