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Luis CharloDeputy Regional Director
for EropeMapfre Asistencia
( Spain )
Friday, 3 September 2010
Claims Settlement – Experience in MAPFRE
Luis Charlo
Hydra, September 3rd 2010
1- MAPFRE and MAPFRE ASISTENCIA
2- MAPFRE’s Direct Claims Settlement in Spain
3- Innovation in claims settlement processes
4- Exporting the Direct Claims Settlement model
5- Challenges in claims management
MAPFRE and MAPFRE ASISTENCIA
2009Spanish business group which undertakes insurance, reinsurance and
service provision activities for companies and individuals
Leader in Non-Life insurance in Spain and Latin America. Among the top 10 insurers in Europe, with noteworthy presence in the United States
One of the main Assistance and Reinsurance groups in the World
Present in 40 countries
More than 35,200 employees and over 5,800 offices
Consolidated revenue in 2009: more than 18,800 million euros
1 MAPFRE and MAPFRE ASISTENCIACLAIMS SETTLEMENT EXPERIENCE
MAPFREMAPFRE
MAPFRE ASISTENCIA is a multinational insurance, reinsurance and services company with a direct presence in 40 countries
We are the unit within MAPFRE S.A. specialized in Assistance , Specialty Risks and Claims Management Services and in charge of exporting MAPFRE’s Spanish know-how and best practices to other markets: in the areas of automobile , home, travel and health
1,330 corporate clients (1,000 Insurance companies), 74 million insured and 161 million beneficiaries, designing quality products and services tailored to meet the needs of our clients
We are certified as conforming to the ISO 9001:2000 International Quality Standard and have warranted Moody’s A1 financial rating since 2002
1 MAPFRE and MAPFRE ASISTENCIACLAIMS SETTLEMENT EXPERIENCE
MAPFRE ASISTENCIAMAPFRE ASISTENCIA
MAPFRE’s Direct Claims Settlement in SpainMAPFRE’s Direct Claims Settlement in Spain2
2 MAPFRE’s Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
Direct Claims Settlement Agreements emerge in order to:
• To improve the quality of the service received by the policy holder when having a claim • To avoid delays in the resolution of the claim
• To avoid disputes: with the damage assessment, with the payment, etc
• To set up regulations and sector criteria
• To minimize the number of legal claims
¿Why did Direct Claims Settlement agreements emerge?
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
First agreement - CIDE
High number of claims going to court only to resolve material damages
Traffic accidents managed as civil proceedings on court
It gives impulse to the agreements
January 1st 1988: CIDE agreement starts
¿What is the CIDE agreement?
CIDE:
Convenio de Indemnización Directa Español
Target:
Direct settlement of the claim to the insured involved in a car accident, and that based on responsibility assignment regulations and internal market/sector criteria is not responsible for it.
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
Basic principles of the CIDE agreement
High automation
Specific response deadlines
Avoid going to court
Automatic compensation
Supervision and Arbitration Commission for resolving possible discrepancies
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
¿When can the CIDE agreement take place?
Only two vehicles involved in the accident
Damages produced because of a collision
Accurate fulfillment of the DAA (Friendly Accident Notification Form) including clear responsibility assignment
Material damages produced in the vehicle, not exceeding the TPL mandatory insurance limits
Insurance companies of both vehicles members of the CIDE agreement
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
Key fact is the correct fulfillment of DAA and that responsibility is determined on it
To determine who is responsible a Responsibility Matrix based on the circumstances/situation of each involved vehicle was developed
The creditor entity (non responsible) will indemnify its policy holder and receive a fix amount (Average Sector Cost) from the debtor entity
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
¿When can the CIDE agreement take place?
Supplementary Agreement to CIDE: It is signed with the aim of resolving those “CIDE” claims without or without an accurate or complete DAA Friendly Accident Notification Form
Acuerdo Suplementario del convenio CIDE
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
May 1st 1990 second agreement: ASCIDE starts
¿When can the ASCIDE agreement take place?
ASCIDE agreement is based exactly on the same principles of the CIDE agreement, but it is not mandatory to fullfil the DAA.
