Insurance claims management has come under the spotlight and poor claims handling is cited as one of the major culprits when it comes to insurance grievances.
Numerous financial instruments and products are used in financial planning. Life insurance is an example of both because it assists individuals accomplish financial goals via a financial mechanism that is legally structured differently from other financial planning products such as 401(k)s and individual retirement accounts.
Enterprise Act 2016 and its impact on the insurance sectorBrowne Jacobson LLP
We recently carried out a survey of insurance market participants to assess the likely impact of the Enterprise Act 2016 and to understand any concerns in relation to it. We are delighted to share the results.
Our report is based on the results of the survey and our own analysis of the Act.
If you have any concerns or queries around the Enterprise Act, please get in touch -
https://www.brownejacobson.com/insurance/training-and-resources/legal-updates/2017/04/enterprise-act-2016-and-its-impact-on-the-insurance-sector
P&C Market Outlook: 2020 Insurance Planning Insights CBIZ, Inc.
After approximately 20 years of a soft, buyer-friendly insurance market, we are facing a hardening market – one that is less friendly to insurance buyers. This article discusses trends to be aware of, rate forecasts, factors you can manage that affect your rates and tips for insurance buyers.
CBI Comments on FATF Implementation of Corporate Transparency ActJasonSchupp1
Despite the IRS designation of certain captive arrangements in its “Dirty Dozen” of tax fraudsters and an increasingly intense IRS campaign scrutinizing alleged financial abuses by these entities, Treasury's Financial Crimes Enforcement Network (FinCEN) does nothing to close or otherwise control the massive loophole in U.S. financial crime defenses created by an exemption of captive insurance companies from the Corporate Transparency Act.
Broad Application of Medicare’s Mandatory Insurer Reporting Requirements to N...NationalUnderwriter
Broad Application of Medicare’s Mandatory Insurer Reporting Requirements to Non-U.S. Property & Casualty Carriers Flouts Supreme Court Limitations on Extraterritorial Reach of U.S. Law By Richard L. McConnell and Kathryn Bucher
This article attempts to demystify some of the issues regarding possible extraterritorial application of the
requirements under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007, comments on
claim situations that frequently may confront non-U.S. insurers, and alerts readers to the need to evaluate the potential Section 111 ramifications of claim payments to Medicare beneficiaries.
Numerous financial instruments and products are used in financial planning. Life insurance is an example of both because it assists individuals accomplish financial goals via a financial mechanism that is legally structured differently from other financial planning products such as 401(k)s and individual retirement accounts.
Enterprise Act 2016 and its impact on the insurance sectorBrowne Jacobson LLP
We recently carried out a survey of insurance market participants to assess the likely impact of the Enterprise Act 2016 and to understand any concerns in relation to it. We are delighted to share the results.
Our report is based on the results of the survey and our own analysis of the Act.
If you have any concerns or queries around the Enterprise Act, please get in touch -
https://www.brownejacobson.com/insurance/training-and-resources/legal-updates/2017/04/enterprise-act-2016-and-its-impact-on-the-insurance-sector
P&C Market Outlook: 2020 Insurance Planning Insights CBIZ, Inc.
After approximately 20 years of a soft, buyer-friendly insurance market, we are facing a hardening market – one that is less friendly to insurance buyers. This article discusses trends to be aware of, rate forecasts, factors you can manage that affect your rates and tips for insurance buyers.
CBI Comments on FATF Implementation of Corporate Transparency ActJasonSchupp1
Despite the IRS designation of certain captive arrangements in its “Dirty Dozen” of tax fraudsters and an increasingly intense IRS campaign scrutinizing alleged financial abuses by these entities, Treasury's Financial Crimes Enforcement Network (FinCEN) does nothing to close or otherwise control the massive loophole in U.S. financial crime defenses created by an exemption of captive insurance companies from the Corporate Transparency Act.
Broad Application of Medicare’s Mandatory Insurer Reporting Requirements to N...NationalUnderwriter
Broad Application of Medicare’s Mandatory Insurer Reporting Requirements to Non-U.S. Property & Casualty Carriers Flouts Supreme Court Limitations on Extraterritorial Reach of U.S. Law By Richard L. McConnell and Kathryn Bucher
This article attempts to demystify some of the issues regarding possible extraterritorial application of the
requirements under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007, comments on
claim situations that frequently may confront non-U.S. insurers, and alerts readers to the need to evaluate the potential Section 111 ramifications of claim payments to Medicare beneficiaries.
This paper examines the broad net Congress cast to capture event contracts under the Commodities Futures Trading Commission's (CFTC) jurisdiction and the exclusion the CFTC crafted allowing traditional indemnity-based insurance to remain within the jurisdiction of state insurance regulation.
The attached analysis untangles the criteria for triggering Civil Authority Coverage and compares them to COVID-19 orders directed at non-essential businesses. It then measures business income and extra expense coverage against the terms of the new Payroll Protection Program.
The NAIC & Center for Insurance Policy and Research have placed a special call for policy position briefs exploring the “potential development of a federal program to provide pandemic related business interruption coverage.”
The Centers for Better Insurance has submitted the attached short policy brief proposing the Payroll Risk Insurance Act.
CBI Comments on Treasury's TRIP Data Call for CaptivesJasonSchupp1
Every year the Federal Insurance Office (FIO), as administrator of the Terrorism Risk Insurance Program, requires participating insurers to respond to a detailed data call.
Among other changes, FIO recently announced its intention to improve the data it collects from captive insurers. A captive is an insurance company that is owned by its policyholder. In many cases, a large corporation sets up a captive to manage retained risks, directly access reinsurance, and capture substantial tax advantages.
Many of these corporations also use captives to directly extract billions of dollars in benefits from government programs such as the Terrorism Risk Insurance Program and Federal Home Loan Bank system. In fact, prior data calls revealed that large corporations are expected to receive up to 95% of Terrorism Risk Insurance Program payouts through their captive insurers.
CBI has offered a number of practical suggestions to FIO to improve its data call templates and instructions. These suggestions, if adopted, would make it more likely captives will provide data that leads to useful insights for Congress and other stakeholders.
