The event brought together industry experts and leaders to discuss the latest trends and challenges in the auditing world, highlighting the increasing scrutiny of Third-Party Administrators (TPAs/DCAs) and the growing cyber threats facing the industry. With insights from Pro Global’s Audit Team and experts from Cyber Security Associates (CSA), attendees gained actionable strategies to navigate the complexities of regulatory requirements and cyber defense. Here are the key takeaways from this dynamic and informative session.
Regulatory Trends and Audit Findings: Increasing scrutiny of MGAs & TPAs
Robert Sherman, U.S. Head of Audit & Advisory at Pro Global, kick started the event by highlighting some significant regulatory trends in the region, : “The Property and Casualty (P&C) market in the U.S. is expected to grow by 7% in 2024, with a notable rise in the use of Managing General Agents (MGAs) and Third-Party Administrators (TPAs). As a result of this regulators are emphasising the importance of robust data documentation and underwriting guidelines; viewing MGAs as extensions of carriers.”
Key findings presented at the event by Robert, from Pro Global’s analysis of 200 U.S. audits, revealed that compliance, policy documentation, adherence to binding limits, and sanctions checking are areas needing attention. The audits showed an average of five findings per engagement, with 55% of these being high-priority issues. Compliance lapses, poor claims handling, and inadequate coverage analysis also emerged as significant risks, potentially leading to financial losses and regulatory penalties.
Similarly, he emphasised how an audit helps enhance overall risk management and governance policies, making businesses more resilient to unforeseen challenges while safeguarding their reputation. In addition, it ensures compliance with regulatory standards, reducing risks and building trust with stakeholders. Moreover, audits pinpoint and address conduct-related issues, promoting ethical practices and reinforcing the company’s integrity and transparency. By rigorously examining internal controls and operational processes, audits also mitigate financial risks, ensuring the reliability and accuracy of business operations.
The key takeaway for attendees was that regulators are increasingly scrutinising MGAs and TPAs/DCAs, and proactive audits are critical to ensuring ongoing compliance and best practice.
Cybersecurity Threats and Defense
Phil Cordey, Operations Director at CSA, then provided an in-depth overview of the evolving cyber threat landscape. He warned that ransomware incidents remain the top threat to businesses, with active criminal gangs targeting insurance companies and using collated information to infiltrate their third-party partners. These groups specialise in conducting sophisticated reconnaissance and penetration testing, making them formidable adversaries.
He stressed the importance of using comprehensive audits to tackle increasingly sophisticated attempts to hijack a company’s core systems and data: “AI is increasingly being used in both cyber-attacks and cyber defense, balancing an increase in attempted incidents with better monitoring and automation to prevent complete compromise of organisations’ IT systems. Data protection remains a critical concern, with inadvertent data leaks through services like ChatGPT posing significant risks, a breach that many companies are unaware and unprepared for.”
To mitigate these threats, Phil emphasised the importance of putting in place stringent security audit assessments, available to organisations using globally recognised frameworks like NIST – used by most, if not all, U.S. based companies – ISO 27001, the Centre for Internet Security, and the UK’s National Cyber Security Centre’s Cyber Assurance Framework & Cyber Essentials Frameworks.
Confirmation was provided that companies can obtain technical assurance of their security controls through Penetration Tests, Gap Analysis Assessments, or a combination of both using Cyber Due Diligence Assessments.
Phil added: “These are three important active steps that companies should undertake to cement and assure themselves they are on the right security journey in line with budget and strategic considerations.”
Canadian law and regulation
Elaine Collier, Senior Auditor (Canada), in her session, talked to the importance of Bill 96 and increased regulatory scrutiny:
“A year after Bill 96, known as Law 14, came into effect in June 2023, questions about its implementation continue to dominate discussions. The legislation, which enforces French as the official and common language of Québec, gave MGAs and contract writers a year to comply, though no audits have been conducted to ensure adherence.”
In response, Pro Global has developed a specific audit approach to evaluate compliance, finding that whilst some organisations already had French-language policies in place, others struggled with the requirement to issue French documents first, followed by English versions if requested.
A key recommendation for companies is to establish a clear policy on handling Bill 96 and effectively communicate this to staff. Eliane stressed that the “French First” rule remained untested in courts, adding to the regulatory uncertainty.
“Additionally, we observed instances where policies were issued in French but included English endorsements, highlighting the need for thorough audits to ensure full compliance. Another grey area involves handling policies written outside Québec or companies with both English and French names, which cover holders need to address carefully under binding authority agreements.”
