What’s influencing the claims landscape today?

What’s influencing the claims landscape today? | Insurance Business Canada

Claims

What’s influencing the claims landscape today?

Sedgwick leader breaks down three key trends

The growth of managing general agents (MGAs) and Lloyd’s syndicates in Canada and the prominent rise of artificial intelligence (AI) have become notable influences in claims.

This expansion requires claims handlers to stay agile and efficient as they understand the expanding role these factors play in the claims process, according to Paul Burns (pictured above), vice president of UK TPA operations and client services in Canada for Sedgwick.

“The MGA sector is becoming a noteworthy sector we are dealing with more,” he said. “It’s exciting to see new companies emerging, and for Sedgwick, it’s about knowing what’s happening so we can better support their operations.”

‘It’s not just about claims handling anymore’

One unique challenge MGAs and Lloyd’s syndicates face compared to traditional insurance providers is the complexity and number of players involved in the claims process. This requires Sedgwick to understand each player’s roles and needs.

“From our standpoint, there’s a retail broker, an MGA, a London broker, and ultimately a syndicate,” Burns said. “Sometimes you’re dealing with multiple syndicates on a contract or binder.

“Our strength is connecting those dots, knowing who’s involved at what stage, their role, and what’s important to them. It’s not just a simple carrier-broker-provider setup; the process is more complicated with many more people involved.

“Our job is to create ease of operation, set up points of contact, facilitate any issues or needs, and keep lines of communication open to keep things moving. We need to understand who our clients are and what their needs are.”

Burns was speaking to Insurance Business following his appointment earlier this month. He also identified several significant influences in Canada’s claims environment, including consolidation, wherein a few major carriers now dominate a substantial portion of the market.

Consolidation presents challenges and opportunities, particularly in how claims must be handled and managed.

The rise of artificial intelligence (AI) has dramatically altered the claims landscape.

“The increase in the use and speed of technology is playing a significant part in what we do. The emergence of AI, for example, is changing everything,” Burns said.

At the same time, Burns marked a growing demand from clients for big data, which requires a more comprehensive understanding of their needs and operations. 

“It’s not just about claims handling anymore; it’s about navigating our clients’ world as well,” he added.

Relationships more critical than ever in claims

With the industry’s consolidation, technological advancements, and the rise of the MGA sector, staying nimble and nurturing client relationships are the keys to success in claims.

Burns emphasized the importance of relationships and communication with all stakeholders in the claims process, particularly amid the impact of consolidation. As consolidation reduces the number of clients, maintaining strong connections becomes even more crucial.

“Having good relationships with your clients and understanding what they’re going through is key,” said Burns.

He emphasized that delivering excellent claims service and customer service is fundamental to retaining clients. At the same time, he acknowledged that maintaining relationships has become more challenging post-pandemic due to reduced face-to-face interactions.

“It’s still a relationship business, and it’s about finding ways to maintain those relationships in a post-COVID world,” Burns said.

Asked whether he sees MGAs, Lloyd’s cover holders, and syndicates forming a greater share of the Canadian market, Burns said: “I’m always a little leery of trying to predict things. Our role is to be aware of what’s happening and respond to it to ensure we can still serve our clients and understand what they’re up to.

“The landscape is changing constantly at increasingly faster speeds, and we need to ensure we know what’s happening and who’s doing what. From that standpoint, we do an excellent job.”

What do you think are other forces influencing claims? Please share your thoughts below.

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