Connections and links to Government and non-Government support for sole traders and small businesses in Australia during COVID-19.
(Please note the data and links are valid as of 23 March 2020)
Business Continuity Protection ProgramJasonSchupp1
On May 21 the National Association of Mutual Insurance Companies (NAMIC), the American Property Casualty Insurance Association (APCIA), and the Independent Insurance Agents & Brokers of America, Inc. (Big “I") released their proposal to address future pandemics: The Business Continuity Protection Program (BCPP).
2021 tria small insurer study commentsJasonSchupp1
The Terrorism Risk Insurance Act requires the Federal Insurance Office (FIO) to conduct a study of the program’s impact on small insurers. We have suggested FIO focus its upcoming report on two heighten program risks facing small insurers:
• Compliance with the separate line-item disclosure of terrorism premium; and
• A disproportionate burden of post-event policyholder surcharges.
Compliance with TRIA - Comments to TreasuryJasonSchupp1
Treasury currently has no tools to investigate or enforce compliance with the program until after an insurance company claims a payout from the backstop. By then it will be far too late for the insurer to fix any compliance issues. Treasury’s only recourse at that point is to deny the requested reimbursement and, if appropriate, pursue civil or criminal penalties against the insurer and the company executive signing the certificate of compliance.
Pandemic Risk Insurance Act - Make AvailableJasonSchupp1
A discussion draft of the “Pandemic Risk Insurance Act” has circulated over recent weeks. Based on the Terrorism Risk Insurance Act, the text is an excellent jumping off point to think about what part of TRIA would work for the pandemic risk and which would not.
Insurance Sector Development & Economic Growth in MalaysiaSofia Naznim
To investigate the link between the insurance sector development and economic growth of Malaysia and to fill a gap in the current finance-growth nexus.
Research Based.
This paper examines the broad net Congress cast to capture event contracts under the Commodities Futures Trading Commission's (CFTC) jurisdiction and the exclusion the CFTC crafted allowing traditional indemnity-based insurance to remain within the jurisdiction of state insurance regulation.
The attached analysis untangles the criteria for triggering Civil Authority Coverage and compares them to COVID-19 orders directed at non-essential businesses. It then measures business income and extra expense coverage against the terms of the new Payroll Protection Program.
The NAIC & Center for Insurance Policy and Research have placed a special call for policy position briefs exploring the “potential development of a federal program to provide pandemic related business interruption coverage.”
The Centers for Better Insurance has submitted the attached short policy brief proposing the Payroll Risk Insurance Act.
CBI Comments on Treasury's TRIP Data Call for CaptivesJasonSchupp1
Every year the Federal Insurance Office (FIO), as administrator of the Terrorism Risk Insurance Program, requires participating insurers to respond to a detailed data call.
Among other changes, FIO recently announced its intention to improve the data it collects from captive insurers. A captive is an insurance company that is owned by its policyholder. In many cases, a large corporation sets up a captive to manage retained risks, directly access reinsurance, and capture substantial tax advantages.
Many of these corporations also use captives to directly extract billions of dollars in benefits from government programs such as the Terrorism Risk Insurance Program and Federal Home Loan Bank system. In fact, prior data calls revealed that large corporations are expected to receive up to 95% of Terrorism Risk Insurance Program payouts through their captive insurers.
CBI has offered a number of practical suggestions to FIO to improve its data call templates and instructions. These suggestions, if adopted, would make it more likely captives will provide data that leads to useful insights for Congress and other stakeholders.
Connections and links to Government and non-Government support for sole traders and small businesses in Australia during COVID-19.
(Please note the data and links are valid as of 23 March 2020)
Business Continuity Protection ProgramJasonSchupp1
On May 21 the National Association of Mutual Insurance Companies (NAMIC), the American Property Casualty Insurance Association (APCIA), and the Independent Insurance Agents & Brokers of America, Inc. (Big “I") released their proposal to address future pandemics: The Business Continuity Protection Program (BCPP).
2021 tria small insurer study commentsJasonSchupp1
The Terrorism Risk Insurance Act requires the Federal Insurance Office (FIO) to conduct a study of the program’s impact on small insurers. We have suggested FIO focus its upcoming report on two heighten program risks facing small insurers:
• Compliance with the separate line-item disclosure of terrorism premium; and
• A disproportionate burden of post-event policyholder surcharges.
Compliance with TRIA - Comments to TreasuryJasonSchupp1
Treasury currently has no tools to investigate or enforce compliance with the program until after an insurance company claims a payout from the backstop. By then it will be far too late for the insurer to fix any compliance issues. Treasury’s only recourse at that point is to deny the requested reimbursement and, if appropriate, pursue civil or criminal penalties against the insurer and the company executive signing the certificate of compliance.
Pandemic Risk Insurance Act - Make AvailableJasonSchupp1
A discussion draft of the “Pandemic Risk Insurance Act” has circulated over recent weeks. Based on the Terrorism Risk Insurance Act, the text is an excellent jumping off point to think about what part of TRIA would work for the pandemic risk and which would not.
Insurance Sector Development & Economic Growth in MalaysiaSofia Naznim
To investigate the link between the insurance sector development and economic growth of Malaysia and to fill a gap in the current finance-growth nexus.
Research Based.
Trinity Insurance Services ( http://trinityclaims.com ) is an independent insurance adjusting firm. Our expert teams of independent adjusters and managers are capable of handling all lines of coverage to help our clients settle claims accurately and quickly.
Trinity Insurance can help you with all your property damage insurance claims. Contact us today. For more details please visit: http://trinityclaims.com/Property-Insurance-Claims
Claims Management - Edge through Efficiencyneetamundra
The objective of this paper is to talk about the current state of the claims process and how an efficient and ideal claims system should be. This document is most relevant for the Indian insurance industry.
