Flipbook
Setting the Scene
A major global insurance provider approached Pro two years ago to help with a significant project relating to third-party claims administrators (TPA) who handle claims on the company’s behalf.
The business was looking for independent support and advice to give them the necessary assurance that TPAs were managing claims appropriately, treating customers fairly and meeting corporate and regulatory requirements.
Pro has been working successfully with this client in the UK for two years and has just started working with them in the US.
The Challenge
A major global insurance provider approached Pro two years ago to help with a significant project relating to third-party claims administrators (TPA) who handle claims on the company’s behalf.
The business was looking for independent support and advice to give them the necessary assurance that TPAs were managing claims appropriately, treating customers fairly and meeting corporate and regulatory requirements.
Pro has been working successfully with this client in the UK for two years and has just started working with them in the US.
Signs of Success
A major global insurance provider approached Pro two years ago to help with a significant project relating to third-party claims administrators (TPA) who handle claims on the company’s behalf.
The business was looking for independent support and advice to give them the necessary assurance that TPAs were managing claims appropriately, treating customers fairly and meeting corporate and regulatory requirements.
Pro has been working successfully with this client in the UK for two years and has just started working with them in the US.
The Solution
Pro adopted the client’s scope – a bespoke product which Pro tailored to ensure continuity as well as consistency of reporting and, in doing so, made Pro a natural extension of the client’s in-house team.
Pro provided dedicated resource in the UK and more recently, the US, as well as other auditors to support the business on European audits – people who were claims experts but who also had language skills to audit a selection of TPAs annually.
As part of the agreement, Pro had monthly update meetings with the insurer to check on progress; pre-audit meetings with the claims representatives to understand particular issues and nuances; and produced an audit report and a RAG rating with recommendations and findings from the audit.
The arrangement between Pro and the insurer is ongoing and the feedback received from the client is that Pro has successfully validated a number of concerns that they had – both generic and more specifically by individual audit.
Get in touch
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