This article was published in Insurance Business Magazine and is being republished to Pro Global website with thanks.
The ‘turbo-rise’ of the market is reflected in the fact that 2023 saw a record 15+ MGAs incubated in Europe through Pro MGA, he said, and is forecasting double-digit opportunities and €100 million in premiums across its supported MGAs by year-end 2024. For Døhlen, the question now is how to support businesses looking to enter and grow in new territories. It’s a task he has ample experience in accomplishing having previously served as MD of an MGA and Lloyd’s Syndicate ably supported by Pro MGA Solution’s infrastructure and people.
“It was about five years ago that I came out of corporate insurance after 10 years with one of the global carriers,” Døhlen said. “At the time, I felt that innovation wasn’t really a core strength in a marketplace where there should be a lot more, as showcased by the insurance coverage gap and how insurers aren’t being seen by clients to be innovating in order to develop the products and solutions required to meet their coverage needs.”
The support of Danny Maleary [CEO of Pro MGA Solutions] and his team in helping him establish his MGA was his first introduction to the business, but what held his attention was their stated ambition to make MGAs a standpoint of innovation and market growth. When he was asked to help develop the business’s European expansion ambitions, he said, it was a rare case of “the stars aligning”.
Assessing the MGA market in Europe today, Døhlen noted the 20-plus set-ups carried out by Pro MGA were across different business classes, risk classes and sizes. The pipeline for this year is similarly strong, he said, and the firm is seeing high demand from individuals and organizations who are actively pursuing the MGA path.
There are a lot of factors at play behind this, he said, but key has been the changing attitude of risk carriers towards MGAs. These carriers no longer see MGAs as a threat to their market superiority but instead are embracing the opportunity to benefit from partnering with organisations with innovation and agility at the core of their mindsets.
“They are embracing more of a risk partnership model, which we’re seeing across the insurtech sector with how they’re evolving from ‘foe to friend’ by partnering and combining strengths instead of being in competition,” he said. “So, it’s all about being high-pace and having the ability to work with data and technology without being stopped by the legacy issues, which is a typical challenge amongst big insurers.
“It’s about them being able to dip their toes into new products and new markets and, in doing so, achieving growth. Something we’re seeing more insurers enjoying and embracing is the Lloyd’s coverholder model as well, which insurance companies are happy to support given that they know the framework.”
The change in approach has been “more of an evolution than a revolution” Døhlen said, because MGAs have worked to get themselves into shape as the clear go-to set-up for risk carriers. Brokers have also been instrumental in enabling that evolutionary shift by supporting MGAs, and affirming the value case of this business model.
He highlighted that some of the credit must also be given to clients because they have proven themselves prepared to purchase insurance from new and emerging companies, buoyed by their appetite for a rejuvenated value proposition that is more aligned with their specific needs and interests. It’s a very rewarding time to be in the market, he said, because with innovation now front of mind, MGAs have a very clear role to play– and he’s positive this will continue in the coming years.
The future is especially bright in Europe, he said, where, largely speaking, it’s relatively easy to set up an MGA and the path to doing so is increasingly well-trodden. Insurance companies giving the MGA model their stamp of approval is leading to increased instances of insurers partnering with MGAs which, in turn, is encouraging more brokers and clients to step away from traditional placement models.
How MGAs continue to utilise data and technology remains a key driver of the success of the model, he said, and it’s when all these factors come together that you have a really strong platform on which MGAs can thrive.
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Name: Hans Martin Døhlen
Job title: Managing Director, Pro MGA Solutions Europe GmbH
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With reputations, brands, and quality standards under scrutiny, there’s a pressing need for robust internal audit functions to provide steadfast support and reassurance to insurers that they are maintaining their standards across business functions, and focused on continuous improvements.
Internal Audit Services are strategically imperative for insurers. Regulators and market bodies demand assurance that carriers are upholding their promises, safeguarding their reputation, and adhering to stringent quality standards. This necessitates a thorough evaluation of internal processes, controls, and compliance measures.
Strengthened internal audit functions serve as the frontline defense, instilling confidence by providing independent assurance that risk management, governance, and internal control processes are operating effectively.
Internal audits play a pivotal role in objectively enhancing an organization’s business practices. By scrutinizing culture, policies, and procedures, internal auditors contribute to the oversight of the board and management. They verify the effectiveness of internal controls, assess operational efficiency, mitigate risks, and ensure compliance with laws and regulations. This kind of objective insight can be critical to shaping the future tactics and strategies for an insurer.
