Delegated Claims Oversight

In September of 2018, the Lloyd’s Market Association outlined a programme of work that it would be undertaking in relation to Delegated Claims and provided an update on the programme in December 2018 to carriers and third party administrators (TPAs). The LMA has now published the deliverables within a consultation phase, which is scheduled to end on 5 April 2019.

The key areas the LMA is engaging the market on throughout that period is:

  • Delegated Claims Administrator Agreement (replacing the TPA agreement LMA9008)
  • SLA and MI (performance) measures
  • TPA audit framework, plus changes to the Coverholder framework for claims

These core deliverables have been designed by the market following the output of Lloyd’s Claims DA Thematic Review, to which the LMA Claims Committee (LMACC) set clear objectives and priorities around due to the inconsistent, uncommon, and complex approach to managing delegated claims.

The objectives of the programme are to:

  • Provide an improved and consistent delegated claims experience between managing agents (MAs) and TPAs/Coverholders
  • Improve the service delivered to policyholders via common and consistent delegated transactional and management methods.

The LMACC sponsors Nick Sinfield and Richard Folger said: “Our delegated agents are there to serve our policyholders and we must allow them to do so with authority and autonomy in a seamless and efficient manner, with effective, robust controls and oversight in place at the appropriate points that don’t negatively impact the delegated agents operation or claims transaction.”

The LMA concludes that the engagement and adoption level of each of the deliverables from MAs is critical to meeting the objectives above, and is looking for feedback and the re-shaping of any deliverables ahead of implementing at a market wide level.

As any Delegated Authority Services (DAS) team in the London market is managing a process, MOTOSI adopts an activity-based approach, understanding the nuances that need to be applied in any given situation. To learn more about our Delegated Claims Authority expertise please contact me [email protected]