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Luis Charlo mapfre

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  • La cuantía económica exacta de los límites se puede encontrar actualizada en la Intranet de Siniestros. Los países que están adscritos a estos convenios también se pueden encontrar en la Intranet de Siniestros, en: Intranet de Siniestros / Varios / Siniestros Extranjeros / Otra información / Enlace con Ofesauto / Español / Consejo de Bureaux Si el asegurado desea viajar a un país distinto de los que están adscritos a estos convenios, deberá contratar un seguro en la frontera del país.
  • ¿Siempre se puede aplicar el convenio CIDE? No, como veremos ahora, se tienen que dar una serie de requisitos.
  • Para resumir escribe en el rotafolios el siguiente esquema: Anualmente el sector analiza los siguientes conceptos para determinar el CMS: Coste medio de las reparaciones asumidas por las entidades acreedoras. Índices de referencia para la estimación del Coste Medio obtenido.  El importe actual del módulo de CMS lo puedes encontrar actualizado en la Intranet de Siniestros. Compañía Acreedora Perita Para la reparación Cobra CMS Compañía Deudora Paga CMS
  • De esta forma se resuelven aquellas circunstancias que dificultan su cumplimentación (p. Ej., rellenar la DAA en una vía de circulación rápida con peligro para los conductores).
  • ¿Qué es el Manual de criterios?  Se encuentra en la Intranet de Siniestros
  • Interlocución. En cada Entidad Aseguradora existe una figura, denominada Interlocutor, cuya función principal consiste en resolver las incidencias derivadas de los Convenios. Los interlocutores tienen poder decisorio en la interpretación de los convenios, interviniendo en aquellos casos en los que por vía amistosa no se haya podido llegar a un acuerdo en cuanto a la responsabilidad.
  • ¿Qué es el Manual de criterios?  Se encuentra en la Intranet de Siniestros

Luis Charlo mapfre Luis Charlo mapfre Presentation Transcript

  • Luis Charlo Deputy Regional Director for Erope Mapfre Asistencia ( Spain ) Friday, 3 September 2010
  • Claims Settlement – Experience in MAPFRE Luis Charlo Hydra, September 3 rd 2010
  • 1- MAPFRE and MAPFRE ASISTENCIA 2- MAPFRE’s Direct Claims Settlement in Spain 3- Innovation in claims settlement processes 4- Exporting the Direct Claims Settlement model 5- Challenges in claims management
  • MAPFRE and MAPFRE ASISTENCIA
  • 2009
      • Spanish business group which undertakes insurance, reinsurance and service provision activities for companies and individuals
      • Leader in Non-Life insurance in Spain and Latin America. Among the top 10 insurers in Europe, with noteworthy presence in the United States
      • One of the main Assistance and Reinsurance groups in the World
      • Present in 40 countries
      • More than 35,200 employees and over 5,800 offices
      • Consolidated revenue in 2009: more than 18,800 million euros
    MAPFRE and MAPFRE ASISTENCIA
      • CLAIMS SETTLEMENT EXPERIENCE
    MAPFRE 1
    • MAPFRE ASISTENCIA is a multinational insurance, reinsurance and services company with a direct presence in 40 countries
    • We are the unit within MAPFRE S.A. specialized in Assistance , Specialty Risks and Claims Management Services and in charge of exporting MAPFRE’s Spanish know-how and best practices to other markets: in the areas of automobile , home, travel and health
    • 1,330 corporate clients (1,000 Insurance companies), 74 million insured and 161 million beneficiaries, designing quality products and services tailored to meet the needs of our clients
    • We are certified as conforming to the ISO 9001:2000 International Quality Standard and have warranted Moody’s A1 financial rating since 2002
    MAPFRE and MAPFRE ASISTENCIA
      • CLAIMS SETTLEMENT EXPERIENCE
    MAPFRE ASISTENCIA 1
  • MAPFRE’s Direct Claims Settlement in Spain 2
  • MAPFRE’s Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    • Direct Claims Settlement Agreements emerge in order to:
    • To improve the quality of the service received by the policy holder when having a claim
    • To avoid delays in the resolution of the claim
    • To avoid disputes: with the damage assessment, with the payment, etc
    • To set up regulations and sector criteria
    • To minimize the number of legal claims
    ¿Why did Direct Claims Settlement agreements emerge? 2
  • Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    First agreement - CIDE 2 High number of claims going to court only to resolve material damages Traffic accidents managed as civil proceedings on court It gives impulse to the agreements January 1 st 1988 : CIDE agreement starts