Elaine also highlighted how regulatory scrutiny is intensifying in other provinces. Specifically, in Ontario, the Council of Registered Insurance Brokers of Ontario regulates MGAs, although licensing is not yet mandatory. However, the Financial Services Regulatory Authority of Ontario (FSRA) is beginning to focus on MGAs due to complaints, although its strategic plan primarily targets consumer business outcomes.
She concluded: “Despite this, the growing presence of MGAs in Canada, particularly within the Lloyd’s market, underscores the importance of regular audits to navigate these evolving regulatory landscapes.”
Integrating IT and Security
Kristy Lovegrove, Group Head of Technology at Pro Global, stressed the need to view IT as integral to business operations rather than simply a cost centre within the business; adding that effective data management and security were crucial for business continuity and risk management.
Kristy also highlighted the importance of defining security goals aligned with business objectives and ensuring compliance at all user levels within an organisation:
“As technology evolves, businesses must educate employees about new tools like ChatGPT while maintaining stringent security standards. The focus should be on continuous improvement in response to changing threats.
“The two core takeaways from a technology perspective from me would be that security must support the business in achieving its goals and objectives, but it must increase the value of the business.”
Conclusion
Pro Global’s event underscored the critical role audits play in ensuring robust regulatory compliance, effective use of AI and Big Data, and proactive cybersecurity measures. The key takeaway is clear: to safeguard their future against evolving threats, companies must conduct diligent audits that encompass IT, MGAs, and TPAs. This also requires integrating audit and business strategies that consistently enhance and test their processes.
As Kristy emphasised: “An audit is not a tick box exercise; it should be a journey of continuous improvement, as the threats to the business are constantly changing.”
Pro Global offers comprehensive audit and consultancy services to help businesses navigate these challenges, ensuring compliance with regulatory and corporate standards. Visit our Audit Services page to learn more.
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This was our second year at the conference, and it was heartening to see the increased recognition of Pro Global as a Claims management provider for local authorities. Unlike last year, where many of our conversations were introductory, this year, attendees proactively approached our stand seeking support with claims, ideas, concepts, and clarifications. This shift indicates that our solutions are resonating well, particularly with local authorities, which is incredibly encouraging.
The conference agenda was rich with learning, networking, and training opportunities, allowing us to connect with members and industry experts. Our involvement in the logistics of the event provided us valuable insights into how we can refine our approach for next year to better serve the community.
One of the standout themes from our discussions with delegates this year was the integration of technology in claims handling, particularly automation and AI. The interest in digital transformation was palpable, with many questions about how these innovations can streamline claims processes and enhance efficiency. It is evident that the market is currently underserved in terms of smart automation due to the perceived high barriers to entry. At Pro Global, we are committed to lowering these barriers and enhancing our support with advanced digital services, ensuring local authorities can benefit from cutting-edge claims management solutions and smart automation.
Our support for Employers’ Liability (EL) and Public Liability (PL) claims handling, bolstered by our technology enablement, resonated strongly with attendees. The discussions reinforced the need for robust claims management solutions that leverage technology to improve efficiency and overall outcomes.
We extend our heartfelt thanks to the ALARM team for organising such a stimulating and successful conference and everyone who took the time to engage with us during the event. Your insights and feedback are invaluable as we continue to innovate and enhance our offerings.
If you would like to find out more about how Pro Global can support your claims management needs, please get in touch.
Name: Michael Mackenzie
Job title: Head of Specialist Claims
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Having worked for large insurers earlier in your career, what attracted you to Pro Global?
The Insurance sector, whilst large in size, is full of small circles (everyone knows everyone). I was aware of Pro and the work they did in the Employers’ Liability legacy space. Working as a Third Party Administrator was something I had experience of. I was familiar with – and liked – the Pro values, the work they did and the client base they had. I believed I had a skillset that could enhance that further.
You’ve worked in the Claims sector for most of your career – how have you seen it evolve?
I think we have seen significant evolution in the last 15-20 years. When I started my career everyone was looking at how to offshore their claims work – I even spent some time in India as part of the project team doing exactly that. However, now we’re seeing a lot of that work coming back onshore with Insurers and Reinsurers looking for either a full onshore model or a hybrid model, and for UK TPA’s to be working collaboratively with offshore providers.
We’ve also seen changes in technology. This will be an ever-evolving reality as automation and AI continue to grow and develop. However, whilst technology has a part to play in creating greater claims efficiencies, I believe that we still require the skill set that only our people bring, to handle the more complex claims.
What challenges do you think your clients face and how can Pro Global help solve them?
Our clients today are looking to reduce cost and settle genuine claims quickly. Pro has the technology in place along with an expert Disease and Illness team who can best advise on Strategies for these portfolios, streamline processes and ensure the right outcome, always ensuring customers are treated fairly.