Effective claims management has become a sophisticated process and one that draws upon numerous areas of expertise including data analysis, accident investigation, managed care, return to work, subrogation, alternative dispute resolution, structured settlements, and Medicare compliance as well as more traditional areas of claims expertise. Technology is continually evolving allowing the risk manager improved decision-making capabilities. Strong claims management fundamentals can apply to any major line of coverage including general liability, workers’ compensation, and auto liability. This session will explore how to identify key cost drivers, ways to better integrate claims resources, how to achieve faster reporting, the use of performance standards and guarantees, and how to evaluate the quality of your current claims services.
On February 16, construction law attorney, Mike Madigan hosted an in-house seminar discussing construction claim management + project documentation. The seminar focused on the steps to make a claim, key project documentation considerations, and dealing with a claim from the perspectives of the owner, the CM, and the subcontractor.
Product liability insurance in china report by daxue consultingDaxue Consulting
With support from Asian Risks Management Services Co. Ltd. (ARMS) we are happy to share our new report on product liability insurance in China.
Overview of the product liability insurance market, policies & obstacles of product liability insurance, legal cases, and main insurers & key products have been covered in this report.
Commercial insurance risk and liability review, February 2016Browne Jacobson LLP
Our annual review provides a comprehensive review of some of the most important judgments and legal developments during 2015 and our analysis of some of the changes on the horizon for 2016 and beyond. We have covered a lot of ground this year so I hope you will be able to find a number of updates that are relevant and useful to you.
If you would like to know more about any of the topics, please feel free to contact any of the authors of the articles.
https://www.brownejacobson.com/insurance/training-and-resources/legal-updates/2016/01/commercial-insurance-risk-and-liability-review-2015-2016
The Insurance Act 2015 comes into effect today, meaning that any insurance or reinsurance contract entered into or varied from today will be governed by the Act.
The effects of the Act are far reaching: changing insurance legislation that has been in place for over a century, and impacting on any transaction governed by the laws of England, Wales, Scotland and Northern Ireland, with a potential to affect organisations across the world.
The Insurance Act 2015 has introduced the most significant reform to insurance law in over 100 years. The Act impacts all those involved in the insurance sector. In this report we review key markets' response to the Act and outline the practical steps you should have addressed ahead of the Act coming into force.
Visit our hub to access information and resources tailored to brokers: www.brownejacobson.com/brokers
The Insurance Act 2015 Finch Insurance Brokers ltdJo Kennedy
The Insurance Act 2015 is a new piece of legislation that relates to commercial insurance and comes into force on 12 August 2016. The Act will result in some changes to the way that we work, in particular to the information provided, how this is collected and presented to insurers and the way that claims are handled. If you would like more information please contact us at info@finchib.co.uk.
Road to Reform: Tackling the UK’s Compensation Culture July 2014Aviva plc
Aviva’s report, ‘Road to Reform: Tackling the UK’s Compensation Culture’ calls for three key reforms which will reduce cost and improve service for Britain’s insured drivers:
Compensate minor, short-term personal injuries in road accidents with rehabilitation only. Insurers would arrange and pay for the customer’s rehabilitation, regardless of whether the customer is at fault or not. Cutting cash compensation for minor whiplash injuries could save an estimated £900m from the current annual £2 billion* cost of whiplash claims in the UK
Restrict personal injury lawyers to cases where their expertise is needed. Raising the threshold at which legal costs can be recovered by a lawyer could save £300m in straight-forward cases for minor injuries where lawyers are not necessary
Ban referral fees. A further £200m can be saved annually by banning referral fees for vehicle recovery, car repairs and car hire
Accounting services overview of insurance contract under ifrsAhmedTalaat127
The majority of accounting services in Dubai and UAE ignore insurance accounting because they are not in the insurance business. Now that there will be a new accounting standard related to insurance contracts, chartered accountants should check to make sure they aren’t erroneously issuing them.
Representations and Warranties Claims ReportEmily Maier
Great data from the AIG Reps and Warranties Team. When do claims on reps and warranties happen? What type of breaches happen most? Do big deals or small deals have the most claims.
Les assureurs seraient avisés de prendre la menace très au sérieux. D'après la nouvelle édition du « World Insurance Report » réalisé par Capgemini et l'Efma auprès de plus de 15.500 consommateurs dans 30 pays, un nombre non négligeable de jeunes clients (23,4 %) est en effet prêt à se tourner vers des opérateurs non traditionnels.
Discover how emerging technology themes, enabled by the Internet of Things, are slowly transforming customer lives and allowing insurers to measure and control risks with the World Insurance Report 2016. Using data from over 15,000 customers worldwide, and over 180 executive interviews, the report also reveals that Gen Y customers, with their high digital expectations have held the overall customer experience down.
Les assureurs seraient avisés de prendre la menace très au sérieux. D'après la nouvelle édition du « World Insurance Report » réalisé par Capgemini et l'Efma auprès de plus de 15.500 consommateurs dans 30 pays, un nombre non négligeable de jeunes clients (23,4 %) est en effet prêt à se tourner vers des opérateurs non traditionnels.
Enterprise Act 2016 and its impact on brokers - survey resultsBrowne Jacobson LLP
From 4 May 2017, the Enterprise Act updated the law to enable policyholders to recover unlimited damages caused by the late payment of claims from insurers. This is not a penalty against insurers for negligently delaying payment. Policyholders must demonstrate and evidence the actual loss they have suffered and show that it was caused by a delay in the payment of a claim. Any damages claim against the insurer must be brought within 1 year of the claims payment under the policy.
We have conducted a survey of insurers, brokers and loss adjusters to understand the expected impact of the Act. Here’s a summary of the key findings.
Visit our hub to access information and resources tailored to brokers: www.brownejacobson.com/brokers
Elevating Tactical DDD Patterns Through Object CalisthenicsDorra BARTAGUIZ
After immersing yourself in the blue book and its red counterpart, attending DDD-focused conferences, and applying tactical patterns, you're left with a crucial question: How do I ensure my design is effective? Tactical patterns within Domain-Driven Design (DDD) serve as guiding principles for creating clear and manageable domain models. However, achieving success with these patterns requires additional guidance. Interestingly, we've observed that a set of constraints initially designed for training purposes remarkably aligns with effective pattern implementation, offering a more ‘mechanical’ approach. Let's explore together how Object Calisthenics can elevate the design of your tactical DDD patterns, offering concrete help for those venturing into DDD for the first time!
