Transcript Document
Electronic Claims Electronic Claim File Update Mike Smith 25th August 2005 1 Electronic Claims Update Started October 2004 Last full briefing 24th February 2005 Updates at each of the monthly briefings 2 Electronic Claims Objectives To implement the electronic infrastructure for the London market to negotiate, settle, and record claims quickly and efficiently and to achieve a critical mass of live usage. 3 Electronic Claim Files - a Critical Requirement Electronic Claims Enable parallel presentation to insurers Reduce overall transaction time Improve transparency of process Underwriters can control their own work load. Allow brokers to concentrate on those claims where value is added Claim file always available to insurers Fundamental pre-cursor to the LMP objective of streamlined claims agreement 4 Electronic Claims Repositories Multiple repositories in the London market - Brokers and carriers have their own - Carriers shouldn’t have to learn different brokers’ repository dialects Insurer’s Market Repository - to hold electronic claim files for carriers. - International ACORD Document Repository Interoperability (DRI) standard to exchange documents - CLASS will manage the claims transactions. 5 Electronic Claims Governance 1 Directed by MRG - Brokers, Companies, Lloyd’s through Claims Infrastructure Project Board Programme Office Owns implementation issue definition and resolution Market associations’ claims groups to 6 timetable resolve market wide claims practice issues. Electronic Claims Governance 2 LMA - Managing Agents manage contractual delivery to them from XIS - Claims practitioners define processes and functions IUA - Formed a group to review function - Discussing charging mechanisms LMBC - BEFIT – meets quarterly to review impact on brokers 7 Electronic Claims Project Scope 1 Delivers an interactive Insurers’ Market Repository to carriers Interactive service available to brokers - At a price Adopts ACORD standards for the transfer of electronic documents To/From brokers’ repositories - At no charge to brokers To/From 8 carriers’ repositories Electronic Claims Project Scope 2 Implements CLASS at Lloyd’s To support Lloyd’s Claims Schemes Integrates CLASS and IMR a single electronic claims service for Lloyd’s managing agents Does NOT change CLASS for brokers Multiple interactive services: one for each market LIMCLM: operational for IUA - defined and trialled for Lloyd’s 9 Electronic Claims LMA Enhancements in 5 Phases Phase 1 See all documents in one view Completed February Phase 2 Leader control of file/Improved searching Completed April Phase 3 ACORD DRI (Subset) Phases 4/5 CLASS @ Lloyd’s data through GUI/Seamless link In Test Q3 2005? Merged into single phase Detailed specification completed Being re-planned by XIS, including change request 10 Timeline for Electronic Claims implementation - 28th July 2005 (MRG 2nd August) Oct 2004 Nov Dec 2004 2004 Jan Feb Mar Apr May 2005 2005 2005 2005 2005 Aug Sep 2005 2005 Electronic Claims Oct 2005 Nov Dec Jan Feb Mar Apr May Jun Jul 2005 2005 2006 2006 2006 2006 2006 2006 2006 Build and fully tested Ongoing Marsh, Aon, Benfield, JLT present 100% of Lloyd’s new claims and their subsequent processing electronically MAT MAT Phases 1 & 2: Repository enhancements Phase 3: Document Repository Interoperability (DRI) Phase 4: Enhancements to CLASS for Lloyd’s Phase 5: Integrated CLASS and Repository Aug Sep Oct Nov Dec 2006 2006 2006 2006 2006 Lloyd’s managing agents processing new claims electronically* 10% new Lloyd’s claims transacted electronically Implementation partnerships commenced Target Milestones XIS Jun Jul 2005 2005 *Commitment from: Brit, Amlin, Limit, Wellington, Faraday, St. Paul Travelers, SVB, Marlborough, Hiscox. MAT Build and fully tested Slippage- due to focus on Phase 2 MAT Business design Slipp age DRI, hot topic for brokers and carriers. More functionality required hence change requests. MAT Build and fully tested Build and fully tested MAT Hull & Liability Marine Cargo XCS operational readiness Direct Late sign off of design, with some caveats. Awaiting new dates from XIS for combined Phases 4 & 5. Aviation Reinsurance Energy Non-Marine Property Non-Marine Liability PI All other Political Risk Binding Authorities Lloyds published version SP&P Reinsurance Non-proportional XL) London Claims Market S P & Ps Lloyds version for comments Implementation underway Aon Benfield Brokers Review, revise definition of variations Review, revise, definition of variations Cooper Gay } Own repositories† } Benfield Marsh Guy Carpenter Interoperable with Market repository Aon Miller Millers St Paul Travelers Beazley Aegis Amilin Hiscox Carriers Complete Slow, but gradual take up of electronic claims on existing technology. Jeopardizes end of year volume target. Board views volumes as less important. Global Aerospace, Allianz, Munich Re, GE Francona Undertaking Training Brit, TOE outstanding Wellington Aspen Re Alea Group Legend IUA published version - date dependent on IUA involvement Managing XIS April 26, 2020Brokers Agents MAP, Chaucer Faraday Amlin Market Unconfirmed