However, to reap the full benefits of internal audit services, credibility and expertise are paramount. Pro Global’s team of proven experts stands ready to augment existing staff or provide invaluable third-party insight. Our experienced insurance auditors can provide an independent and unbiased view, adding value to the organization by identifying areas for improvement without operational bias. Whether it’s enhancing current processes or offering a fresh perspective through due diligence and quality assurance, Pro’s Internal Audit Services are tailored to elevate your organization’s performance and compliance standards.
Augment your internal audit team with Pro’s experts or allow Pro to perform a Due Diligence review of your current internal audit program. Get in touch to learn more about how our Internal Audit Services can fortify your business and ensure its sustained success.
Name: Robert Sherman
Job title: US Head of Audit & Advisory
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At the same time, the traditional methods of evaluating agency performance are evolving. Beyond mere adherence to contractual and underwriting provisions, there is a growing demand for deeper insight into how individual agencies impact overall performance and loss ratios. This necessitates a shift towards tailored audit solutions that address the unique needs of each client.
Recognizing this emerging trend, Pro Global has developed a cutting-edge Agency Management Review service tailored specifically for the US market. This innovative offering leverages our partnerships with actuarial staff to provide unparalleled insights into the performance of agency partners.
One of the key pillars of our Agency Management Review service is ensuring compliance with underwriting standards. By meticulously evaluating adherence to contractual obligations and underwriting guidelines, we help safeguard the reputation, brand, and quality standards of our clients. This not only instills confidence in stakeholders but also mitigates potential risks associated with non-compliance.
Moreover, our approach goes beyond compliance by identifying specific areas that may be affecting agency performance. Whether it’s poor loss ratios or operational inefficiencies, our team of experts conducts a thorough analysis to pinpoint areas for improvement. Armed with this actionable intelligence, our clients can make informed decisions to optimize agency performance and enhance overall profitability.
At the heart of this new service is our commitment to delivering accurate and actionable audit result reports. We understand that generic, one-size-fits-all solutions fall short in today’s complex insurance landscape. That’s why our Agency Management Review service is tailored to meet the specific needs and objectives of each client. Whether it’s a comprehensive assessment of agency operations or a targeted review of underwriting practices, our reports provide invaluable insights that drive tangible results.
By partnering with Pro Global for Agency Management Review, insurers and MGAs can enjoy a myriad of benefits. Firstly, they gain the confidence that their reputation, brand, and quality standards are being protected by a team of seasoned professionals. Secondly, our accurate audit result reports serve as a roadmap for enhancing agency performance and driving sustainable growth.
As the US P&C insurance market looks set for substantial growth in the coming years, the importance of effective agency portfolio management cannot be overstated. Insurers and MGAs must proactively monitor and optimize the performance of their agency partners to capitalize on emerging opportunities and mitigate potential risks.
Pro Global has responded quickly to market demand by developing an expert new Management Review service, designed to support clients in knowing that their agency partners are meeting underwriting standards and driving sustainable growth in-line with the robust growth forecast expected for the market as a whole in the coming years.
Name: Robert Sherman
Job title: US Head of Audit & Advisory
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Insurance regulatory bodies face mounting challenges to keep pace and maintain robust, reliable reviews of carriers that take into account the shifting landscape around them.
In the US, the National Association of Insurance Commissioners (NAIC) has outlined its 2024 strategic priorities, which underscore the critical need for coordination and innovation in addressing these challenges.
NAIC’s strategic priorities for 2024 encompass a wide array of issues crucial to the insurance sector’s stability and resilience. From tackling climate risks and enhancing insurer financial oversight to addressing deceptive insurance marketing and promoting financial inclusion, these priorities reflect a proactive stance in safeguarding consumer interests and fostering industry integrity.
Meanwhile, in Canada the P&C sector is grappling with similar risk horizons and regulatory shifts, as well as internal policy issues such as adherence to Quebec’s French language law, Bill 96, which mandates that all policy contracts conducted with clients in the province must be in French initially.
Working with Insurance Regulators
These are just a handful of examples, but the overall message is clear. As state-based insurance regulation continues to evolve, collaboration between regulators and industry experts becomes paramount. There is growing demand for sector specialists to support regulators in auditing carriers’ performance.