What do you see as the market opportunities and challenges over the next 12 months?
Pro continues to work with the market and clients on a number of strategies which will see some good opportunities in the Legacy space. We see Head Injury in Sport as the ongoing market challenge and this is likely to gain momentum over next 12 months.
What is your call to action for claims specialists in insurance?
We all have a part to play in ensuring the next generation of Claims specialists have the right knowledge, skillset and confidence to continue handling these legacy books. My call to action is for all of the existing Claims Specialists to ensure they spend time training the more junior members of staff, passing on the knowledge you have like others did for you.
Name: Debbie Roome
Job title: Client Engagement Executive (Claims)
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This article was published by Insurance Business and is being shared here with thanks to the publication.
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In an interview with Insurance Business last year, Danny Maleary CEO of Pro MGA Solutions underscored the need for the managing general agent (MGA) sector to take a “grown-up” approach to creating a healthy talent pipeline.
Cautioning against complacency in efforts to bridge the talent gap facing insurance, he championed taking a grow-your-own approach to talent, which leverages the expertise and insights of existing team-mates. It’s a model his own team have taken to heart, as seen by the appointment of Emily Lewis to a new role as business development representative at Pro MGA Solutions in January 2024.
Having joined Pro Global in 2020 as an assistant technician within insurance services, Lewis noted the importance of firms being willing to recognise the potential of their people and to mentor them to help them fulfil that potential. When you have a business that’s willing to make that investment and to guide you along that journey, it makes all the difference, she said, but also essential is you being able to seize that opportunity and make the most of it.
Emily Lewis and Danny Maleary pictured above.
What it takes to bring young talent into and through the market
“For me, bringing in people like Emily who were in a different part of the business into the sector and into our world is something we’re looking to do more of,” Maleary said. “It’s by mentoring, coaching and guiding young talent as to what we do as a business but also in terms of their personal aspirations and career path that we can really make a difference.
“It’s good to see so many young, passionate individuals who are part of our talent pipeline and part of the future of our business. And our investment in them will continue throughout the whole of our growth story, not just in the UK but also overseas.”
How is the MGA sector faring with regards to talent development?
From his vantage point of observing the market, Maleary said it has become clear to him that certain areas of the MGA sector are underserved when it comes to embracing better diversity. It’s on the right path, he said, but the sector still has a lot more work to do. What is also clear is that it’s going to take a continuous programme of change and an ongoing commitment to nurturing and supporting a more diverse talent pipeline to move that dial.
“It has to start somewhere,” Lewis said. “And it really starts with having that physical representation where you see a team that is diverse and that has young people. Because that’s how you evidence progress.”
Is the wider insurance industry embracing talent initiatives?
The 2024 BIBA Conference was a great opportunity to speak with key stakeholders from all across the industry – from insurers, to reinsurers, to distributors – Maleary said, and it was interesting to see how conversations about talent are evolving. These businesses are really starting to build teams that are geared towards the future, he said, and are placing strong emphasis on empowering the next generation of talent.
“They’re putting the right focus on fostering and bringing along good quality individuals that just need that little bit of encouragement to help them develop a bit more confidence,” he said. “I’ve also seen that there are still some that sadly, haven’t done it yet. But there’s still time and generally speaking, I think where we are today is quite encouraging.”
Delivering the message of insurance to a broader talent base
Lewis highlighted that becoming part of the insurance has opened her eyes to the breadth of what the market does, but also to the range of opportunities an insurance career can offer. Before you join, she said, it’s easy to just think about insurance as being limited to cars and houses, but her experience in the sector has made her an advocate for spreading the word about the potential encased within an insurance career.
The next step now is for the market to embrace the opportunity to get out into the communities it serves and educate young people on the jobs that are available, she said. It’s something the industry hasn’t done enough of in the past and the time is right because more people are considering different career routes. Whether it’s graduate schemes or apprenticeships, or even support for travel expenses etc. there’s so much that insurance businesses can do to create greater access to insurance careers.
“It’s something I tend to kick around as an idea with my head of operations and people, how we can target people at the early end of their career,” Maleary said. “And we’ve nurtured individuals, we’ve taken on some internships. But I don’t think we do enough as a sector to get into schools early enough and have the right conversations with career advisors to really set out the stall of the insurance sector. Because there is still lots to be done and, as Emily said, it does have to start somewhere.”
Name: Danny Maleary
Job title: CEO, Pro MGA Global Solutions
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Data, often referred to as the oil of our sector, remains central to success. It’s the battleground where victories are won and lost. Initiatives like Lloyd’s Blueprint 2 underscore the pivotal role of data in market-wide transformation efforts. Whether structured or unstructured, mastering data manipulation is crucial for leveraging technologies like AI and forms of automation to benefit every facet of re/insurance.
