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The Knowledge: Claims excellence - The People
Find out what four industry players have to say about claims
"The most useful information that can allow you to understand what's happened in a claim is sitting
in unstructured or semi-structured data. There are nuggets of gold to be found in that unstructured
"We are looking at ways to apply innovative advanced analytics to unstructured data
to understand the full story behind a claim and identify claims leakage.
Our TV screens seem to be full of adverts from lawyers pleading with us to claim for each and every
mishap, there is obviously no such thing as an accident in this day and age. Somebody can be
blamed and they need to pay!. With this in mind, it would be an extremely brave (or perhaps foolish)
small business owner who made the decision that public liability insurance wasn't necessary.
Clicking on the following link will answer any questions that you might have on .
"For example, someone goes into a store and slips and breaks an arm. The structured information
will be 'cause of loss: slip and fall'. But on the claim form the claimant may give other useful
information, such as that they didn't see the yellow warning triangle.
"A lot of indicators of fraud are potentially in unstructured data. Text analytics can also help you
spot whether the claim has been inflated and the benefits are tangible.
"Analytics can also help determine the optimum point in settling a claim, and the indictors that will
tell you are typically found in unstructured data."
"Everybody across the industry is supportive of the claims working group, which was set up in 2013
by Biba, the ABI, CILA, brokers, insurers etc.
The group is engaging with the FCA, which is talking about its thematic review, and the Law
Commission and Financial Services Consumer Panel as well.
"The aim of the working group is to enhance the customers' experience and ensure that they have an
understanding of the claims process and the role of the insurance industry in meeting claims.
"We identified early on that the bad press [the industry gets] is often a result of repudiations, so we
wanted to find out why these repudiations were occurring. Then we can do something about it.
"AXA agreed to look into this. It worked closely with Biba to analyse the common reasons for
repudiations, such as car keys left in the ignition.
"If we can help inform brokers on this, it should be good for customers and it's better for the image
of the industry if there are fewer disputes."
"If we can automate cars, couldn't claims handling become more automated? Because if there are no
drivers in the cars, it's much more a product liability issue rather than a negligence claim.
"In 10 years you probably won't need claims handlers. As long as liability isn't an issue and you've
got a medical expert of good standing you could just standardise the amount of damages. So, for
example, a six-month whiplash confirmed by a medical expert is worth £2,000. No negotiation. If it's
12 months you get £3,000.
"Some vehicles will trigger telematics if there's an accident and we'll get a report on the speed of
impact. Some even show the g-force of the collision if there was one. Even the fastest computers
can't stop somebody deliberately trying to swerve in front of them.
"But on the plus side, an autonomous vehicle is going to be full of sensors and cameras recording
this and that will be our evidence."
"Claims by large multinationals have become more complicated over the years, in large part because
of the complex supply chain. That really comes into play with industries such as technology and
pharmaceuticals, where they are heavily dependent on complex supply chains.
"That came to light a few years ago with the floods in Thailand and the technology industry, where
the supply chains were very deep. Some of the claims I was involved with are only just being settled
"Forensic accounting is, in part, about assisting clients in the quantification, measurement and
documentation of their losses and the resolution of the claims and disputes.
"I've been in this business for 30 years and I can tell you that every claim is unique. The best way to
respond to a catastrophic event is to have a plan in place beforehand, so that right after the loss
happens you take control of the claim and move it along as quickly and efficiently as possible."