Our team stands ready to assist insurance regulators in evaluating carrier behavior, performance, and customer outcomes, ensuring compliance with market requirements. With expertise spanning regulatory audits, underwriting, claims, and run-off assistance, we bolster market conduct functions and provide invaluable support to regulatory bodies.
Benefits of Collaboration
By partnering with our team, regulators gain confidence in protecting consumers while strengthening market conduct functions. Our experts augment regulatory staff, offering tailored solutions to meet evolving regulatory standards. Through collaborative efforts, we ensure industry participants uphold regulatory requirements, fostering trust and integrity within the insurance ecosystem.
Extensive experience is required to work closely and effectively with insurance regulators, conducting detailed reviews of carriers to uphold regulatory standards. By leveraging our expertise, regulators can effectively fulfill their mandate of safeguarding consumers and maintaining market integrity in an ever-changing regulatory landscape. Together, we pave the way for a more resilient and consumer-centric insurance industry.
Name: Robert Sherman
Job title: US Head of Audit & Advisory
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This article is shared with the kind permission of Canadian Underwriter. Original article here
Insurance providers “should have an overlaying company policy saying, ‘Here is how we, as an MGA or insurer, etc., are handling production of all of our insurance policies with respect to Bill 96,’” said Elaine Collier, senior auditor at Pro Global, which conducts Lloyd’s audits of Canadian and U.S. coverholders. “They should have something they ensure all staff are aware of as part of their training: ‘This is what you need to do.’”
Under Bill 96, passed in 2022, businesses offering goods or services in Quebec must inform and serve their Quebec clientele in French first. “This principle is now an express obligation which, if contravened, is an offence punishable by fines,” as Stikeman Elliott notes on its website.
It’s unclear how Quebec’s government and courts will interpret the scope of the law’s application. For example, ambiguity exists around whether the law’s reach will extend to insurance providers with offices both inside and outside Quebec.
“If, for example, the insured and the main risk is located and domiciled in Ontario but there may be secondary locations in Quebec, I think a case could be made that you could issue everything in English,” Collier says. “But if there is some variation on that, it might be better to default to issuing a separate policy in French for Quebec locations.
“I think [the company policy is] something each entity has to decide for themselves.”
Whatever the corporate policy, insurance providers must make sure front-line staff who serve the clients know how to issue documents in proper accordance with the provisions of Bill 96.
“It’s not just a discussion for the higher-ups — the lawyers and presidents,” Collier told Canadian Underwriter in an interview. “It filters right down to the front-line…It’s a training issue as much as anything else.”
Insurance providers serving customers and clients in Quebec should be prepared to prove they issued a French version of the policy documents to the consumer first, before the customer provides express consent to receive English copies of policy documents.
“Section 55 [of Bill 96] clarifies that the French version of the agreement must have “been given to the other party” and that [the consumer] must have ‘explicitly expressed willingness’ to conclude an English version of the agreement,” as the law firm Gowling WLG notes on its website.
Keeping track of this may be complicated, as Collier observes.
“If our English [clients] want [their policies] in English, they have to make a formal request to have it in English,” Collier says. “And [insurance providers] need to adequately document their files, which is often poorly done. In some of my audits prior to Bill 96, there’s nothing clearly retained in an underwriting file that tells me the client said, ‘Yes, I would like my policy in English.”
Issuing renewal policies will also be complicated, Collier adds. For example, if the policy was first issued in French, and the consumer at that point confirms a preference to receive further documents in English, can the renewal policies be issued in English? Or must they be delivered in French first?
Insurance providers “need to have a renewal strategy so that any policies outside of the envelope [of the law] are [translated into French] in a certain amount of time,” Collier says. “All renewals have to be done in a different light…
“This is an area where probably not enough attention is being paid, but more attention should be paid. Do [insurance providers] just issue renewable [French] declarations and they don’t provide [French] copies of the wordings? That’s a risk factor there.”
Translating English insurance policies to French is not as easy as it sounds, for several reasons. For example, Collier’s seen examples of French and English sections contained in a single insurance policy document.
“How do we deal with all of these policies we have that are…what I call ‘moitié-moitié,’ which is half and half?” she asks. “You might get a dec page that’s French and a Lloyd’s endorsement in English, and then another endorsement that’s in French. Some of them can be messy.