The fusion of vast data potential with AI capabilities brings immense promise, but it also harbors risks, particularly concerning the potential for discrimination within models. Without adequate checks and balances, these biases could permeate decision-making processes. Thus, understanding the context of AI-generated insights is paramount. We must prioritise explainability and embed ethical considerations into model designs to ensure that the pursuit of advantage is aligned with ethical principles.
Looking ahead to the second half of the year, as technology hurtles forward, the question arises: Can we keep up? Are we instilling the right value structures into organisations and model designs to safeguard against unintended consequences? It’s essential to ensure that the evolving business of insurance remains true to the core values we aim to uphold. This alignment is the key to staying ahead in the rapidly evolving tech landscape.
With this in mind, I feel strongly that the next two to three years will be pivotal for our industry, marked by fresh momentum in the transformative potential of technology across the insurance value chain. With projections indicating robust growth, particularly in the US property and casualty (P&C) sector and the European managing general agent (MGA) sector, the stage is set for insurers worldwide to capitalise on opportunities while navigating through global challenges. At Pro Global, we stand at the forefront of this dynamic environment, witnessing firsthand the intersection of technological innovation and insurer operations.
The outlook for 2024 continues to be promising, with significant premium growth and easing inflation pressures forecast over the course of the year. Swiss Re predicts industry return on equity (ROE) at 9.5% in 2024 and 10.0% in 2025, supported by premium growth of 7.0% and 4.5% respectively in these years.
However, amidst this optimism, it’s crucial to acknowledge the diverse regional landscapes shaping the industry. 2024 sees ongoing multiple economic and geopolitical crises converging; and political shifts, with more than 80 countries – over half the world’s population – voting this year in elections that could be pivotal for global democracy. And, while the US P&C sector shows signs of strength, challenges such as hyperinflation in countries like Argentina and shifting regulatory pressures particularly with a focus on the applications of AI and automation in insurance, and ongoing scrutiny over governance, underscore the need for agility and adaptability across jurisdictions.
Challenges and Opportunities of Running Multinational Businesses
Running multinational insurance businesses entails navigating complex regulatory landscapes, addressing varying market demands, and optimising operational efficiencies across jurisdictions. In today’s interconnected world, insurers must deploy strategic solutions to capitalise on growth opportunities while mitigating risks associated with geopolitical uncertainties and regulatory changes. Against this backdrop, technology emerges as a critical enabler, offering solutions to streamline operations and enhance competitiveness, while maximising the value of their human expertise.
At Pro Global, we recognise the transformative power of technology in reshaping insurer operations. Our international team of insurance experts, spanning across the UK, Europe, Latin America, and the US, collaborates seamlessly to deliver value-added services to our clients worldwide. From this perspective, we can see that from claims management to underwriting – automation solutions are revolutionising every aspect of the insurance value chain.
Last year’s acquisition of Propel Automation underscores our commitment to delivering value through cutting-edge technology, empowering insurers to drive operational efficiencies and capitalise on growth opportunities, and throughout 2024 we have been embedding digital services across our business verticals to augment and enhance our support for leading re/insurers.
Ethics and Automation: a headline topic for 2024
As I alluded to at the start, a key part of this conversation is the ethical considerations of weaving automation into the corporate fabric of re/insurance. While technology offers unprecedented opportunities for efficiency and innovation, it is imperative that insurers maintain a human-centric approach and prioritise ethical practices.
Moreover, as insurers increasingly rely on data-driven algorithms for pricing and risk assessment, ethical oversight is paramount. It is essential to ensure that these algorithms are transparent, fair, and free from bias, particularly when sensitive data such as health or personal information is involved. Our sector has a regulatory and ethical duty to uphold trust, integrity, and fairness in the way re/insurance operates, ultimately benefiting both customers and society at large.
A key focus for 2024 and 2025 is striking the balance between automation and human expertise. Rather than replacing humans, automation should complement and enhance the capabilities of insurance professionals, enabling them to focus on high-value tasks that require empathy, creativity, and critical thinking.
At the same time, the significant introduction of technology that both streamlines and augments the tasks that are completed by human beings introduces a critical new point of potential operational failure. It is therefore essential that insurers recognise this potential failure point, and proactively work to address eventualities, to assure business continuity and resilience in all contexts. This control-focused and anticipatory thinking applies not only during digital transformation programmes, but also with post transformation operations, which need as much focus on measurement and continuous improvement as the technology opportunity that is being harnessed. It is vital that insurers avoid inadvertently automating flaws into their core operations and processes that could, if left unchecked, snowball into significant operational challenges.
