Property & Household

Often what is perceived as a very low headline cost for TPA claims service, is subsidised by increased claims cost from undisclosed commissions, higher loss adjuster costs because the TPA cannot make decisions on straightforward cases, a lack of identification of the opportunity for subrogated recoveries.

Although loss adjusters have a place there is a tendency to over – utilise them because staff at the TPA do not have the experience / training to dispose of cases on sensible terms without the need to incur loss adjuster costs.

Connexus senior manager have been engaged in audit of both current and run off books of business where there has been a clear failure to consider or pursue the prospect of recovery because it has wrongly been perceived as having limited prospects or of insufficient value to pursue, or, as a result of the loss adjuster often focusing on keeping the cost of the claim low – which is good- but failing to consider, or adequately determine prospects of recovery from a third party or arranging for another insurer to deal with, or contribute to a claim.

If a scheme is large enough a dedicated team, branded email and telephony and direct links via API can be facilitated at competitive rates.

Connexus has its own tied panel law firms on hand to advise on coverage, liability, fraud and quantum issues on larger claims and an opinion on strategy can be sourced and dealt with swiftly.

On several schemes Connexus manages both loss adjusters and its internal panel lawyers and external lawyers on a transparent allocation of work that best satisfies the particular needs of the insurer- MGA- or broker.

Although Connexus has it own panel of experts and suppliers it is able to include insurer nominated suppliers and loss adjusters as well as any favoured law firms or Counsel.

This level of flexibility allows insurers to nominate what it perceives as its best and most cost-effective options and integrate it into the Connexus solution.

Connexus allocate an implementation team for any new scheme and manages the process with the Insurer weekly on “Teams” or in person to ensure processes are agreed and followed.

An analysis of digital and IT requirements will be carried out and a visit to the client’s premises and those of Connexus would normally follow.

Consideration is given to volume and nature of cases and a claims team established based on nature, value and complexity of claims.

A loss fund is available via a Trust bank account administered by a qualified accountant and her senior team.

Training is given on specific products related to the client and processes are signed off.

Market leading service levels along with sophisticated management information is standard.

Agreed protocols to combat forward using both software and internal processes are available and agreed.

The implementation process normally takes 4 to 6 weeks to agree and then contract arrangements are finalised.