“How are they going to deal with that legally? Because there’s still some discussion about the legislation and there’s also been no testing of this new legislation in the courts.”
Plus, translating documents is a nuanced art that includes technical industry jargon. Ambiguity exists around specialty or manuscript wordings that have no Quebec equivalent, and/or have not been tested in the Quebec courts under the Civil Code.
Name: Elaine Collier
Job title: Senior Auditor (Canada)
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2023 saw a record number of 20+ MGAs incubated in Europe through Pro MGA, and for 2024 we are already working on a double digit number of opportunities and we are expecting forecasted premiums of EUR 100m+ across our supported MGAs by year end. It’s clear that Pro MGA’s commitment to innovation and industry expertise is empowering MGAs to drive meaningful change within the insurance industry.
For decades, MGAs have been a stalwart presence in the insurance industry. However, unlike previous cycles where MGAs struggled amidst market instability, they are now not just surviving but thriving as valuable extensions of insurer underwriting capability, connecting innovative and relevant new products with local markets.
We feel 2024 has the hallmarks of a milestone year of expansion for MGAs in Europe. So, what’s turbo-charging this growth drive?
Traditional year-by-year arrangements are being replaced by multi-year contracts, fostering greater alignment and stability. This move towards long-term partnerships incentivises both parties to focus on sustained profitability and mutual growth, rather than short-term gains.
MGAs are also increasingly aligning with panels of insurers to explore capacity options. These alliances allow MGAs to access a diverse range of underwriting capacities, enabling them to offer comprehensive coverage across various lines of business while mitigating risk. By collaborating with multiple insurers, MGAs can maintain their independence while ensuring a secure and well-backed operation. Some MGAs have successfully secured non-classical risk capital by securing alternative risk capital from for example pension funds/trusts, looking to diversify their investment portfolios.
This model is not only enhancing the resilience of MGAs but also fostering competition among insurers, driving greater efficiency and innovation in the market.
Moreover, the increase in profit commissions, coupled with delayed earnings accrual, strengthens the financial performance of MGAs over time. By prioritising long-term relationships, insurers and MGAs are cultivating partnerships of trust that foster entrepreneurialism, and support the sustainable navigation of market fluctuations, laying the groundwork for enduring success.
Meanwhile, the investment landscape surrounding MGAs reflects both challenges and opportunities. While securing investment remains a hurdle in the current volatile investment environment, the attractiveness of proven MGAs as investment targets persists despite market uncertainties.
2023 saw a cooling-off period in the broader M&A market, but this is expected to turn around in 2024, and the MGA sector in particular remains active. MGAs with a track record of successful growth are fetching attractive multiples, drawing interest from investors and traditional insurers alike. Limited targets and heightened competition underscore the lucrative nature of MGA investments.
This competitive environment highlights the strategic importance of M&A activity within the MGA space and as part of an MGA’s strategic objective, as players vie to capitalise on the industry’s growth potential and secure their position in an evolving market landscape.
The most critical element to the value proposition of an MGA is of course the team behind it. MGAs are often formed by ambitious entrepreneurs who have grown frustrated with slow-moving systems at large insurers, and the space is also fostering and securing talent as start-ups grow. Talent is attracted to fast-growing, agile start-up environments, and there are many more in the market who want to be part of the MGA success stories that we are seeing. In fact, anecdotally we are seeing talent gravitate towards MGAs at a pace outperforming the general insurance space.
In particular, specialised niche underwriters are realising that their expert underwriting knowledge is highly valuable, and by joining an MGA structure that aligns with their area of expertise, they become more than a small cog in a large machine, and can drive a business forward and be rewarded for it.
The barriers to entry to start an MGA are now lower than ever before – the path is well-trodden. Enabling platforms like Pro MGA Global Solutions are keen to support high quality ideas backed by expert underwriting talent, and can take on the heavy lifting when it comes to the sometimes daunting regulatory and operational hurdles that can be overwhelming, particularly when resources are limited with start-ups.
The turbo-charged rise of European MGAs is not merely a short-lived trend but an upwards gear shift in the dynamics of the insurance industry. MGAs are poised to grow in influence in the European insurance sector, through collaborative partnerships, a strategic focus on insurer diversification and relentless pursuit of innovation.