  • ¿What is the CIDE agreement? Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    CIDE: C onvenio de I ndemnización D irecta E spañol Target: Direct settlement of the claim to the insured involved in a car accident, and that based on responsibility assignment regulations and internal market/sector criteria is not responsible for it. 2
  • Basic principles of the CIDE agreement Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    • High automation
    • Specific response deadlines
    • Avoid going to court
    • Automatic compensation
    • Supervision and Arbitration Commission for resolving possible discrepancies
    2
  • ¿When can the CIDE agreement take place?
    • Only two vehicles involved in the accident
    • Damages produced because of a collision
    • Accurate fulfillment of the DAA (Friendly Accident Notification Form) including clear responsibility assignment
    • Material damages produced in the vehicle, not exceeding the TPL mandatory insurance limits
    • Insurance companies of both vehicles members of the CIDE agreement
    Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    2
    • Key fact is the correct fulfillment of DAA and that responsibility is determined on it
    • To determine who is responsible a Responsibility Matrix based on the circumstances/situation of each involved vehicle was developed
    • The creditor entity (non responsible) will indemnify its policy holder and receive a fix amount (Average Sector Cost) from the debtor entity
    Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    ¿When can the CIDE agreement take place? 2
  • Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    May 1 st 1990 second agreement: ASCIDE starts Supplementary Agreement to CIDE: It is signed with the aim of resolving those “CIDE” claims without or without an accurate or complete DAA Friendly Accident Notification Form A cuerdo S uplementario del convenio CIDE 2
  • ¿When can the ASCIDE agreement take place? Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    ASCIDE agreement is based exactly on the same principles of the CIDE agreement, but it is not mandatory to fullfil the DAA. It is a compilation of regulations and resolutions from the Supervision and Arbitration Commission generated during the years of life of the agreements Not filling the DAA may present different versions of the circumstances. For resolving it a Criteria Manual was developed with additional subsidiary regulations 2
  • Resolution phases for both CIDE/ASCIDE agreements Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    Friendly phase Dialog phase Supervision and Arbitration Commission Most of the claims are settled in this phase Versions and assignment of responsibility not clear. Specialized claim handlers have to participate in order to decide Resolves all unresolved versions from the previous phases 2
  • Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    Main Figures CIDE and ASCIDE MAPFRE in Spain 2 December 2009 June 2010 Total number of files managed     CICOS module payment 327,427 172.438 CICOS module recovery 394,588 203.635 TOTAL 722,015 376,073 Files resolved in Dialog or Commission phases     Dialog 5,699 1,889 Commission 100 27 Friendly phase Dialog phase Supervision and Arbitration Commission
  • Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    Advantages for Insurance Companies 2
    • Simplified procedures: claims settlement is speeded up due to the responsibility criteria and the response deadlines
    • Reduction of legal expenses
    • Reduction of Administration Expenses
    • Companies’ image improvement. Good perception from policy holders
  • Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    Advantages for Insurance Companies 2
    • Avoid claims going to court as well as discussions between insurance companies
    • Faster damage assessment: Each Insurance company takes care of its own insured
    • No repair budgets are needed
    • Repair can start earlier and repair shop payment is done faster: increased claims settlement speed
  • Direct Claims Settlement in Spain
      • CLAIMS SETTLEMENT EXPERIENCE
    Advantages for Policy Holders
    • Faster Claims Management increases satisfaction of the policy holder
    • Personalized customer service by his/her own insurance company, not by the third party
    • Assessment and payment to repair shop done by his/her own insurance company, avoiding delays and out of pocket expenses
    2
  • Innovation in claims settlement processes 3
  • Innovation in Claims Settlement process
      • CLAIMS SETTLEMENT EXPERIENCE
    3
    • For MAPFRE, with a portfolio in Spain of + 5,8 million vehicles innovation in claims management has to provide an increase in efficiency as well as a higher customer retention and satisfaction.