JMeter webinar - integration with InfluxDB and GrafanaRTTS
Watch this recorded webinar about real-time monitoring of application performance. See how to integrate Apache JMeter, the open-source leader in performance testing, with InfluxDB, the open-source time-series database, and Grafana, the open-source analytics and visualization application.
In this webinar, we will review the benefits of leveraging InfluxDB and Grafana when executing load tests and demonstrate how these tools are used to visualize performance metrics.
Length: 30 minutes
Session Overview
-------------------------------------------
During this webinar, we will cover the following topics while demonstrating the integrations of JMeter, InfluxDB and Grafana:
- What out-of-the-box solutions are available for real-time monitoring JMeter tests?
- What are the benefits of integrating InfluxDB and Grafana into the load testing stack?
- Which features are provided by Grafana?
- Demonstration of InfluxDB and Grafana using a practice web application
To view the webinar recording, go to:
https://www.rttsweb.com/jmeter-integration-webinar
GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using Deplo...James Anderson
Effective Application Security in Software Delivery lifecycle using Deployment Firewall and DBOM
The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
State of ICS and IoT Cyber Threat Landscape Report 2024 previewPrayukth K V
The IoT and OT threat landscape report has been prepared by the Threat Research Team at Sectrio using data from Sectrio, cyber threat intelligence farming facilities spread across over 85 cities around the world. In addition, Sectrio also runs AI-based advanced threat and payload engagement facilities that serve as sinks to attract and engage sophisticated threat actors, and newer malware including new variants and latent threats that are at an earlier stage of development.
The latest edition of the OT/ICS and IoT security Threat Landscape Report 2024 also covers:
State of global ICS asset and network exposure
Sectoral targets and attacks as well as the cost of ransom
Global APT activity, AI usage, actor and tactic profiles, and implications
Rise in volumes of AI-powered cyberattacks
Major cyber events in 2024
Malware and malicious payload trends
Cyberattack types and targets
Vulnerability exploit attempts on CVEs
Attacks on counties – USA
Expansion of bot farms – how, where, and why
In-depth analysis of the cyber threat landscape across North America, South America, Europe, APAC, and the Middle East
Why are attacks on smart factories rising?
Cyber risk predictions
Axis of attacks – Europe
Systemic attacks in the Middle East
Download the full report from here:
https://sectrio.com/resources/ot-threat-landscape-reports/sectrio-releases-ot-ics-and-iot-security-threat-landscape-report-2024/
Kubernetes & AI - Beauty and the Beast !?! @KCD Istanbul 2024Tobias Schneck
As AI technology is pushing into IT I was wondering myself, as an “infrastructure container kubernetes guy”, how get this fancy AI technology get managed from an infrastructure operational view? Is it possible to apply our lovely cloud native principals as well? What benefit’s both technologies could bring to each other?
Let me take this questions and provide you a short journey through existing deployment models and use cases for AI software. On practical examples, we discuss what cloud/on-premise strategy we may need for applying it to our own infrastructure to get it to work from an enterprise perspective. I want to give an overview about infrastructure requirements and technologies, what could be beneficial or limiting your AI use cases in an enterprise environment. An interactive Demo will give you some insides, what approaches I got already working for real.
Key Trends Shaping the Future of Infrastructure.pdfCheryl Hung
Keynote at DIGIT West Expo, Glasgow on 29 May 2024.
Cheryl Hung, ochery.com
Sr Director, Infrastructure Ecosystem, Arm.
The key trends across hardware, cloud and open-source; exploring how these areas are likely to mature and develop over the short and long-term, and then considering how organisations can position themselves to adapt and thrive.
LF Energy Webinar: Electrical Grid Modelling and Simulation Through PowSyBl -...DanBrown980551
Do you want to learn how to model and simulate an electrical network from scratch in under an hour?
Then welcome to this PowSyBl workshop, hosted by Rte, the French Transmission System Operator (TSO)!
During the webinar, you will discover the PowSyBl ecosystem as well as handle and study an electrical network through an interactive Python notebook.
PowSyBl is an open source project hosted by LF Energy, which offers a comprehensive set of features for electrical grid modelling and simulation. Among other advanced features, PowSyBl provides:
- A fully editable and extendable library for grid component modelling;
- Visualization tools to display your network;
- Grid simulation tools, such as power flows, security analyses (with or without remedial actions) and sensitivity analyses;
The framework is mostly written in Java, with a Python binding so that Python developers can access PowSyBl functionalities as well.
What you will learn during the webinar:
- For beginners: discover PowSyBl's functionalities through a quick general presentation and the notebook, without needing any expert coding skills;
- For advanced developers: master the skills to efficiently apply PowSyBl functionalities to your real-world scenarios.
Connector Corner: Automate dynamic content and events by pushing a buttonDianaGray10
Here is something new! In our next Connector Corner webinar, we will demonstrate how you can use a single workflow to:
Create a campaign using Mailchimp with merge tags/fields
Send an interactive Slack channel message (using buttons)
Have the message received by managers and peers along with a test email for review
But there’s more:
In a second workflow supporting the same use case, you’ll see:
Your campaign sent to target colleagues for approval
If the “Approve” button is clicked, a Jira/Zendesk ticket is created for the marketing design team
But—if the “Reject” button is pushed, colleagues will be alerted via Slack message
Join us to learn more about this new, human-in-the-loop capability, brought to you by Integration Service connectors.
And...
Speakers:
Akshay Agnihotri, Product Manager
Charlie Greenberg, Host
Epistemic Interaction - tuning interfaces to provide information for AI supportAlan Dix
Paper presented at SYNERGY workshop at AVI 2024, Genoa, Italy. 3rd June 2024
https://alandix.com/academic/papers/synergy2024-epistemic/
As machine learning integrates deeper into human-computer interactions, the concept of epistemic interaction emerges, aiming to refine these interactions to enhance system adaptability. This approach encourages minor, intentional adjustments in user behaviour to enrich the data available for system learning. This paper introduces epistemic interaction within the context of human-system communication, illustrating how deliberate interaction design can improve system understanding and adaptation. Through concrete examples, we demonstrate the potential of epistemic interaction to significantly advance human-computer interaction by leveraging intuitive human communication strategies to inform system design and functionality, offering a novel pathway for enriching user-system engagements.
