Stake your claim as a key role player

The insurance industry comprises of various stakeholders; each one playing a key role in the financial lives and well-being of the customers with which they engage. In a situation where there are multiple stakeholders, multiple touch points will exist.

The current environment is one of extreme competition, driven by economic and regulatory developments and characterised by more and more stakeholders entering the insurance sector. These include insurers, intermediaries, motor body repairers and other insurer appointed suppliers, admin houses, finance houses, outsourced claims services and underwriting management agencies. Leaving aside the legal and regulatory requirements for a moment, let us examine the roles and responsibilities of the three key stakeholders and their accountability to the customer.

The insurer

The insurer is first and foremost the risk taker and the entity that makes certain commitments that, in return for a premium, will provide a value proposition. This translates into a set of processes that will take place from issuing the policy contract to the processing of a claim. Ultimately, the insurer’s responsibility is to place the insured in the same or similar position that he/she was in prior to the loss.

The paying customer who keeps the insurer in business is therefore entitled to expect that no service related issues will arise when it comes to incidents that require the company’s response.

Internal insurer issues must not become the problem of the insured. No excuse is acceptable after having accepted a premium in return for a future promise, unless the policy does not provide the cover, or terms and conditions have not been complied with.

The insured

The insured is the customer who pays the premium, and keeps all the stakeholders in business. He has the final say in terms of where and whom he does business with.

However, when a customer makes that decision, he also commits to making sure that premiums are paid on time, that only genuine losses are claimed for and that claims are not inflated.

It is also the customer’s responsibility to provide all necessary information upfront and during the lifetime of the engagement.

The broker

The broker is a key stakeholder in the tripartite partnership, as he knows that sustainable relationships on both sides are an imperative to creating a sustainable business.

Undoubtedly, it is the intermediary’s duty to obtain a competitive price with suitable and appropriate cover, and to ensure that the customer is provided with the right advice and understands all aspects of what he has purchased and what is expected of them as a policyholder.

It is also vital to highlight any stipulations to the customer that could affect him financially and address any issues that may arise during the policy term. Liaising with the insurer on behalf of the insured, when required, is also critical during the lifetime of the policy contract.

Other role players

This is where it all comes together for the stakeholders. Other role players (motor body repairers, service providers etc) are obligated, in terms of their agreements with the insurer, to provide a repair or replacement of quality that will satisfy the insured.

They will need to demonstrate the necessary technical skills and have the capability to conduct specific repairs or replacement. In the event of failure, contractually speaking, the service provider will need to make good as soon as possible and endeavour to eliminate future incidents of a similar nature. The reputation of both brokers and insurers rests by and large on the performance of these suppliers.

Having considered the above, it is clear that a non-intermediated environment is simply lacking in a number of key areas; customers are always looking for advice and assistance with what is really a specialist and sometimes a highly technical industry. The insured, at all times, is entitled to fair value and fair treatment irrespective of legislation.