The transition towards longer-term relationships between insurers and MGAs signifies an important maturation of the partnership model, emphasising stability, alignment, and sustained profitability over short-term gains.
Name: Hans Martin Døhlen
Job title: Managing Director, Pro MGA Solutions Europe Gmbh
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"We're committed to fostering a culture where inclusivity and equality isn't just a priority, but a guiding principle. Whilst there is always more to do, we strive to embrace diversity, uphold equality, and champion inclusion for a brighter, more equitable future."
- Steve Lewis, CEO of Pro Global
London, UK: 8th March 2024: International Women’s Day is an appropriate moment to reflect on the strides we’ve made at Pro Global towards fostering diversity, equality, and inclusion within our organisation. The past year has been marked by a number of initiatives aimed at closing the gender pay gap, enhancing family-friendly policies, and championing community engagement.
In 2023, Pro Global continued its journey towards gender equality by significantly reducing the gender pay gap. Our commitment to this cause is evident in the tangible progress we’ve achieved, with the mean gap decreasing from 45% to 30% and the median dropping from 35% to 8%. While this progress is commendable, we acknowledge that our work is far from over.
One of our key focuses has been on enhancing family-friendly policies, including increasing parental leave provisions and company pay for employees. These initiatives aim to support our employees as they navigate the challenges of growing their families while maintaining their careers. Additionally, our flexible hybrid working approach ensures that our workforce can thrive both personally and professionally.
In addition to internal initiatives, we’re proud to partner with Gloucester Hartpury Women’s Rugby team, championing the sporting achievements of women in our community. This partnership reflects our commitment to supporting diversity and inclusion both within and beyond Pro Global.
Focus fuels success
Looking ahead, we remain steadfast in our commitment to advancing diversity, equality, and inclusion, both at Pro Global and in the global re/insurance industry. We will continue to review and refresh our EDI policies, deliver further training, and prioritise inclusive practices to ensure that Pro remains a great place to work for all.
As we celebrate International Women’s Day, we reaffirm our commitment to empowering women and fostering a culture of inclusion where everyone can thrive and succeed.
Name: Steve Lewis
Job title: CEO and Group Head of Claims
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This article is shared with the kind permission of Insurance Edge. The original article can be accessed here
“The revolution will not be televised” – that famous phrase coined by the poet and musician Gil Scott-Heron – is a powerful statement of fact: significant societal change won’t be captured or conveyed adequately through headlines (and yes, that irony is not lost on me). Instead, it implies that real change happens on the ground, among people, away from the public gaze. In the context of technology’s impact on society, this phrase is never far from my mind.
Robotic process automation (RPA) may not be in the headlines on a daily basis like its altogether buzzwordier cousin Artificial Intelligence, but its impact on society and industry – specifically our global re/insurance sector – is growing steadily. That’s because it’s not about flashy robots or sci-fi scenarios; rather, it’s the gradual integration of automation into various aspects of our jobs, and into the fabric of the systems we use to make decisions and shape strategies.
The automation revolution is subtle – driven by algorithms that operate invisibly in the digital realm. And to understand how this technology is transforming re/insurance today, we must look beyond the surface and pay attention to the deeper, often unseen forces shaping the fabric of the industry.
One of the key areas experiencing transformation is claims processing. Through new RPA algorithms, insurers can now expedite the evaluation and settlement of claims, reducing manual intervention and improving accuracy. This not only enhances customer satisfaction by providing quicker resolutions but also optimises operational costs for insurance companies by triaging the most complex claims for human attention.
Fraud detection is another critical aspect where RPA can play a pivotal role. By employing sophisticated models, insurers are analysing vast amounts of data to automate the identification of fraudulent patterns and anomalies, enabling proactive intervention and mitigation of risks. This not only safeguards the integrity of insurance systems but also protects legitimate policyholders from potential fraudulent activities.
Similarly, another current and evolving application is in auditing. By automating auditing processes, insurers can conduct comprehensive assessments with greater precision and efficiency, minimising the risk of non-compliance while optimising resource allocation.
However, as we progress into 2024, the most valuable current applications for insurers already lie in enhancing their own operational efficiency. Insurers are embracing process automation, often through expert third-party service providers, to streamline complex operations and adopt smarter workflows. Particularly, fronting carriers and programme management businesses are turning to digital tools and partnerships to overcome scalability challenges and drive business growth.
