cross-border cooperation in motor insurance claims
DESCRIPTION
Cross-border cooperation in motor insurance claims. InterEurope AG European Law Service Head Office Hansaallee 249 40549 Düsseldorf Germany Tel. +49 211 586 584 18 Fax. +49 211 586 584 34 e-mail: [email protected]. IIF 2014, Istanbul, April 6-7th. - PowerPoint PPT PresentationTRANSCRIPT
Cross-border cooperation in motor insurance claims
InterEurope AG European Law Service
Head Office Hansaallee 24940549 DüsseldorfGermany
Tel. +49 211 586 584 18Fax. +49 211 586 584 34e-mail: [email protected]
IIF 2014, Istanbul, April 6-7th.The road towards profitability
Cees WerffInterEurope AG European Law Service www.intereuropeag.com
Fraud
AGENDA
Cross-border cooperation in motor claims management
Data protection & privacy regulation in EU
Introduction to cross-border motor claims
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Introduction
* Implementation of the system of the International Certificate of Motor
Insurance (‘Green Card System’) on 01.01.1953
* Council of Bureaux (CoB) is the organisation coordinating the different
National Insurance Bureaux (NIB) participating in the Green Card system.
* The NIB represents around 2000 motor insurers in 47 countries in
Europe, North Africa and the Middle East.
• CoB operates under the United Nations
• Number of cross-border traffic accidents reported in 2012: 355.759
• General trend: declining. Reasons: economical crisis, road-safety measures, road-traffic information, safety measures car manufacturers, in car technology (mainly technology innovations)
• Movers and shakers in cross-border traffic accidents
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Relationship between TPL insurer and foreign Correspondent and his Correspondent/Representative must be considered as a legally regulated Outsourcing situation with the respective rules of Compliance and Governance.
The Correspondent / Representative is a full range defender of the interests of the mandating foreign MTPL Insurer not just a loss adjuster.
Requirements to integrate targets, structures and procedures between the mandating MTPL insurer and the foreign service provider.
International Complexity require service providers‘ total focus on international claims: international claims must be core business free of conflicts of interest.
Principles in international claims
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Without direct compensation systems
Direct settlement on basis of conventions
Mandatory direct compensation systems on basis of law
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Claims handling schemes: traditional system vs. direct settlement of claims
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Introduction
Accidents which occurred in the country involving land vehiclesregistered abroad: Top 5 countries (2012):
1. Germany (54.623)2. France (53.914)3. Italy (41.188)4. Austria (29.055)5. UK (24.875)
Top 5 countries CEE1. Poland (12.919)2. Romania (10.173)3. Hungary (7.280)4. Czech Republic (5.566)5. HR (5.344)
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Introduction
Countries of registration of the vehicle involved in the accident: Top 5 countries (2012):
1. Germany: F, CH, NL, A, PL, Ro2. France: B, CH, E, UK, I, P3. Italy: CH, G, F, Ro4. Austria: D, H, I, CH5. UK: D, F
Top 5 countries CEE1. Poland: CZ, G, F, UK, I, NL2. Romania: G, F, UK, I, H3. Hungary: A, G, UK, I4. Czech Republic: A, G, UK, I, PL, SK5. HR (5.344); BIH, I, GTurkey: G, UK, F, I, Ro
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Migration in EuropeSource: Berlin Institut für Bevölkerung und Entwicklung, Die demografische Zukunft von Europa (2008)
108.548
16.866
74.198E
P
RO
BG
PL
I
CH
B
NL
D
SEST
LTGB
IRL
10.523
48.038
6.777
5.859 51.151
11.424
38.367
18.015
EU 25
4.865
20.785
2.312
5.989
2.074
1.695
47.000
Fraud
AGENDA
Cross-border cooperation in motor claims management
Introduction to cross-border motor claims
Data protection & privacy regulation in EU
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Data protection & privacy regulation in the EU
EDPS: European Data Protection Supervisor Started on 01.01.2004 Main tasks: Control, Advise & Cooperation Each member state have an DPO (Data Protection Officer) Advise after control: health status, employment, security research, etc. Complaint procedure for EU citizens: breach of confidentiality, access
to information, right of correction, erasure of information, unnecessary saving of confidentiality information
Recently special advise on: TFTP-SWIFT, e-privacy guideline for electronic communication and public access to documents
Also advise on Court of Justice: ‘Bavarian Lager case’: connection between transparency and data protection
Cooperation with Eurodac: sharing responsibility regarding control between local data-protection authorities
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Data protection & privacy regulation in EU
AGENDA
Cross-border cooperation in motor claims management
Introduction to cross-border motor claims
Fraud
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FRAUD
Common fraud techniques
Underwriting side (total-loss)
Claims sideSpecialist fraudsters (groups)
Mobile numbers, witnesses, addresses, etc.Vendors (garage’s)Digital pictures (photo shopping)
Majority are coincidence fraud cases
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Data protection & privacy regulation in EU
AGENDA
Fraud
Introduction to cross-border motor claims
Cross-border cooperation in motor claims management
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Cross-border cooperation in motor claims management
Who is entiteled to handle cross-border MTPL claims?