While embracing innovation with this critical thinking in mind, insurers must also contend with legacy systems that pose challenges to modernisation efforts. Legacy technology, particularly in run-off and legacy portfolios, can impede operational efficiency and inhibit the adoption of new technologies.
However, it’s essential to recognise that legacy systems play a vital role in supporting core business functions and must be integrated effectively with newer technologies. We advocate for a balanced approach to legacy tech, leveraging modernisation strategies to enhance operational efficiencies while ensuring seamless integration with existing systems. By adopting a phased approach to technology transformation, insurers can unlock the full potential of the data within their legacy systems while embracing the benefits of new technologies.
The Rise of MGAs and Tech-Centric Startups
At the same time that traditional insurers are evolving, the MGA sector continues to serve as a hotbed of innovation, bridging the gap between traditional insurers and emerging technologies. Pro Global’s subsidiary, Pro MGA Global Solutions, stands as a testament to this trend, with tech at the heart of every startup’s proposition.
The agility and flexibility inherent in the MGA model allow capacity providers to access startups to experiment with new technologies and underwriting approaches, driving innovation and differentiation in the marketplace. Pro MGA Global Solution’s multi-territorial platform supports the incubation of new MGA startups, enabling them to scale rapidly and capture market opportunities efficiently. In 2024, we anticipate continued growth and expansion in the MGA sector as insurers seek innovative solutions to meet evolving customer needs.
With the increasing emphasis on efficiency and multi-territory access, brokers are also increasingly seeking collaboration opportunities with entities like Pro MGA Global Solutions to develop more efficient models for distributing and placing business into global markets. Parametric insurance and tracker-type syndicates represent just a few examples of how the insurance industry is aligning with wider financial services in terms of data-driven progress.
Expertise and Tech Combined as Core Enablers of Growth
I am firmly of the view that technology working in harmony with sector-specific expertise will remain the cornerstone of insurer success. From harnessing AI for risk insight to streamlining processes through automation, re/insurers, brokers and MGAs have unprecedented opportunities to drive growth and profitability, through the focused lens of human expertise.
Pro’s competencies lie in its unique blend of proprietary technology and market practitioner insights, which form the backbone of its service offering. Unlike traditional tech companies, our technology is not developed in isolation but is intricately crafted through the lens of Pro’s own market practitioners. This ensures that our solutions directly address real challenges encountered in the field, honed through repeated encounters over time.
Pro stands out as both an enabler and a partner. Our approach bridges the gap between the old and the new, leveraging the expertise of practitioners alongside cutting-edge technology, both proprietary and partnered. Moreover, our partnerships extend to solutions developed by market practitioners for market practitioners, enhancing the relevance and applicability of our offerings.
The differentiation we offer is not merely in transformation but also in our thoughtful consideration of the post-transformed operating state. We focus on the thematic of automation and the evolution of capabilities and controls beyond the initial transformation phase. This holistic approach ensures that our solutions not only bring about change but also pave the way for sustained innovation and efficiency.
We recognise the interconnected nature of global challenges, and the need to reject old silos in favor of collaborative, innovative approaches. As the CEO of Pro Global, I am confident that together, we can navigate through the complexities of the insurance landscape and emerge stronger, more agile, and better prepared to thrive in the evolving global marketplace.
Name: Steve Lewis
Job title: CEO
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Key to this challenge lies the post-audit phase. It’s not merely about ticking boxes or meeting regulatory requirements; it’s about instilling a culture of continuous improvement and forging longer-term partnerships that transcend the audit cycle. This is where the significance of post audit consultancy emerges as a partnership approach providing support for MGAs and TPAs striving to achieve and maintain best practice in this rapidly growing side of the industry.
So, why is Post Audit Consultancy not just a value-add but a strategic necessity for MGAs and TPAs?
Extension of Audits and Professional Due Diligence
The audit lifecycle shouldn’t conclude with the delivery of a report; it should seamlessly transition into a phase of partnership aimed at improving observations and recommendations. Post Audit Consultancy extends this lifecycle, ensuring that audits aren’t just isolated events but part of a broader commitment to compliance best practice and operational excellence.
Guidance Tailored to Your Needs
Our consultancy team doesn’t just point out observations; we roll up our sleeves and work alongside MGAs and TPAs to address them comprehensively. Whether it’s underwriting, claims management, technical accounting, compliance, or SOX, our subject matter experts provide tailored guidance that’s rooted in deep industry knowledge.
Comprehensive Compliance Posture
With regulatory frameworks evolving constantly, maintaining compliance is an ongoing challenge. Post Audit Consultancy deepens your compliance posture by implementing expert guidance within your processes and procedures. This proactive approach ensures that your organisation not only meets regulatory standards but exceeds them.