UK insurer iGO4, launched a transformational Robot Process Automation (RPA) programme with the Pro Digital Solutions team – creating 160+ bots in 12 months and automating 40% of its processes to deliver seven-figure cost savings. The approach enabled iGO4 to automate high-volume and small, infrequent tasks that would not otherwise have been financially viable, reducing regulatory risk. Employee job satisfaction is also increased by removing routine tasks and enabling the focus to switch to more complex and rewarding work.
Human expertise at the heart of the automation revolution
This is just one example of the real revolution taking place right now in insurance. As well as return on investment, and cost reductions, it is about how this technology frees up our industry’s experts to take action based on the deeper insights and more efficient processes that the underlying systems can now support.
And that’s the key. Automation is not about replacing humans but rather enhancing their productivity, transforming service delivery, ensuring compliance, improving decision making, and accelerating the digitisation of complex operations.
In essence, the revolution spoken of by Gil Scott-Heron remains true: significant change unfolds quietly, away from the spotlight. While the allure of sci-fi scenarios may capture imaginations, at the moment we are seeing strong demand for the transformative power of RPA across insurance processes to empower human expertise, not replace it. Through streamlined processes, enhanced decision-making capabilities, and refined risk management strategies, this increasingly sophisticated “background” tech is taking the foreground in augmenting our industry’s capabilities, driving us towards greater efficiency and innovation.
As we venture into 2024 and beyond, the path forward for insurers lies in embracing these transformative technologies while staying true to our commitment to customer-centricity. In this quiet revolution, the future of insurance is being shaped, not by what’s televised, but by what’s diligently cultivated behind the scenes.
Name: Louisa Pavis
Job title: Head of Digital Services
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The Legacy Burden for Brokers
Legacy business is often seen as an inconvenient burden, impacting the value and profitability of broking operations. The challenges range from the ongoing cost of managing accounts in run-off to resolving aged funding, unallocated cash, and retaining knowledgeable staff. Legacy systems, often outdated and incompatible, add to the complexity, requiring costly maintenance or intricate transfers.
For brokers, a passive approach to legacy management might yield satisfactory results, but a proactive strategy can unlock significant benefits. Pro Global’s proven track record in descaling over US$3 billion in liabilities across various business classes positions us as a key ally for brokers seeking a strategic shift in effective and efficient legacy management.
A proactive legacy management strategy involves identifying, segregating, and de-scaling entire legacy portfolios, allowing brokers to focus on growth and core business activities.The key lies in a dedicated, multi-functional team, including claims handling, technical processing, IBA resolution, and credit control expertise.
This can be achieved by diverting experienced resources to establish an in-house legacy team or outsourcing to a specialist provider like Pro Global. From premium and claims technical accounting to legacy broker acquisition, our expertise is renowned for ensuring a comprehensive and strategic approach to legacy management.
An opportunity for Transformation
As the market plans for highly competitive market conditions across many classes of business in 2024, brokers can view legacy business not as a burden but as an opportunity for transformation. Pro Global’s Broker Services division stands ready to assist brokers in navigating the challenges of legacy administration. By adopting a proactive approach, brokers can unlock value, protect market reputation and optimise processes to minimise the legacy burden going forward.
Broker Transfer: A Path to Finality and Certainty
For brokers seeking finality and certainty in legacy management, the Broker Transfer solution provided by Pro Global is a game-changer. This solution allows Pro to assume entire legacy portfolios and accounts, becoming the formal Broker of Record.
The process usually involves an interim period where Pro works with Brokers to ring-fence the business to be transferred and ensure a smooth transition. Following regulatory approvals, Pro takes on all obligations and liabilities for ongoing administration, providing brokers with the freedom to concentrate on their core business priorities.
The call to action is clear: By collaborating with specialists like Pro Global, brokers can concentrate on strategic growth opportunities while we handle the complexities of legacy management. This allows them to reduce the unwanted distraction of legacy liabilities, optimise operational processes, and resolve long-standing issues. The future of brokerage lies in transforming challenges into growth potential. While our clients lead the way in their respective fields, Pro Global is here to provide our expert support.
Name: Dani Rosser
Job title: Head of Broker Services
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In der Vergangenheit verhielten sich die deutschen Versicherer bei der Auslagerung an TPAs eher zurückhaltend. Grund hierfür war, dass viele Versicherer die Leistungsbearbeitung als ihre Kernkompetenz betrachten.