It is a compilation of regulations and resolutions from the Supervision and Arbitration Commission generated during the years of life of the agreements
Not filling the DAA may present different versions of the circumstances. For resolving it a Criteria Manual was developed with additional subsidiary regulations
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
Resolution phases for both CIDE/ASCIDE agreements
Friendly phase
Dialog phase
Supervision and Arbitration
Commission
Most of the claims are settled in this phase
Versions and assignment of responsibility not clear. Specialized
claim handlers have to participate in order to decide
Resolves all unresolved versions from the previous phases
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
December 2009 June 2010
Total number of files managed
CICOS module payment 327,427 172.438
CICOS module recovery 394,588 203.635
TOTAL 722,015 376,073
Files resolved in Dialog or Commission phases
Dialog 5,699 1,889
Commission 100 27
Main Figures CIDE and ASCIDE MAPFRE in Spain
Friendly phase
Dialog phase
Supervision and Arbitration
Commission
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
• Simplified procedures: claims settlement is speeded up due to the responsibility criteria and the response deadlines
• Reduction of legal expenses
• Reduction of Administration Expenses
• Companies’ image improvement. Good perception from policy holders
Advantages for Insurance Companies
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
Advantages for Insurance Companies
• Avoid claims going to court as well as discussions between insurance companies
• Faster damage assessment: Each Insurance company takes care of its own insured
• No repair budgets are needed
• Repair can start earlier and repair shop payment is done faster: increased claims settlement speed
• Faster Claims Management increases satisfaction of the policy holder
• Personalized customer service by his/her own insurance company, not by the third party
• Assessment and payment to repair shop done by his/her own insurance company, avoiding delays and out of pocket expenses
2 Direct Claims Settlement in SpainCLAIMS SETTLEMENT EXPERIENCE
Advantages for Policy Holders
Innovation in claims settlement processesInnovation in claims settlement processes3
3 Innovation in Claims Settlement processCLAIMS SETTLEMENT EXPERIENCE
• For MAPFRE, with a portfolio in Spain of + 5,8 million vehicles innovation in claims management has to provide an increase in efficiency as well as a higher customer retention and satisfaction.
• At the same time MAPFRE was leading the Direct Settlement Agreements creation in Spain, the first Drive-In Assessment Centers were launched with the expertise of CESVIMAP.
Service to policy holders and third parties.
Managing Direct Agreement Claims
Damage Assessment and payment order for the repair shop.
Specifically designed centres for QUICK DAMAGE EVALUATION
3 Innovation in Claims Settlement processCLAIMS SETTLEMENT EXPERIENCE
Drive-In Assessment Centers:Drive-In Assessment Centers:
3 Innovation in Claims Settlement processCLAIMS SETTLEMENT EXPERIENCE
MAPFRE Service CentersMAPFRE Service Centers
How can be the service to the policy holder improved when a loss takes place?
How to receive the highest quality perception from the customer?
How to generate an integral management of the claim?
How improve the loss ratio?
How to settle claims in a more efficient way?
How to keep Policy Holders loyal?
How to…..?
Accident takes place
Accident takes placeClaim
notification
Claim notification
to MAPFRE
to MAPFRE
Going to repair shop
Going to repair shopDam
age assessment
Damage assessm
ent
Repaired vehicl
e
Repaired vehicl
e
in repair s
hop
in repair s
hop
Customer perception
MAPFRE presenceNot MAPFRE presence
Traditional Claims CycleTraditional Claims Cycle
Claims service settlementClaims service settlement
3 Innovation in Claims Settlement processCLAIMS SETTLEMENT EXPERIENCE
Accident takes place
Accident takes place
Contact MAPFRE
Contact MAPFRE
Take the re
paired
Take the re
paired
carcar
Leave th
e replace
ment vehicl
e
Leave th
e replace
ment vehicl
e
Customer perception
MAPFRE presenceNot MAPFRE presence
3 Innovation in Claims Settlement processCLAIMS SETTLEMENT EXPERIENCE
Service Center Claims CycleService Center Claims Cycle
Claims service settlementClaims service settlement
Centro de Servicio de Alcalá
Looking forward to:
To be One Stop Solution for the Policy Holder when having a claim:
Resolve all doubts regarding the settlementLeaving damaged car for damage assessment Taking a Replacement CarMost appropriate repair shop selected by MAPFREShortest repair period MAPFRE’s life guarantee certificate on body
and painting jobs
MAPFRE Service Centers:MAPFRE Service Centers:
3 Innovation in Claims Settlement processCLAIMS SETTLEMENT EXPERIENCE
Benefits for MAPFRE
Customers loyalty Portfolio retentionAverage cost reduction of the repairNo delays in starting the repairsClaims’ settlement speed under controlBetter control of the repair shop networkExtremely high customers satisfaction ratios
3 Innovation in Claims Settlement processCLAIMS SETTLEMENT EXPERIENCE
MAPFRE Service Centers:MAPFRE Service Centers:
Centro de Servicio de Alcorcón
Exporting the Direct Claims Settlement ModelExporting the Direct Claims Settlement Model4
4 Exporting the Direct Claims Settlement modelCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
MAPFRE ASISTENCIA looking forward to offer the best solutions to its Clients, is always challenging the circumstances and adapting proven MAPFRE experiences to other markets.