Global Reach, Local Expertise
Our consultancy services aren’t bound by borders. With teams based in multiple locations and experienced in multiple languages, we offer unparalleled flexibility and adaptability. Wherever you operate, whatever your regulatory environment, our experts are ready to support you.
Protection of Reputation and Quality Standards
In an industry where reputation is paramount, Post Audit Consultancy provides peace of mind. By ensuring that observations are corrected promptly and compliance posture is continually enhanced, MGAs and TPAs can safeguard their reputation, brand, and quality standards.
In the fast-paced world of MGAs and TPAs, the only constant is change. With Post Audit Consultancy, we are working with leading MGAs and TPAs to help them embrace change as an opportunity for growth and innovation, confident in the knowledge that they have a trusted partner by your side, every step of the way.
Name: Robert Sherman
Job title: US Head of Audit & Advisory
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Con temperaturas de la superficie de los océanos en niveles récord y un debilitamiento de El Niño que reduce la velocidad del viento, el escenario se estaría preparando para tormentas potencialmente devastadoras. En esos momentos, la eficiencia en el procesamiento de siniestros, se vuelven primordial para brindar un excelente servicio a los asegurados afectados.
Las pérdidas aseguradas mundiales por catástrofes naturales en 2023, superaron los US$ 100.000 millones por cuarto año consecutivo, según Swiss Re. El citado Reasegurador, también indicó que el principal factor de las pérdidas de US$ 108 mil millones del año pasado, fue la frecuencia de los eventos, mientras que las tormentas convectivas severas (SCS), representaron un récord de US$ 64 mil millones de pérdidas durante el año.
La temporada de huracanes del Atlántico Norte, comienza oficialmente el 1 de junio de 2024 y finaliza el 30 de noviembre de 2024.
A continuación, detallamos tres consejos claves para ayudar a las aseguradoras a prepararse ahora y evitar retrasos en la gestión de los siniestros:
En primer lugar, las aseguradoras necesitarán delinear un plan de adecuación de recursos humanos y tecnológicos para poder afrontar el incremento estacional de los siniestros. Poner a los asegurados en primer plano, significa garantizar un pago rápido, eficiente y justo de las reclamaciones una vez ocurrida una catástrofe natural. Las preguntas que cada aseguradora debe hacerle a su equipo operativo incluyen:
El procesamiento eficiente de siniestros catastróficos, depende de flujos de trabajo optimizados y de una colaboración eficaz, especialmente con las Reaseguradoras. Es crucial contar con los protocolos de gestión de siniestros y aprobación de pagos correctos para garantizar el rápido pago de montos significantes. Además, es imperativo anticipar y prepararse para los reclamos de Business Interruption que también impactarán a corto y mediano plazo, posteriores al evento catastrófico.
En Pro Global, nuestro equipo cuenta con una amplia experiencia en brindar soporte a las Aseguradoras y Reaseguradoras durante los aumentos repentinos de reclamaciones, tal como sucedió luego de los huracanes Irma y María en 2017. Entendemos la importancia crítica de la precisión y la eficiencia en el proceso de ajuste de pérdidas y manejo de siniestros. Al identificar los desafíos comunes que enfrentan nuestros clientes, desarrollamos las mejores soluciones alineadas con las demandas de huracanes y otros eventos catastróficos.
No espere a que llegue la tormenta; actúe ahora para organizar sus recursos humanos y tecnológicos. Ponerse en contacto con expertos en reclamaciones como los de Pro Global, puede ayudar a las Aseguradoras y Reaseguradoras a prepararse de forma pro-activa para los desafíos que se avecinan. Al aprovechar nuestra experiencia y soluciones personalizadas, las Aseguradoras y Reaseguradoras, pueden afrontar con confianza las complejidades de una potencial temporada de huracanes superior al promedio.
La prestación eficiente de servicios de siniestros durante un aumento de reclamaciones por eventos catastróficos, puede mejorar o empeorar la reputación de una Aseguradora. La planificación proactiva, los procesos optimizados y el apoyo de expertos son esenciales. Al priorizar las necesidades de los asegurados, optimizar los flujos de trabajo y aprovechar la experiencia de la industria, las aseguradoras y reaseguradoras podrán confiar en que están preparadas para cumplir su compromiso con los clientes en tiempos de crisis, cuando se demuestra el valor de estar asegurado.
Name: Guillermo Ogan
Job title: Claims Manager (LatAm)
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Global insured natural-catastrophe losses in 2023 surpassed $100bn for the fourth year in a row, according to Swiss Re. The carrier said the main driver of last year’s $108bn in losses was the frequency of events, with severe convective storms (SCS) accounting for a record $64bn in losses during the year.