Zumindest in den Bereichen, in denen die Pro in Deutschland aktiv ist – Arbeitskraftabsicherung, Heilwesen/Arzthaftpflicht, Bau und Architektenrecht und allen weiteren Segmenten komplexer Haftpflichtschäden – hat der Mangel an Experten und die Zunahme komplexer Schadenfälle jedoch zu einer steigenden Nachfrage nach vertrauenswürdigen Partnern geführt.
Angesichts dieser sich stetig weiterentwickelnden Dynamik auf dem Markt gibt es erste Anzeichen für ein Umdenken. Das TPA-Modell gewinnt an Akzeptanz als strategisches Instrument für Versicherer und eine wachsende Zahl von Versicherern eröffnet in 2024 Diskussionen über die Möglichkeiten einer strategischen Partnerschaft mit Dienstleistern.
Das sich wandelnde Gesicht von TPAs
Der weltweite Markt für TPAs im Versicherungsbereich befindet sich auf einem stetigen Wachstumskurs, mit einem Wert von 324,9 Milliarden Dollar im Jahr 2022, der bis zum Jahr 2032 ein beeindruckendes Volumen von 795,1 Milliarden Dollar erreichen soll, bei einer bemerkenswerten Wachstumsrate von 9,6 % zwischen 2023 und 2032. TPAs haben sich als anerkannte Anbieter von Versicherungsleistungen erwiesen, die dem Markt administrative Lösungen zur Verfügung stellen, insbesondere in den komplexen Bereichen der Bearbeitung von komplexen Fällen.
Ein Zuwachs an Schadensfällen kann zu einem erheblichen Arbeitsaufkommen bei den Versicherern führen, manchmal auch auf Kosten der Servicequalität. TPAs haben sich diesem Problem angenommen, indem sie die Versicherer bei der nahtlosen Schadensregulierung unterstützen und komplexe Leistungsfälle regulieren. Sie spielen eine wichtige Rolle bei der Bearbeitung von Leistungsfällen und sorgen für eine effizientere und kundenfreundliche Abwicklung.
Was treibt diesen Wandel in der deutschen TPA-Landschaft voran und warum ziehen die Versicherer eine strategische Partnerschaft nun ernsthafter in Betracht?
Der Hauptgrund ist der Mangel an Experten in vielen Leistungsabteilungen. Dies gilt insbesondere für die Bearbeitung von Berufsunfähigkeitsfällen und anderen Leistungsfällen, bei welchen die Sachverhalte sehr komplex sind. Die Herausforderungen sind für die verschiedenen Versicherer unterschiedlich. Große Versicherer setzen oftmals auf technische Unterstützung und eigene Experten im Haus, aber wenn das Volumen komplexer Schadensfälle steigt, reicht die Anzahl der Experten oft einfach nicht aus und es wird externe Hilfe benötigt.
Anders als bei einfachen Schadenfällen (Massengeschäft) ist bei sehr komplexen Fällen oftmals auch noch keine vollständige automatisierte Bearbeitung möglich.
Für große Versicherer spielen auch die Unterstützung der TPA bei Arbeitsspitzen, sowie Elternzeit und Urlaubsvertretung eine wichtige Rolle. Mittelständische Versicherer haben oft weniger technische Unterstützung. Hier kann der Ausfall eines Experten bereits einen relevanten Produktivitätsverlust bedeuten.
Viele kleine Versicherer können ihr Fachwissen nicht mehr aufrechterhalten und benötigen externe Unterstützung.
Darüber hinaus verschärft der demografische Wandel die Situation, da in den kommenden fünf Jahren erfahrene Fachkräfte auf dem Markt in den Ruhestand gehen werden und es an neuen Experten mangelt, die diese ersetzen könnten.
Datenschutz und Fachwissen
Gleichzeitig sind deutsche Versicherer, wie auch Unternehmen in ganz Europa, seit langem besorgt über die Einhaltung regulatorischer Vorgaben. Die Datenschutz-Grundverordnung (DSGVO) hat z.B. die Komplexität der Datenverarbeitung und -weitergabe erhöht. Die Sensibilität im Zusammenhang mit personenbezogenen Daten – insbesondere Gesundheitsdaten und Daten zum Beruf – hat für die Versicherer zu Recht einen sehr hohen Stellenwert.