MIB can give delegated authority to external service providers Insurers are member of the MIB and are allowed to handle claims MIB can handle claims themselves as well, or can delegate this In general insurers can appoint correspondent/representative
themselves, but some exceptions apply
What are selection criteria in choosing a cooperation partner?• Quality (people: claims handling vs. claims processing)• Main countries• Finance management• Data protection & privacy regulation• Internal audit structure• Vendor management
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Cross-border cooperation in motor claims management
What are selection criteria in choosing a cooperation partner?• Quality (people: claims handling vs. claims processing)• Communication• Main countries• Finance management• Solvency II requirements • Data protection & privacy regulation• Internal audit structure• Vendor management• Client relationship structure• Innovation (e.g. Telematics, electronic accident report via smart app)
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Cross-border cooperation in motor claims management
Vendor management?• Many parties could be involved in the claims process:
• Claims service provider, technical experts, accident investigators, medical experts, external lawyers (criminal), body repairs shops, special experts, etc.
• SLA• Auditing• Costs• Payment structure• Quality• Communication
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Cross-border cooperation in motor claims management
Euro Kasko Claims support• Asssistance network (Atrium)• Road-side assistance• Towing network• Body-repair shop network• Surveyor network• Mobile app
Advantage:Early stage pro-active claims handling to reduce time and costs!
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Cross-border cooperation in motor claims management
Point of view of the insurance company:
Keep indemnity/ compensation reasonable Avoid sanctions Accurate reserves Governance & Compliance
• Data Protection• Fraud prevention• Controlling, reporting, auditing
Client retention (marketing function of claims management: service and assistance towards insured)
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No legal and/or contractual obligation of the policy holder to report an accidentLower control over claims costs but also processing costs (survey reports, medical experts, legal costs)Poor or inefficient communication with correspondentsUnclear / unstructured processes of claims handlingCompetitive advantage of the car manufacturers (i.e. technology & data)
Challenges for insurers
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Bentley Continental GTC 6.0 l badly damaged, estimated repair costs GBP 55,000Credit car hire vehicle obtained on the day of the accident(Bentley Continental Flying Spur 6.0 l) – daily rate: GBP 762.50 + VATClaims notification: 3 weeks post accidentConfirmation of insurance cover: 7 weeks post accidentsRepairs completed: 8 weeksTotal credit car hire 159 days / GBP 121.237,50
Example for higher costs due to delays
For example: Credit Car Hire in the UK
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“If detailed information about an accident could be obtained earlier, this would dramatically effect the efficiency of the claims handling process and thus reduce costs“
Hypothesis
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Telematics
How can modern technology help?
Online claims formsIT-interfaces
Automatic data transfersCommunication platforms
Apps
The use of modern technologies results in changing traditional processes, reducing claims costs but also administrative and other costs
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Ideal process
Insurer
Call center 24/7
Telematics box
TPA
Data transfer
Information (e.g. false alarm
Instruction
File opening
Key processesData transfer
Contact
InterEurope
Claim rejection or claim settlement
Expert instruction
Receipt of expertises
TP
Signal
File opening & confirmation of insurance cover
Confirmation of insurance cover
Request for confirmation of insurance cover & 1st reserve
Investigation & legal assesment
Querries
Further information, legal evaluation, reserve update
Claim rejection or claims settlement
Information
Invoicing & file closing
Payments
Invoices & supporting documents
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Claims handling process becomes shorter due to faster communication
Swift decision making Decrease of claims costs and processing costs Better control in terms of insurer being informed of an accident Avoiding time gaps between accident occurrence and notification
of a claim Swift access to legal expertise (InterEurope) – more adequate
handling Risk identification and reduction (taylor-made premiums)
Effects / possible cost reductions
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Data protectionFuture technical developments (e.g. e-call, driverless cars, google
glass)Cost pressureLegal developmentsAutomatizationStandardization vs. Industrialization
Challenges & summery
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Thank you for your attention!
For further questions,
please do not hesitate to contact me
Cees WerffInterEurope AG European Law Service
Head Office
Hansaallee 249
40549 Düsseldorf
Germany
www.intereuropeag.com