The North Atlantic Hurricane season officially begins on June 1, 2024, and ends on November 30, 2024.
Here are three key tips to help insurers prepare now, to prevent claims delays when it matters most for policyholders.
1. Plan for Surge Resources
First and foremost, insurers need robust surge resource plans tailored to handle the expected influx of claims. Putting policyholders front and center means ensuring fast, efficient, and fair payment of claims as soon as possible after a catastrophe strikes. Questions to ask your operational team include:
2. Streamline Claims Processing
Efficient claims processing hinges on streamlined workflows and effective collaboration, especially with reinsurers. It’s crucial to have the correct approval protocols in place to ensure smooth authorisation and payment of large catastrophe claims. Moreover, anticipating and preparing for business interruption and related liability claims in the medium-term aftermath of a storm is imperative.
3. Leverage Expertise and Experience
At Pro Global, our team boasts extensive experience in supporting insurance businesses during surges in claims, including the aftermath of Hurricanes Irma and Maria in 2017. We understand the criticality of accuracy and efficiency in the loss adjusting and claims handling process. By identifying common challenges faced by our clients, we develop best-in-class solutions aligned with the demands of catastrophic hurricanes.
4. Act Now
Don’t wait for the storm to hit—act now to put resources in place. Getting in touch with claims experts like those at Pro Global can help insurers proactively prepare for the challenges ahead. By leveraging our expertise and tailored solutions, insurers can navigate the complexities of an above-average hurricane season with confidence.
Efficient claims servicing during a surge in catastrophe claims can make or break an insurer’s reputation. Proactive planning, streamlined processes, and expert support are essential. By prioritising policyholder needs, optimising workflows, and leveraging industry experience, insurers can ensure they are ready to fulfill their commitment to customers in times of crisis, where the promise of insurance matters most.
Get in touch with the claims experts at Pro Global today to fortify your claims servicing capabilities and prepare for the challenges ahead.
Name: Guillermo Ogan
Job title: Claims Manager (LatAm)
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Our U.S. Head of Audit & Advisory, Robert Sherman, recently attended the IRES Foundation 2024 National School on Market Regulation in San Diego, USA. Here are his three key takeaways from the event…
Insurers needs to be clear on their MGA relationships
To ensure market conduct is being met, it’s vital the relationship between the insurer and MGA is clear. When an insurance company gears up for review, it must be clear who does what, to understand the MGAs involvement in market conduct and responding to requests. The MGA must therefore be on notice when an exam is called.
It’s also important to ensure there is thorough and complete documentation, too. Too many companies don’t know who has access to what information or data. Getting ducks in a row will make a big difference when an MGA is then made aware there is a formal enquiry. There should be a contractual agreement between the two parties to gain access to carrier information. The carrier may be ‘outsourcing duties’ to the MGA, but the carrier remains responsible for the data and sharing with regulatory authorities when requested.
Third parties (MGAs, TPAs) are an extension of a carrier, who are responsible for their vendor
It’s important for carriers to take full responsibility when auditing, including adopting proactive auditing and reporting of issues.
Carriers may outsource or vend aspects of their business but, ultimately, the carrier is responsible for compliance. They must have a clear sight of what their vendors are doing, how data is maintained, and how such things as artificial intelligence (AI) may be utilized in diverse processes..
For example, if a carrier is vending out its claims, they must have the ability to access claims files, and must make sure they get information from administrators. Ultimately the carrier is the one that is licensed.
Carriers must also be proactive. When something is found, report it as soon as possible along with justification and explanation. It’s important to also consider controls that can be put in place to prevent this from happening in the future.
An uptick in self reporting will lead to an improved relationship with companies and regulators.
AI is evolving fast, as is the regulation around it. A degree of flexibility will need to be in place from insurers to ensure they can adapt when needed.
Regulators will want to know what AI processes are in place in the context of market conduct, and will want to understand what companies are doing – for example, understanding potential gaps. It is recommended that insurers sit with regulators and explain the processes they have in place, showcasing how the data is being used.
Insurers need to begin sooner than later to implement governance frameworks and be flexible as AI and its regulation develops. If there’s one word I would repeat to insurers, it would be Document; Document; Document!
Finally, insurers need to be able to explain their use in understandable terms. Cumbersome explanations or jargon just won’t cut it!
These insights from the IRES Foundation 2024 National School on Market Regulation event underscore the critical importance of clarity and responsibility within insurer-MGA relationships, as well as the necessity for thorough oversight of third-party vendors, and the imperative for insurers to adapt and remain flexible in the face of evolving AI technologies and regulations.