Seriöse Dienstleister haben diese Herausforderungen erkannt und stark in robuste Datensicherheitsmaßnahmen und Compliance-Protokolle investiert. Sie wissen, wie wichtig die Wahrung der Vertraulichkeit von Daten ist. Einige Anbieter haben sich aus diesem Grund gesondert zertifizieren lassen und verfügen über das nötige Fachwissen, um die erhaltenen Daten in voller Übereinstimmung mit den gesetzlichen Vorschriften zu verarbeiten.
Dies hat das Vertrauen der Versicherer gestärkt, da sie nun mit TPAs zusammenarbeiten können, die über das erforderliche Wissen und die Erfahrung verfügen, um ihre besonderen Anforderungen zu erfüllen.
Partnerschaftlicher Ansatz
Ein partnerschaftlicher Umgang ist für den sich entwickelnden Drittanbietermarkt in Deutschland entscheidend. Die bewährte Praxis sieht vor, dass TPAs und Versicherer eng zusammenarbeiten, um sicherzustellen, dass die Lösungen auf die spezifischen Bedürfnisse und Ziele des Versicherers abgestimmt sind. Das Modell ist flexibel, denn Versicherer, die eine solche Unterstützung suchen, können den Umfang der Zusammenarbeit selbst bestimmen. So ist beispielsweise eine vollständige Übernahme der Leistungsprüfung möglich, aber auch eine partielle Übernahme, bei der die Entscheidungsbefugnis beim Versicherer verbleibt. Auf diese Weise erhält der Versicherer die benötigte Unterstützung, verliert aber nicht seine Kernkompetenz.
Diese flexible Partnerschaftsmentalität gewinnt an Zugkraft, da beide Parteien die gegenseitigen Vorteile und die Effizienz einer harmonischen Zusammenarbeit erkennen.
Da TPAs als verlängerter Arm der Versicherer fungieren, führt die gemeinsame Verantwortung für die Kundenzufriedenheit und eine effiziente Leistungsprüfung zu besseren Ergebnissen für alle Beteiligten. Diese kollaborative Denkweise fördert Innovationen und ermöglicht maßgeschneiderte Lösungen, die das Wachstum, die Flexibilität und die Effizienz fördern und sicherstellen, dass die Dynamik bei der Leistungsprüfung auch in Spitzenzeiten nicht nachlässt.
Ein Blick auf andere Märkte
Um das volle Potenzial des TPA-Modells zu verstehen, ist es hilfreich, andere TPA-Märkte wie das Vereinigte Königreich und die Niederlande zu untersuchen, in welchen die Beziehung zwischen Versicherern und Dienstleistern deutlich weiterentwickelt ist. In diesen Regionen hat sich das Geschäftsmodell bereits bewährt und den Versicherern geholfen, schneller zu wachsen, agiler zu werden und effizienter zu arbeiten.
Die Einführung von TPAs in diesen Märkten hat entscheidend dazu beigetragen, die Leistungsprüfung zu rationalisieren, die Kosten zu senken und die Servicequalität insgesamt zu verbessern. Die Versicherer im Vereinigten Königreich und in den Niederlanden haben von dem Fachwissen und den Fähigkeiten der TPAs profitiert, die es ihnen ermöglichen, sich auf ihre Kernaufgaben und ihr strategisches Wachstum zu konzentrieren.
Fazit: Förderung des Wachstums im Jahr 2024
Im Jahr 2024 ist der TPA-Markt in Deutschland auf Wachstum eingestellt. In einem Markt, in dem die internen Ressourcen oft überstrapaziert sind, wird das ausgereifte TPA-Modell mit seinem Schwerpunkt auf Fachwissen und Partnerschaft die Effizienz steigern und das Kundenerlebnis für Versicherer und Versicherungsnehmer gleichermaßen verbessern, insbesondere in bei steigenden Leistungsfallzahlen.
Die Erkenntnisse aus etablierten Märkten können auch dazu beitragen, dass die deutschen Versicherer von Anfang an bewährte Verfahren für eine TPA-Partnerschaft übernehmen. Diese Entwicklung verspricht eine neue Ära des Wachstums und der Effizienz für die Branche in Deutschland, und das Team von Pro Global steht bereit, um sie zu unterstützen.
Name: Stilianos Kalaitzidis
Job title: Head of Business Development (Germany)
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