    • At the same time MAPFRE was leading the Direct Settlement Agreements creation in Spain, the first Drive-In Assessment Centers were launched with the expertise of CESVIMAP.
      • Service to policy holders and third parties.
      • Managing Direct Agreement Claims
      • Damage Assessment and payment order for the repair shop.
    • Specifically designed centres for QUICK DAMAGE EVALUATION
    Innovation in Claims Settlement process
      • CLAIMS SETTLEMENT EXPERIENCE
    Drive-In Assessment Centers: 3
  • Innovation in Claims Settlement process
      • CLAIMS SETTLEMENT EXPERIENCE
    MAPFRE Service Centers
        • How can be the service to the policy holder improved when a loss takes place?
        • How to receive the highest quality perception from the customer?
        • How to generate an integral management of the claim?
        • How improve the loss ratio?
        • How to settle claims in a more efficient way?
        • How to keep Policy Holders loyal?
        • How to…..?
    3
  • Accident takes place Claim notification to MAPFRE Going to repair shop Damage assessment Repaired vehicle in repair shop Repair Customer perception Traditional Claims Cycle Claims service settlement Innovation in Claims Settlement process
      • CLAIMS SETTLEMENT EXPERIENCE
    MAPFRE presence Not MAPFRE presence 3
  • Accident takes place Contact MAPFRE Replacement vehicle MAPFRE takes care of the repair MAPFRE Guarantee MAPFRE Service Center Customer perception Innovation in Claims Settlement process
      • CLAIMS SETTLEMENT EXPERIENCE
    Service Center Claims Cycle Claims service settlement Take the repaired car Leave the replacement vehicle MAPFRE presence Not MAPFRE presence 3
        • Looking forward to:
        • To be One Stop Solution for the Policy Holder when having a claim:
          • Resolve all doubts regarding the settlement
          • Leaving damaged car for damage assessment
          • Taking a Replacement Car
          • Most appropriate repair shop selected by MA PFRE
          • Shortest repair period
          • MAPFRE’s life guarantee certificate on body
          • and painting jobs
    MAPFRE Service Centers: Innovation in Claims Settlement process
      • CLAIMS SETTLEMENT EXPERIENCE
    Centro de Servicio de Alcalá 3
        • Benefits for MAPFRE
          • Customers loyalty
          • Portfolio retention
          • Average cost reduction of the repair
          • No delays in starting the repairs
          • Claims’ settlement speed under control
          • Better control of the repair shop network
          • Extremely high customers satisfaction ratios
    Innovation in Claims Settlement process
      • CLAIMS SETTLEMENT EXPERIENCE
    MAPFRE Service Centers: Centro de Servicio de Alcorcón 3 Centro de Servicio de Alcorcón
  • Exporting the Direct Claims Settlement Model 4
  • Exporting the Direct Claims Settlement model
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    MAPFRE ASISTENCIA looking forward to offer the best solutions to its Clients, is always challenging the circumstances and adapting proven MAPFRE experiences to other markets. A good example is the development and implementation of a Direct Claims Settlement Agreement in Panamá for several insurance companies, through our subsidiary PANAMA ASISTENCIA, based on MAPFRE’s Spanish experience and know-how. It was launched in 2007 and the companies that currently are under the Direct Claims Settlement Friendly Agreement are: HSBC, Fedpa, ANCON, Suramericana and Nacional. Exporting MAPFRE experience: 4
  • Exporting the Direct Claims Settlement model
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    Spanish Friendly Agreement declaration form was adapted by MAPFRE ASISTENCIA to the local Panamanian requirements and a Responsibility assignment matrix was developed according to the Panamanian legislation. 4
  • MAPFRE ASISTENCIA Claims declaration Accident Scene: File The Claim And Photos Our Contact Center Customer Client Company Exporting the Direct Claims Settlement model
