Briefing: BI claims portals a savvy loss adjuster initiative – but policyholders feel they are stuck ironing out kinks

With the BI court case initially threatening a wave of up to 370,000 claims it is no surprise that loss adjusters turned to technology for a solution.

For an industry not historically famed for its foothold in tech (see: legacy systems, Lloyd’s innovation drive, swathes of insurtech commentary) the claims sector has been proud of its achievements in getting prepared for an increase in claims.

The result was the creation of portals, bespoke to each loss adjuster.

Not all adjusters have gone down this route. Graeme Fitzpatrick, executive director of Woodgate & Clark, told Post that the business “decided at an early stage” not to use a portal system and is instead working on a case-by-case basis.

In theory, with portals, streamlined data goes in, it can be examined faster with the aid of tech, and claims payments go out faster. This in itself is sound logic. Loss adjuster Sedgwick has already processed “several thousand” claims through its portal, managing director forensic advisory services Adrian Cartwright-Bain told Post.

But there is an issue – and that centres around the input of data.

Policyholder advocates have flagged to Post that businesses that have already (some months ago) submitted all the material – accounts, returns, grants information – to their insurers are now being asked to complete spreadsheets described as “complex” and “confusing”.

With furlough and restrictions still in play, business leaders do not necessarily have access to accounting staff. For smaller businesses, many would have to draft in an external accountant to understand complex figures.

Some firms have reported being asked to submit accounts data from 2020 that they simply do not have yet.

While some policies will cover claims preparation cover – albeit with stipulated restrictions – many will not.

At any rate, businesses are already struggling financially; some say they cannot afford an accountant, others have received vital interim payments but balk at the idea of using money intended to cover last year’s losses to pay for their claim to progress.

While they may already have access to facts, figures, documents and stats following months of preparation, Post has heard examples where the physical task of inputting this data has proved too much for some business leaders who say they do not have the skillset to navigate a spreadsheet or system (see below for Crawford example of data requested from policyholders).

Further, there are concerns – perpetuated by a lack of trust in insurance after months of legal wrangling – that where incorrect information is input, down to a lack of technical knowledge rather than intent to deceive, policyholders could be penalised.

This is proving to be an additional stressor for already financially and, in cases, mentally stretched business owners who are also coping with other impacts of the pandemic.

Insurers are already facing a deluge of BI claims, shown by loss adjuster testimony and software house stats. This has led to a sharpening of focus and a redistribution of resources.

Insurers, for example Hiscox, have set up dedicated BI phonelines and email contacts.

Efforts have been complicated, it is understood, by claims resubmissions from businesses who were either not subject to the test case or whose policies did not trigger as per the judgment.

With a backlog of claims applications, policyholders report it can take up to two weeks to get a response. In cases this ‘radio silence’ has led to more contact attempts, further perpetuating a cycle that threatens to continue bogging down the process.

So what is the solution for legitimate claimants who are struggling with requirements?

Where policyholders are hitting brick walls, loss adjusters and claims handlers must be understanding. A lifeline must be thrown to those who do not have the current capability to input data in the requested format.

Response

Of the loss adjusters who responded to a request for more information, firms were sympathetic.

Sedgwick’s Cartwright-Bain said that where policyholders are unable to complete portal information, “more traditional methods are also possible”. In cases, this has already happened, Cartwright-Bain confirmed.

So far, just 3% of submissions have been made via an accountant, with more than 80% submitted by policyholders themselves, Cartwright-Bain said.

As for concerns around screening errors, Cartwright-Bain said the loss adjuster has deployed “several methods” to spot anomalies and will go back to policyholders to verify and correct information.

Cartwright-Bain explained the portal was tested on claims professionals and others “who do not have a BI or technical background” and designed with input from behavioural scientists.

Cartwright-Bain added: “Policyholders were at the front and centre of our system design as it was imperative that it was as straightforward as possible to use.  However, business interruption claims are by their very nature complex. Most policyholders will never have had to make a claim before and detailed financial information is required for us to understand the sums involved and the extent of claim. 

“Designing a portal that would suit all types of business is, however, a significant challenge and thus any design is a compromise between technical accuracy and ease of use.

“In normal circumstances it can take policyholders two or three weeks to get all the information together to submit a claim.  This is the same now but we’re offering a solution whereby policyholders can upload this information in a couple of hours so that their claim can be processed as quickly as possible.  Some policyholders would need to contact their accountant to help them gather any information they do not have readily have available in normal circumstances.  This is also the case now.”

Sedgwick does have a dedicated helpline, Cartwright-Bain added.

Crawford head of forensic accounting services UK & Ireland Andy King also pointed to Crawford’s dedicated helpdesk for businesses that may be struggling with portal steps.

He told Post: “Crawford is committed to helping businesses impacted by the Covid-19 pandemic to achieve a speedy and fair settlement of their related business interruption claims.

“As part of this, our recently launched BI claims portal allows affected policyholders to upload relevant claims information, enabling faster processing and in turn a more efficient and effective review and settlement process. To date, information relating to hundreds of BI claims has been uploaded to the portal and many of these have been successfully processed.

“BI claims can be complex, but the portal is designed to make the process of uploading data as straightforward as possible. Supporting documentation guides the policyholder through each stage and every effort has been made to ensure that this information is accessible to the widest range of potential users. In addition, policyholders can contact our helpdesk directly for assistance at any stage in this process.”