Limit Start of implementation Start of implementation partnership (Broker to edit partnership (underwriters Sample footer, see user repository) market repository) guide Ready to participate, awaiting firm partnership agreement Processed claims Milestone 11 Key Milestone Slippage Electronic Claims Implementation Broker-driven with by carriers and XCS classes of business and risks programme office monitoring progress New claims and their subsequent transactions Using today’s CLASS and repository in parallel with the enhancements early experience of electronic work assess 12 impact on procedures and processes Electronic Claims Take Up Volumes New Advices 30 25 20 Millers Volumes 15 Benfield 10 Cooper Gay 5 Guy Carp 0 Marsh J F M Apr- M an- ebJ Jular- 05 A ay05 05 un05 ug05 05 05 05 13 Electronic Claims Take Up Participants Brokers 14 Carriers Benfield Aegis Cooper Gay Amlin Guy Carpenter Chaucer Marsh Millers Class of Business Marine Hull Aviation Direct Faraday Reinsurance Hiscox PI Limit MAP Non Marine Property St Paul Binding Authorities Aspen Re Electronic Claims Carriers Wanting to Participate 15 Ace AIG Allianz Atrium Brit Global Aerospace Heritage Kiln Liberty Electronic Claims Systems Process and Procedures Manual Documenting how the market process works NOT but how to manage a claim where the systems fit and how to use them Starting with Lloyd’s working under review with LMA and BEFIT Then IUA 16 draft prepared by LMA Lloyd’s Electronic Claims Process Flow (New) Receive advice of loss Retrieve relevant documents Store info 2. Leader Claim Transaction Negotiation 1. Advise Market Third parties - how do they create transactions? Broker Repository - Additional sequences within same transaction Broker If no broker repository but contract with XIS, then load directly If PUSH Broker LIMCLM Lloyd’s Leader Broker analyses response Create CLASS entry LIMCLM 3. Following Market Claim Transaction Negotiation Send documents using ACORD DRI Possible responses: - Accept - Pend - broker to amend/ correct - Query - broker to amend/ correct - Request broker visit (informal response) If PULL Broker Notify DRI ACORD message AT ANY TIME Review loss information, slip, wordings, endorsements and leader’s additions etc held on Insurers Market Repository Consult with necessary parties Assess loss advice Overrides/ Exceptions Advised of settlement authorisation BSM - If original premium not paid may choose to override need to wait for additional premium - If reinstatement premium due then may choose to set simultaneous reinstatement premium indicator - Leader may declare a conflict of interest AT ANY TIME Review loss information, slip, wordings, endorsements and leader’s additions etc held on Insurers Market Repository Overrides/ Exceptions Assess loss advice (on IMR) and Leader response - If original premium not paid may choose to override need to wait for additional premium - If reinstatement premium due then may choose to set simultaneous reinstatement premium indicator - Leader may declare a conflict of interest Advised of settlement authorisation USM Advised of SCM AT ANY TIME Review loss information, slip, wordings, endorsements and leader’s additions etc held on Insurers Market Repository and/or CLASS. Raise comments to XCS and/or Leader if necessary. Declare conflict of interest Receive & process advice & money Security Requirements XIS System Advised of settlement authorisation USM - Additional parties required? - Appoint experts? - Leaders - Other Followers Consult with necessary parties Record response, instructions and comments on CLASS. May add documents to ECF Audit facilities - Wrong leader Receive and verify CLASS entry Insurers’ Market Repository (IMR) Insurers’ Market Repository Update CLASS entry and Issue issue leader responses response to broker. Update to broker agreement parties. (LIMCLM) Insurers’ Market Repository 17 Issue response to broker (LIMCLM) Issue SCMs Exceptions - Update CLASS entry - Issue XCS responses on behalf of followers to broker - Update agreement parties - Change Leader if Leader declares conflict of interest Management Information reporting Receive & process advice & money Advised of SCM Access CLASS entry XCS Receive & process advice & money - Additional parties required? - Appoint experts? Record response, instructions and comments on CLASS. May add documents to ECF Lloyd’s Followers Electronic Claims Possible responses: - Accept - Pend - broker to amend/ correct - Query - broker to amend/ correct - Request broker visit (informal response) Retrieve documents using ACORD DRI Access CLASS entry Broker analyses response 4. Advise Market of Completed Claims Transaction Leaders Action Awaiting Index Followers Work in Progress list If payment CLASS posts payment to central settlement Process settlement - If original premium not paid, then wait for premium unless requirement to wait has been overridden - If reinstatement indicator set, wait for reinstatement premium - Manage withdrawal from central settlement for reinsurance credit control Settlement advices and money movement System Administration, logons, user IDs