People, process and performance: the art of claims consulting

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Adrian Gilbert is the managing director of SX3 a claims consultancy service he set up in 2014 with Laurence Besemer. Claims Media recently caught up with him to find out more about SX3 and how it aims to give insurers a better choice of consultant in an increasingly uncertain claims environment.

“Claims operations typically call on consultants to help them with what I call the three ‘P’s – People, Process, Performance” says Adrian Gilbert.  “I used to find consultants could be stuffy, by which I mean they came with preset solutions but limited insight into my real needs. We’re about removing the stuffiness.”

No wonder then that SX3 – a claims consultancy service that Gilbert set up in 2014 with Laurence Besemer, CEO of the Forum of Insurance Lawyers (FOIL) – aims to deliver straight-talking solutions for insurers who are increasingly looking for an independent second pair of eyes to help them navigate the unpredictable world of claims.

This, he says, is what makes SX3 stand out from some of the larger, or more established, consultancies whose work has become process-driven, meaning that it may not be fully aligned with their clients’ goals.

“They arrive with a team, sit down, agree a scope and deliver that to the letter, but there doesn’t seem to be a lot of value added to it,” explains Gilbert.

“They’ve just taken what they’ve been asked to do and churned it out the other side. But it might not be what you actually need. They’re trying to bend what they do to what the customer needs.”

In contrast, he says that SX3 would never operate on auto-pilot in such a way. Consequently, if there’s something SX3’s network of over 30 consultants can’t do, then it doesn’t accept the work. Instead, Gilbert tries to point insurers in the right direction to another consultancy.

Equally, if it takes on a project but does not deliver the goods, then the consultancy doesn’t expect to get paid.

“We want to help de-risk the chance of getting a consultant that just goes through the motions.”

How it works

 SX3’s structure is not unique – a network of claims professionals who are on call to take on contracts – but it is closely managed at all stages to ensure quality output.

“What we do better than some is how we manage that network. We engage actively with customers and we’re on the phone with them a lot, monitoring progress,” says Gilbert.

“We don’t abdicate responsibility once the contract is signed. We project manage it from start to finish. It’s about understanding what the core issue is and agreeing what the genuine solution should be – and doing all that with the client up front.”

SX3 harnesses a mix of individuals as its consultants. They all have different skill sets, but share one thing in common. They have recently worked within claims. Some of them, for example, are in a transitional phase of their careers and want to carry out some consultancy work while they work out what they want to do next.

“These guys are really good for us because they are fresh out of the market, they were doing a job that was regarded as meaningful. So they’re current,” says Gilbert.

With a pool of seasoned professionals to call upon, SX3 can also help its consultants out when they come across a situation that is unfamiliar or problematic by calling upon the advice of another consultant.

“So if consultant A has an issue and has 75% of the knowledge he needs, we’ve got other people to partner with them to fill the rest of the 25% in. We do that by keeping our knowledge base current.”

Gilbert also keeps track of consultants’ reputation: “Engagement with the market is key. Getting feedback on our consultants, both in terms of what they do for us and for other people, is part and parcel of what we do.”

Background

Given his wealth of experience, it is no surprise that Gilbert chose to move into consultancy. He has over 25 years’ experience in claims management, with roles in motor, property and casualty, product protection and legal expenses. He has operated in technical, supply chain, operational and litigation roles for companies such as QBE and BGL, to name but two. His expertise also saw him land a part on the ABI working group, which dealt with the fallout from the credit hire wars.

“In previous roles I would have been the person receiving the question from the underwriter about what the discount rate change means or, looking at how an insurer would have managed their reserving strategy, or knowing that an important policy review was coming up in six months,” he says.

Services

Given SX3’s pool of expertise, it can consult on a myriad of issues that have a claims strand to them. This includes selecting suppliers, reviewing supply chains or panels of lawyers, controlling leakage, overseeing team restructuring and overhauling repair networks.

“Another thing we do is mentoring,” says Gilbert. “One of the main issues in the market is brain drain. The sector loses quite a lot of the more experienced people, they get moved on, or retired out. And to replace them there are some very bright young people coming through, who clearly have a good structure around them in terms of an L&D programme, but if they need some advice from someone more seasoned, that is not always there.”

SX3 can fill that gap. Acting as mentors, consultants can give an experienced and independent opinion on an idea, or point someone in the direction as to where to go for a particular service or product.

The consultancy can also deliver screening services as Gilbert explains: “If you’ve got ten CVs on your desk and you need to recruit for one role and they’re all saying that they’re hot at credit hire handling, then we can narrow it down to two or three candidates by spending an hour on the phone to them. We can analyse their credit hire experience and weed out the weak candidates.”

SX3’s range of consultancy services is simply driven by the skill sets within its associate database. “If we haven’t got someone to do something we don’t put it out there,” says Gilbert.

“I’m wary of any consultant that says they can do anything. That for me raises alarm bells.”

Issues

At present, Gilbert says the most enquiries he has seen recently have been based around measuring and managing performance.

“These enquiries are coming from insurers of all sizes, and could be leakage auditing, performance benchmarking or conduct risk reviews, and it could either be covering in-house operations or the supplier that works with the insurer.”

“There’s a great need to monitor performance, to make sure it’s being tracked and controlled.”

On the horizon, there is much for insurers, and in turn, consultants, to ponder. The obvious subjects as Vnuk and the ongoing whiplash review. Tied into the latter, says Gilbert is MedCo. He believes that a key issue with the medical reporting portal is making sure that it develops in the right way.

As the Ministry of Justice continues to rely on MedCo for independent medical report production for injury claims, Gilbert says that it must take the next logical step in its development as soon as it can.

“It’s still at a stage of getting ready to be able to benchmark the opinions being provided by independent medical experts. Discovering if say, Doctor A always gave a prognosis of eight months, but has started giving ones of 10 months is crucial.

“How on top of that are they? To what extent have they got the resources to assess if some experts are doing a copy-and-paste job? That’s still got a way to go.”

Then there is also the pressure of budget controls imposed on claims operations and growing application of automation. Both, says Gilbert, will give rise to more robotics in the claims process.

There is a recognition, he says, that insurance boardrooms value claims operations a lot more nowadays and that they have invested more into them over the last ten years. Nevertheless, hearing a claims team saying that they are ahead of the game and able to be more pro-active and investigate claims more deeply is virtually unheard of. Which is where AI comes in the picture.

“Automation coming into the claims process is welcome if having a human being perform that same process is not adding much value. Freeing claims handlers to concentrate on delivering excellent customer service, or investigate uncertain aspects of the claim is a development that satisfies all parties in the claims process”.

“So you’re seeing the evolution of a claims handler into a claims servicer.”

Bolted onto that development is data integration, which should be made easier through automation. Gilbert says that pooling connected data is vital when it comes to analysing and measuring suppliers, investigators and lawyers, among others. Right now, however, how that will be done is still up for discussion.

All of this upheaval means that consultancies such as SX3 will continue to be called upon by insurers, even after the last human claims handler has left the building.

 

 

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About Author

Mark Dugdale is the editor of Claims Media. Mark welcomes articles, letters or feedback from readers and can be reached via mark.dugdale@barkerbrooks.co.uk