There are proactive steps that insurers can take to keep pace with these rapidly evolving dynamics, and ensure they are maintaining compliance best practice at all times. These include comprehensive documentation, proactive auditing, and transparent communication with regulators: a powerful trio that combined will market conduct and compliance practices. As the industry continues to navigate the complexities of market regulation, I hope these key takeaways from the evolving conversations in our market serve as helpful guidance for insurers striving to maintain integrity and effectiveness in their operations.
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Name: Robert Sherman
Job title: US Head of Audit & Advisory
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El mercado asegurador local atraviesa un periodo complejo desde los puntos de vista técnico, económico y financiero, y esto pone a las compañías a redoblar esfuerzos para optimizar recursos. Una decisión de negocio inteligente en este contexto es buscar soluciones innovadoras que permitan reducir gastos fijos directos e indirectos. El ahorro es un concepto calve en estos tiempos.
En esa búsqueda, las aseguradoras están empezando a incursionar en la tercerización de procesos. Esta práctica es muy común en el mercado europeo y en Estados Unidos y hoy se está desplegando cada vez con más fuerza en América Latina. Está claro que la pandemia, al obligar a las empresas a desarrollar el trabajo a distancia, colaboró en el entendimiento de esta solución: la reconfiguración del negocio hacia la transformación digital dejó en evidencia que no es necesaria la presencialidad de los recursos humanos para la ejecución de algunas tareas. La tendencia de compañías livianas que tercerizan procesos clave es cada vez más palpable.
Y uno de los procesos clave del mercado asegurador que está entrando con éxito en esta dinámica es la gestión de siniestros. Las aseguradoras empiezan a entender y dimensionar los beneficios de tercerizar el abordaje administrativo de los siniestros. El desafío, en ese punto, es encontrar al partner indicado para hacerlo.
El socio estratégico especializado para este mandato es Pro Global. Como consultora, el sustento de nuestro expertise es el staff de recursos humanos experimentados en el manejo de carteras de siniestros y la tecnología aplicada al negocio.
Ofrecemos un servicio de excelencia de administración de siniestros de todas las ramas, con las variables de frecuencia e intensidad que presenten, de carteras “vivas” o de “run-offs”, para aseguradoras y reaseguradoras, en la Argentina y en Latinoamérica. Pro Global se adapta a las necesidades que tenga cada cliente: diseñamos el servicio a la medida, moldeando el abanico de posibilidades disponibles o desarrollando nuevas soluciones requeridas.
Pro Global puede abordar tareas específicas o bien todo el proceso de punta a punta (administración, gestión y negociación del siniestro) según se requiera. Los expertos de Pro Global, de forma remota, acceden al Sistema del cliente y le dan tratamiento al siniestro de la misma forma que se lo darían in-house, siguiendo los procesos de control y seguridad fijados por el cliente y respetando las estrategias de gestión definidas, alcanzando los ratios establecidos.
Los principales beneficios directos de la tercerización son la reducción de gastos fijos en recursos humanos y de las contingencias propias del trabajador (ausencias, licencias, vacaciones), y el ahorro en espacio físico e infraestructura in house. Además, queda resuelta la estacionalidad en materia de siniestros: cuando hay picos de casos por eventos masivos o por temporada, Pro Global absorbe la tarea liberando a la empresa de la necesidad de contratar más colaboradores. A esto se suma el relevante hecho de que las compañías pueden dejar en manos de especialistas estas tareas de administración y concentrar sus recursos en su core específico: hacer crecer su cartera de clientes con mayor foco en su negocio.
Por otra parte, el beneficio específico de tercerizar la gestión de siniestros en Pro Global, además, es un abordaje proactivo de cada siniestro que garantiza la aceleración del cierre de casos. Contamos con un sistema propio que logra procesos más eficientes y genera reportes diarios (métrica) de la gestión. Garantizamos los estándares más elevados de protección de datos y confidencialidad, ya que nuestros sistemas cumplen con todas las normas internacionales de Compliance y políticas de Data Protection.
Contamos, además, con los talentos específicos que requiere este abordaje, como abogados, técnicos en seguros, actuarios, contadores y administradores de empresas, entre otros profesionales. Nuestro equipo interdisciplinario da respuesta en todos los frentes del ciclo de vida de un siniestro y gestiona la relación con otros profesionales naturalmente involucrados, como peritos, abogados, médicos, entre otros.
Como consultora, nuestro principal diferencial es nuestra capacidad de innovar para dar respuesta a cada requerimiento. Invitamos a las aseguradoras y reaseguradoras a contactarnos para desarrollar en conjunto la solución a su medida en la gestión de siniestros.
Name: Guillermo Ogan
Job title: Claims Manager (LatAm)
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