Transcript: Selling digital books in 2024: Insights from industry leaders - T...BookNet Canada
The publishing industry has been selling digital audiobooks and ebooks for over a decade and has found its groove. What’s changed? What has stayed the same? Where do we go from here? Join a group of leading sales peers from across the industry for a conversation about the lessons learned since the popularization of digital books, best practices, digital book supply chain management, and more.
Link to video recording: https://bnctechforum.ca/sessions/selling-digital-books-in-2024-insights-from-industry-leaders/
Presented by BookNet Canada on May 28, 2024, with support from the Department of Canadian Heritage.
Software Delivery At the Speed of AI: Inflectra Invests In AI-Powered QualityInflectra
In this insightful webinar, Inflectra explores how artificial intelligence (AI) is transforming software development and testing. Discover how AI-powered tools are revolutionizing every stage of the software development lifecycle (SDLC), from design and prototyping to testing, deployment, and monitoring.
Learn about:
• The Future of Testing: How AI is shifting testing towards verification, analysis, and higher-level skills, while reducing repetitive tasks.
• Test Automation: How AI-powered test case generation, optimization, and self-healing tests are making testing more efficient and effective.
• Visual Testing: Explore the emerging capabilities of AI in visual testing and how it's set to revolutionize UI verification.
• Inflectra's AI Solutions: See demonstrations of Inflectra's cutting-edge AI tools like the ChatGPT plugin and Azure Open AI platform, designed to streamline your testing process.
Whether you're a developer, tester, or QA professional, this webinar will give you valuable insights into how AI is shaping the future of software delivery.
Software Delivery At the Speed of AI: Inflectra Invests In AI-Powered Quality
How to Achieve Claims Excellence And Not Breach New Complaints Legislation
1.
2. INTRODUCTION
Insurance claims management has come under the spotlight and poor claims handling is cited as one of the major culprits when it
comes to insurance grievances. Moreover, the Insurance Act coming into effect throughout 2016 is set to cause the biggest shake up of
insurance law in over a decade. It focuses on the need for transparency and certainty which means insurers must take steps to ensure
that they aren’t still operating in the dinosaur era when it comes to the systems and processes that their company use when dealing
with suppliers and customers.
Figures published show that there are a growing number of complaints in motor and more complex cases such as medical and property
claims. The Financial Ombudsman has quoted that the most complaints arise where there are 3rd parties involved in the fulfilment of a
claim. This is often as a result of not having a clear set of instructions, as well as the customer and supplier expectations not being
effectively identified, communicated and agreed upon.
Even though the issuance of an instruction at the First Notification of Loss (FNOL) is regularly well executed, any subsequent
instructions are frequently lost into a black hole and additional visibility is needed with regards to the ongoing status of claims.
In this white paper we will explore recent complaint statistics and year-on-year (YOY) trends, along with how poor communications
with your suppliers and customers can lead to a higher number of complaints and increasing costs. We’ll summarise some of the latest
legislation along with highlighting helpful ways to prevent complaints through applying improved processes and new technology.
INSURANCE WHITE PAPER
3. HOW TO ACHIEVE CLAIMS EXCELLENCE AND
NOT BREACH NEW COMPLAINTS LEGISLATION
The loudest
message from
the FOS for the
insurance
industry is that it
needs to continue
improving its
communications
with customers to
avoid complaints
and improve
service levels.
Complaints by numbers – what are some of the trends?
Firstly, to remove any confusion as to “What defines a complaint?” according to the
Financial Conduct Authority’s Handbook its “any oral or written expression of
dissatisfaction, whether justified or not, from, or on behalf of, a person about the
provision of, or failure to provide, a financial service or a redress determination”.
On 26 May 2016, the Financial Ombudsman's Service (FOS) published its annual
report. It contains statistics for the period between 1 April 2015 - 31 March 2016 as
well as detailed commentary on trends and themes which we’ve summarised below.
Key themes
PPI still accounts for half of all complaints received by FOS but the volume of new
complaints are dropping.
Insurance (excluding PPI) made up 9% of complaints received
New insurance complaints (excluding PPI) were up from 30,080 to 31,284.
Complaints about misselling made up 24% of insurance complaints.
5% of Small businesses complaints were about commercial property insurance
4. HOW TO ACHIEVE CLAIMS EXCELLENCE AND
NOT BREACH NEW COMPLAINTS LEGISLATION
Poor
communication at
both point of sale
and during the
claims process is
the most significant
driver for
complaints arising!
Key trends
The biggest contributor to complaints (excluding PPI) was for motor with a
share of 27.5%
Buildings insurance came next with 13%.
Most other sectors were below 5%
Poor communication at both point of sale and during the claims process is
the most significant driver
Out of all the complaints received who gets the most?
Banks are responsible for 72%
General insurers are responsible for 10%
Insurance brokers are responsible for 3.5%
Mortgage intermediaries are responsible for 2%
Independent Financial Advisors are responsible for 1%
5. INSURANCE WHITE PAPER
UK Insur ance Categor y 2016 2015 YoY Var iance
motor insurance 8,585 7,361 17%
home emergency cover 1,779 1,298 37%
pet and livestock insurance 1,089 790 38%
personal accident insurance 709 422 68%
extended warranty insurance 934 777 20%
specialist insurance (including
marine and event)
553 404 37%
private medical insurance 873 786 11%
commercial vehicles and
property
1,215 1,159 5%
mobile phone insurance 589 536 10%
legal expenses insurance 715 702 2%
caravan insurance 100 98 2%
guaranteed asset protection
(GAP insurance)
201 206 2%
building warranty 287 299 4%
critical illness insurance 747 791 6%
contents insurance 1,389 1,436 3%
travel insurance 2,267 2,318 2%
buildings insurance 4,095 4,510 9%
card protection insurance 666 1,401 52%
Taking a closer look at Year On Year complaints statistics for the insurance sector
6. Taking a closer look at Year On Year complaints statistics for the insurance sector
Motor
Motor has already been cited as being responsible for the most insurance complaints and the FOS usually leans in favour of
the consumer in most cases. People also complained to the FOS about the repairs that their insurer had arranged after car
accidents. Some said the damage hadn’t been adequately repaired – or that further damage had been caused by the repairs
carried out.
