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Process landscape and efficiency in non-life insurance claims management: An industry benchmark

Nils Mahlow (University of St. Gallen, St. Gallen, Switzerland)
Joël Wagner (Department of Actuarial Science, University of Lausanne, Lausanne, Switzerland)

Journal of Risk Finance

ISSN: 1526-5943

Article publication date: 21 March 2016

970

Abstract

Purpose

In view of the fact that claim payouts account for about 70 per cent of annual direct costs in non-life insurance companies and that claims-handling staff sums up to 10-20 per cent of all employees, an optimal claims management environment is of strategic importance. The purpose of this paper is twofold, i.e. on the one hand, the authors introduce a standardized claims management process model and, on the other hand, they apply process benchmarks to various operational parameters.

Design/methodology/approach

The proposed claims management process landscape comprises current industry standards for claims handling from a theoretical perspective, supported by practice insights from the industry. Our model aims to reflect the most important claims processing activities. The claims-handling work flow is structured into five core steps, namely, notification, registration, coverage audit, settlement and closing of the claim. For these core steps, the authors differentiate between three claim complexity categories and their associated back-office levels. In the second part of the paper, the authors assess the industry’s claims-handling efficiency. The authors benchmark industry processes with reference to detailed claims management data from 11 insurers in Germany and Switzerland.

Findings

The benchmarks are based on the previously defined claims management model and are applied separately to the three retail business lines of car, property and liability insurance. We measure claim process times (cycle times) as well as claim quantities and average claim payouts at different levels. Overall, within each business line, more than 30 data points are gathered from each respondent insurer. This allows us to compare the process performance of different insurance companies and to describe significant differences in their process patterns. Furthermore, principal findings are derived from descriptive statistics as well as ad hoc data analyses.

Originality/value

The paper seeks to contribute to the discussion of how different insurance companies perform in claims management and to define best practice. Our findings are relevant to academics and practitioners alike.

Keywords

Citation

Mahlow, N. and Wagner, J. (2016), "Process landscape and efficiency in non-life insurance claims management: An industry benchmark", Journal of Risk Finance, Vol. 17 No. 2, pp. 218-244. https://doi.org/10.1108/JRF-07-2015-0069

Publisher

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Emerald Group Publishing Limited

Copyright © 2016, Emerald Group Publishing Limited

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