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    4
  • Exporting the Direct Claims Settlement model
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    Change the mentality of drivers was the most important challenge: 1. Hot line for communicating an accident 2. Expert is sent to the place of accident 3. Friendly Claim Form is filled and signed 4. Pictures are taken on the spot 5. PANAMA ASISTENCIA evaluates the form and applies Responsibility Matrix 6. Information loaded on the web (developed by MAPFRE ASISTENCIA) 7. Information is sent to Claims Departments 8. 72 hrs. to decide accepting the decision 99% of claims are accepted by members Damaged car is indemnified by third party company 2.000 claims are managed monthly by PANAMA ASISTENCIA  aprox. 500 are managed through the Direct Claim Settlement Friendly Agreement 4
  • PRESENTACION CORPORATIVA 2010 Exporting the Direct Claims Settlement model
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
      • All the information is stored and accessible through an specific web site developed by MAPFRE ASISTENCIA
    4
      • First step to make claims handling easier, offering a better service to the policy holder
        • Access 7*24 for claim notification.
        • Accident care: Help on the spot  accident report fulfilment, pictures of damages and scene of the accident.
        • Fast processing
        • Neutral analysis and responsibility assignment
      • Reduction of claim settlement time
      • Minimize possibilities of fraud
      • Extending the image of quality service offered to the policy holders
    Direct Claim Settlement Advantages obtained by Insurance Companies members: Exporting the Direct Claims Settlement model
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    4
  • Challenges in claims management 5
  • Challenges in Claims Management
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    5
    • Next challenges for the Claims Departments will come from the innovation in products and from the integration of all participants in the Claims Life
      • Integrating the repair shops networks as part of the value chain.
      • Changing the role of the damage assessors as controllers, offering value to the repairshops
      • Improving the repair techniques delivering better repairs in less time
  • Challenges in Claims Management
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    Mechanical Breakdown Insurance coverage commercialised as an added value within the Motor Insurance Policy, covering the cost of the repairs of mechanical and electrical failures, covering both, the cost of the spare parts as well as labour cost. 5
    • Regarding products, what is missing today in the motor portfolio of most insurance companies?
    Accident Breakdown Cost of Repairs Yes Assistance Yes Yes
      • Some Motor Insurance markets are already offering it.
      • It is the right moment:
        • Crisis – people are worried about having to pay for extra expenses.
        • Big price competition amongst Insurers.
        • Innovate the market (Competitive advantage)
      • Good opportunity: Increase turnover with NO RISK.
    Why is it a challenge? Challenges in Claims Management
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    5
  • Advantages Challenges in Claims Management
      • COMPLEMENTARY SERVICES FOR INSURANCE COMPANIES
    • For the Insured
    • Integrated cover
    • Competitive price
    • No extra out of pocket expenses
    • Repair Quality Control
    • Repair in specialized repair-shops
    • For the Insurance Company
    • Pioneer and differentiation from the Competition
    • “ Global” Insurance
    • Flexible products for each category of insured
    • Strengthens loyalty
    • Non-risk profit source
    5
  • 1- MAPFRE and MAPFRE ASISTENCIA 2- MAPFRE’s Direct Claims Settlement in Spain 3- Innovation in claims settlement processes 4- Exporting the Direct Claims Settlement model 4- Challenges in claims management
  • Ευχαριστώ