Buildings and Contents Insurance
Last year, the FOS were seeing complaints mostly where insurers instructed a 3rd party to act on their behalf and insurers
were failing to take responsibility for their actions (or inactions). For example, Loss Adjusters may be accused of not being
thorough and one of the reasons is poor communications and instructions from the insurer. The floods for instance,
generated a number of complaints. Typically, people were upset that their claim hadn’t yet been dealt with and were
concerned about significant delays in the process, or were unhappy with the quality of repairs.
Travel and Medical Insurance
The FOS has also seen a number of problems with annual travel policies – particularly those that come with a packaged
bank account. These problems often came about because someone’s health had changed during the year – and when they
came to make a claim, they found they were no longer covered.
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7. The other sorts of complaints arose due to customers not being
made aware that their level of cover had changed since the
original policy was written. This is often the case in private
medical complaints where cover for different conditions can
change from year-to-year. Furthermore, complaints were made
as a result of policies not keeping pace with the increased cost
of medical fees so limits applied were unrealistic, leaving
customers out of pocket to cover the shortfall.
This customer satisfaction chart from Capgemini’s ‘2015 World
Insurance Report’ also shows that customer experience scores
deteriorate during the insurance lifecycle from quote gathering,
through policy acquisition to claims servicing. This suggests that
more needs to be done at each stage in the insurance process
but greater focus should be given to the claims fulfilment or
servicing process.
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Taking a closer look at Year On Year complaints statistics for the insurance sector
8. What are the changes being introduced by the 2015 Insurance Act?
The Insurance Act 2015 mainly applies to non-consumer insurance and reinsurance but also in part to consumer insurance and comes
into effect on 12 August 2016. It brings into force the Third Parties (Rights against Insurers) Act, with minor corrections and represents
a significant change to the legal framework of insurance contracts.
Here is a summary of the changes being introduced:
1. The Duty of Fair Presentation:
Insureds will hold the general obligation to disclose all material facts. The insured will have to disclose every material circumstance that
he or she knows or ought to know, with sufficient information to put a prudent insurer on notice that it needs to make further
enquiries to reveal the material circumstances. This applies to disclosure before the contract is concluded, for both new contracts and
renewals, as well as mid-term variations.
2. New Remedies for Non-Disclosure:
New proportionate remedies are available to insurers following a breach of the new duty of fair presentation. For example, where a
deliberate or reckless breach of fair presentation occurs, insurers can still avoid the insurance and retain any premiums paid. This
would normally be from inception except where breach relates to a variation such as a mid-term adjustment. The onus will be on the
insurer to show that a qualifying breach was deliberate or reckless and will need to be judged by the courts.
3.Warranties and Other Terms
Warranties are to be treated as suspensive conditions, meaning that an insurer’s liability will only be suspended during a period of
breach and a breach of warranty will no longer automatically terminate the policy. The breach of the warranty must have some bearing
on the actual loss by increasing the risk of the loss occurring.
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9. Fraudulent claims
If the insured makes a fraudulent claim the insurer is not liable to pay it. If such a claim is presented the insurer may recover sums paid
in respect of the loss and the insurer may give notice terminating the insurance as from the date of the fraudulent act and need not
return the premium. Claims arising from an event before the fraud would however continue to be payable. This reflects the law as it
currently stands as established by the Courts. In this area the Act does not change the law but merely codifies it.
Contracting Out and the Transparency Requirements
For consumer contracts, an insurer cannot agree terms which put the insured in a worse position than that set out in the Act. For non-
consumer contracts, parties will be entitled to agree terms which are less favourable to the insured than those set out in the
Act subject. However, there are certain transparency rules that require; (i) the insurer to take “sufficient steps” to draw
“disadvantageous terms” to the insured’s attention; (ii) the “disadvantageous term” must further be made “clear and unambiguous”. It
will therefore not be possible for insurers to avoid the Act by introducing a simple additional clause into their policy documentation
excluding the application of the Act without bringing the Act to the insured’s attention.
The Third Parties (Rights against Insurers) Act 2010
The Third Parties (Rights Against Insurers) Act 2010 is intended to enable victims of wrongdoers to proceed directly against the insurer,
but it has not come into force due to a number of technical deficiencies. The latest Act rectifies these deficiencies and should allow the
2010 Act to come into force.
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10. How can insurers be prepared?
Although some of the changes may seem subtle they will require new processes and audits to ensure compliance, especially as there is a
shift towards the insurer having more responsibility to question insureds thoroughly in order to disclose any possible required information.
Especially as there is a shift towards the insurer having more responsibility for ensuring the insured has had an opportunity throughout the
length of the policy to disclose and update any required information.
For underwriting:
•Claims, fraud and underwriting IT systems will need to be connected so that underwriters can underwrite at the policy inception stage in
real-time.
•More detailed, thorough questioning to the insured needs to be carried out and documented with further information sought if necessary.
•Underwriters need to be clear that they are responsible in providing the insurer with all of the information required under the Act.
•Insurers must work with underwriters and sales teams to make them aware of their duties so that they don’t fall foul of the Act.
•Insurers need to review their policy wordings, certificates, notices to policyholders, underwriting criteria and question sets to ensure they
are compliant with the Insurance Act.
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11. For claims:
•Claims teams should have access to the information provided by the insured at inception.
•Detailed records must be stored and easily accessed by claims teams to ascertain the facts provided in the event of discrepancies.
•There needs to be close interaction between claims and underwriting teams to establish whether or not a material circumstance is
substantially correct.
•Closer co-operation between claims and underwriting teams will also help to identify and fight fraud.