A good example is the development and implementation of a Direct Claims Settlement Agreement in Panamá for several insurance companies, through our subsidiary PANAMA ASISTENCIA, based on MAPFRE’s Spanish experience and know-how.
It was launched in 2007 and the companies that currently are under the Direct Claims Settlement Friendly Agreement are: HSBC, Fedpa, ANCON, Suramericana and Nacional.
Exporting MAPFRE experience:Exporting MAPFRE experience:
4 Exporting the Direct Claims Settlement modelCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
Spanish Friendly Agreement declaration form was adapted by MAPFRE ASISTENCIA to the local Panamanian requirements and a Responsibility assignment matrix was developed according to the Panamanian legislation.
MAPFRE ASISTENCIA
Claims declaration Accident Scene: File The
Claim And Photos
Our Contact CenterCustomer
Client Company
4 Exporting the Direct Claims Settlement modelCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
4 Exporting the Direct Claims Settlement modelCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
Change the mentality of drivers was the most important challenge:
1. Hot line for communicating an accident2. Expert is sent to the place of accident3. Friendly Claim Form is filled and signed4. Pictures are taken on the spot5. PANAMA ASISTENCIA evaluates the form and applies Responsibility Matrix6. Information loaded on the web (developed by MAPFRE ASISTENCIA)7. Information is sent to Claims Departments8. 72 hrs. to decide accepting the decision
99% of claims are accepted by members
Damaged car is indemnified by third party company
2.000 claims are managed monthly by PANAMA ASISTENCIA aprox. 500 are managed through the Direct Claim Settlement Friendly Agreement
PRESENTACION CORPORATIVA 2010
4 Exporting the Direct Claims Settlement modelCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
All the information is stored and accessible through an specific web site developed by MAPFRE ASISTENCIA
First step to make claims handling easier, offering a better service to the policy holder
Access 7*24 for claim notification.
Accident care: Help on the spot accident report fulfilment, pictures of damages and scene of the accident.
Fast processing
Neutral analysis and responsibility assignment
Reduction of claim settlement time
Minimize possibilities of fraud
Extending the image of quality service offered to the policy holders
DirectDirectClaim Claim
SettlementSettlement
Advantages obtained by Insurance Companies members:Advantages obtained by Insurance Companies members:
4 Exporting the Direct Claims Settlement modelCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
Challenges in claims managementChallenges in claims management5
5 Challenges in Claims ManagementCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
• Next challenges for the Claims Departments will come from the innovation in products and from the integration of all participants in the Claims Life
• Integrating the repair shops networks as part of the value chain.
• Changing the role of the damage assessors as controllers, offering value to the repairshops
• Improving the repair techniques delivering better repairs in less time
• …
5 Challenges in Claims ManagementCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
• Regarding products, what is missing today in the motor portfolio of most insurance companies?
Accident Breakdown
Cost of Repairs
Yes
Assistance Yes Yes
Mechanical Breakdown Insurance coverage commercialised as an added value within the Motor Insurance Policy, covering the cost of the repairs of mechanical and electrical failures, covering both, the cost of the spare parts as well as labour cost.
1. Some Motor Insurance markets are already offering it.
2. It is the right moment:
Crisis – people are worried about having to pay for extra expenses.
Big price competition amongst Insurers.
Innovate the market (Competitive advantage)
3. Good opportunity: Increase turnover with NO RISK.
Why is it a challenge?Why is it a challenge?
5 Challenges in Claims ManagementCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
AdvantagesAdvantages
5 Challenges in Claims ManagementCOMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
For the InsuredFor the Insured
Integrated cover
Competitive price
No extra out of pocket expenses
Repair Quality Control
Repair in specialized repair-shops
For the Insurance CompanyFor the Insurance Company
Pioneer and differentiation from the Competition
“Global” Insurance
Flexible products for each category of insured
Strengthens loyalty
Non-risk profit source
1- MAPFRE and MAPFRE ASISTENCIA
2- MAPFRE’s Direct Claims Settlement in Spain
3- Innovation in claims settlement processes
4- Exporting the Direct Claims Settlement model
4- Challenges in claims management
Gracias
Ευχαριστώ