•Handling guidelines and standard documents/letters will need to be updated to remove references to insurance being a contract of utmost
good faith and setting out the basis of the new ‘duty of disclosure’.
•Once the Act comes into force care will need to be taken when handling claims to apply the new provisions and not confuse them with the
old ones.
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12. How can insurers be prepared?
For Complaints:
•Processes will need to be amended to take into account the provisions of the Act.
•Due regard should be given to the Financial Ombudsman Service, their jurisdiction, their likely interpretation of the Act, and their powers
to apply what is fair and reasonable in their adjudications.
•Insurers should bear in mind the view from the regulator that insurers should put their customer at the centre of their business and
provide policies that provide real value.
For Marketing:
• Insurers should review all marketing materials including their websites to ensure that they are fit for purpose in light of the recent
changes.
For Brokers:
•Training will be needed for all brokers, partners, and key suppliers to ensure that they will be ready for the Act.
During the underwriting stage, these changes should encourage both the insurer and the insured to ask more questions of each other,
which may in turn increase the role and responsibility of brokers. When the Act comes into force, insurers should have a very careful look at
their standard terms to ensure they comply with transparency requirements.
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13. What’s The FCA changing around complaints legislation?
The FCA publishes complaints data every 6 months. They collect data at a market and firm level but only publish data on those firms
reporting 500 or more complaints. These firms must also publish the complaints data on their own websites. In terms of when and what
had to be reported, the rule was that firms must formally acknowledge all complaints by ‘the next business day’. However, they didn’t have
to report on any of the complaints that were resolved by close of business, on the day following the day that it was received.
New legislation by the FCA means that financial firms must now report on all of their complaints, and they need to submit details on the
size of their company, along with more contextual data around their complaints handling. The purpose being to provide an improved service
to consumers and provide greater access to the Ombudsman service. It also provides greater transparency and competitive analysis for end-
customers which could be used to assist them during the process of selecting their financial service providers.
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14. Therefore, the FCA are on a mission to improve the complaints process for the consumer and new guidelines have been set out for firms to
begin implementing from March 2016. The FCA expect these changes to be in place within a year. Consequently, from March 2017 firms’
complaints handling and monitoring procedures need to be well prepared to cope with the new guidelines as summarised below:
•The FCA are extending the ‘next business day rule’. Therefore, firms are permitted to handle less serious complaints more informally,
without sending a ‘final response’ letter, to the close of three business days after the date of receipt.
•Firms will now need to report and publish on all claims received, even those resolved by the next business day.
•Firms will also need to raise consumer awareness of the ombudsman service, by sending a ‘summary resolution communication’ to all
consumers for complaints resolved by the close of the third business day after receipt.
•There are new rules coming into play that must limit the cost of calls for a consumer and firms have to adhere to a maximum ‘basic rate’,
including all post-contractual calls and all complaints related calls.
•There will be an enhanced ‘complaints return’ process which will require more contextual information and transparency around the detail
of the complaint and how it was handled against a set of new metrics.
•More detailed information regarding the changes and what’s required from the new ‘complaints return’ process can be found in the FCA’s
Consultation Paper on Improving Complaints Handling.
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15. INSURANCE WHITE PAPER
How can insurers reduce complaints during the claims process?
It’s important to build trust with customers and your suppliers through having transparency during the writing of a policy and during
the claim should it arise. As the Financial Services industry is cited as one of the least trusted markets in the 2016 European Trust
Barometer, it’s important the insurance industry shifts public opinion by putting customer service and communication as it’s number
1 priority. The fallout from a bad customer experience is now bigger than ever before due to consumers sharing experiences, seeking
reviews online and via social media.
A recent success story to evolve from having an open, transparent service is Uber. The customer gets to see the journey of their taxi in
real-time and can leave a review for each driver. Additionally, the driver can leave a review for the passenger so the trust needs to be
mutual.
Likewise, for an effective insurance policy it’s crucial to know what is important to the customer from the very beginning of the
relationship and ensure that the pertinent points are clearly communicated without room for misinterpretation.
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Below are some of the key things a consumer should have clear instructions about:
•What’s included in my policy – what can and can’t be claimed?
•When’s my renewal due?
•How is my renewal calculated?
•How can I save?
•Are there customer loyalty discounts/benefits? what further products / services are available to me?
•How do I claim – what information is required, and routes to do so?
•How much is my excess?
•How long will my claim take / what stages will it go through?
•What’s the status of my claim?
•How was the decision reached?
•Who will be appointed to carry out the work for my claim?
•What’s their customer service rating?
•Can I choose which supplier I use?
•I want convenience in how I access my policy/claim information.
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How can insurers reduce complaints during the claims process?
The FOS have cited that one of the main causes for complaints is down to the insurer not explaining clearly why a claim was
rejected. The reasons and language used to communicate to the customer should tally up with the original policy wording so
there’s no room for doubt or uncertainty. Insurers need to go to more lengths to communicate with policyholders in the event of a
claim rejection to ensure the facts are understood as it could prevent the complaint from arising in the first instance.
Another main cause for complaints is down to a lack of effective communication during a claim when a 3rd party is appointed. Past
the initial claims instruction, both customers and suppliers are unsure what is happening, when and by whom. Suppliers have told
the FOS that they have received poor instructions from the insurer. There seems to be something of an abyss where
communication and status updates are lost in simple and more complex claims that are handled by a 3rd party. In these cases, the
complaint is almost always upheld due to insurers having failed to take responsibility for the actions (or inactions) of their agents.
So more needs to be done in order to keep all parties informed during the claims process which is the ‘moment of truth’ for the
insured. This is where customer loyalty can be made or broken.
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In the modern digital age, there is no excuse for poor communication. The tools exist to help insurance networks made up of
multiple suppliers, agents and 3rd parties to collaborate and in real-time. Furthermore, customer interaction preferences are
changing. Gen Y’s preference to interact exclusively via digital self-service (web or mobile) increased to 27 percent in 2015, up from
21 percent in 2011. And, this trend is only set to continue as new start-up entrants to the market such as ‘Trōv’ are causing a stir
and attracting high investment from main insurance companies already.
Therefore, adopting technology that connects your insurance supply chain and helps you to keep your customers informed is
crucial to prevent unnecessary grievances. Complaints will always be part of an Insurers Claim File and it’s practically impossible to
have a 100% complaint free claims service. But as regulators become noisier and customers more vocal, it has never been more
important to treat complaints with the upmost priority from the board level and down.
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How to prevent 3rd party claims data falling into a black hole
Although distribution of the initial Instruction is generally well executed, the actual content can be poorly written and
misunderstood. Added to this, claim status updates are not always subject to the same clear process and data exchange as the
instruction. Claim handlers are opting to call or email each other for the latest position or claim status information. This seems to
indicate a lack of trust in the quality of the data or the system behind it.
It may also indicate that logging onto many different supplier portals and navigating through different workflows and dashboards is
just too complex and time consuming compared to email and telephone. Instead look to the following steps to improve
communication and collaborative ways of working.
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Implement a centralised claims portal to access all claims information
Adopting a system that has a defined process and enables claims to be centralised, transparent and visible should mean that claims
are dealt with more proactively. Customers can speak to just one contact for a complete picture about their claim. Additionally, any
complaint that arises against a claim can be seen and dealt with swiftly. A single portal can also help to shorten the length of time
taken to resolve an issue by highlighting where an exception is occurring outside of the standard process and alerts the insurer and
supplier to bring additional resource into play.
Set achievable targets for resolution and create alerts for issues
Recognising that performance perfection is unobtainable in every single claim instruction means that a more obtainable goal of
resolving mistakes and problems quickly and to high levels of satisfaction is achievable. Implement automated alerts to relevant
parties when follow up actions fall outside normal and acceptable response times. Being able to concentrate both insurer and
supplier resources on these problems, by way of quick, clear communications can help to bring about a satisfactory and satisfying
outcome before a complaint arises. If something has gone wrong during the claims process, this needs to be turned into an
opportunity to go beyond the call of duty and fix the issue for the policyholder which can in turn lead to improved customer loyalty.
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Speed up communications through using multiple channels
Using the phone is not the most efficient way to communicate. Insurers and suppliers recognise that automating the claims
instruction process and sharing status updates instantly and electronically over the internet would reduce operational costs and
improve the service for the policyholder. It also provides a digital historical communication chain that is often lost if conversations
are carried out via telephone. Instead messages could be sent to the policyholder directly through the internet to their phone via
SMS, email or a claims app. Future options will include other notification methods, such as Facebook Messenger, Kik and perhaps
even robo-advisors.
Standardise process through the entire supply chain
Most claims admin systems will help to improve the internal claims process but most do not include the required functionality to
get the best out of the external claims supply chain. Whether this is the provision of a supplier view of the claim, communication
with the supplier or management of the supplier. As an example, if your system does not help you with supplier management then
relying on the suppliers to provide the management information to monitor Service Level Agreements means, at the very least,
that you are not in full control of when and how you view it.
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What are the risks of doing nothing to improve claims and reduce complaints?
Lastly, what could happen if insurers don’t take heed of new legislation and work towards more transparent and collaborative
processes when it comes to writing insurance policies and managing claims? In this digital age, it could create a perfect storm as
consumers have access to more information than ever before. They can quickly compare policy premiums and gather reviews and
recommendations for certain products online, as well as be more informed as to how to complain to bodies such as the FOS.
The risks of providing a poorly written policy and slack claims service include:
•Increasing number of fines from the Financial Ombudsman
•Increased costs of managing complaints
•Increased claims leakage
•Loss of market share through poor customer feedback
•Decreased profit margin
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The continuation of high complaint volumes through not addressing straight forward opportunities to improve transparency to
customers, and efficiency in managing information with their suppliers could be fatal for insurers.
Real-time interchange of accurate information between the insurer and their suppliers is essential to providing a positive claims
experience. A quicker, well designed and transparent claims settlement process is beneficial for everyone. A visible collaborative
process is an enabler that puts the right information in the right people’s hands at the right time.
Improved management of suppliers and partners can reduce the settlement time, reduce the potential opportunities to commit
fraud, reduce frictional costs of processing the claim and improve the policyholder’s satisfaction.
Insurers need to embrace the digital age and take the opportunity to provide more value added services to their customers as
insurance cannot continue to be treated as a commodity as it will diminish premiums and profit margins. If insurers don’t look for
more ways to work smarter and reinforce their supply chain processes and engage the customer and win back their trust – then it’s
likely more foreword looking businesses will take their place.
24. About Adjuno
Adjuno is a global software business that is made up of two former supply chain solutions companies that united to launch as a single
world-wide brand in February 2016. We are also part of the $1 Billion + Allport Cargo Services Logistics Group.
We provide a web-based claims fulfilment platform to a number of global insurance companies, as well as Lloyd’s of London insurance
syndicates. Our platform connects insurers with their suppliers to reduce the cost per claim. Insurers who work with us gain complete
visibility of their supply chain, enabling improved supplier management and reduced claims leakage. The end result is a faster, more
efficient process, and a better customer experience.
We have more than 20 years of experience in providing cloud-based business solutions, and a global client base spanning across
America, Europe, South Africa, and Australasia. We have worked with companies of all sizes across the retail, insurance and consumer
product industries, including AXA insurance, Marks and Spencer, ASOS, and John Lewis.
Today, our claims management software has over 13K users logging on each day to effectively manage and drive their business, and
every month we track over 11M processes, at more than 150 customer sites across the world.
Contact us for more information
Adjuno Regional – Europe/ UK Head Office
Worcester House, No 6 Langley Quay, Waterside Drive, Langley, Berkshire, SL3 6EY
+44(0)1753 260 400
enquiries@adjuno.com
www.adjuno.com
25. About Adjuno
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Adjuno UK LIMITED
is a company registered in England and Wales,
VAT No. 226834456, Company No. 1239655
Registered office address: Allport House,
Cowley Business Park, Cowley, Uxbridge, UB8
2AD