Annual Case Studies workshop

A highlight of the Exchange for the past three years has been the case study workshop. With actual case studies, small groups tackle, from the regulator and corporate perspective, what went right and what could be improved upon for the consumer.

What were some of the recommendations to ensure consumers are made whole and the insurance industry delivers on its promises?

• Communicate, communicate, communicate
• When companies make a mistake, admit it and move on
• If agent misrepresents the policy and or behaved less-than-professionally, some review of agent behavior is recommended.
• From a regulator perspective, companies always need to review for legitimacy of claims and pay those claims that are legitimate.
• Worry less about strict interpretation and more about customer service.
• When files no longer exist and or statute of limitations have expired, companies really do not have the obligation to pay claims.

All groups agreed that, sometimes, claims generate significant discussion and no answer is perfect.  However, all parties should take the time to ensure all information is reviewed completely. The most surprising result? In almost every case study, the regulators took a harder line on the interpretation of the facts than the corporations present—corporations constantly considered the litigious or public relations fallout; the regulators tended to focus solely on legal requirements.

If you’re looking to use the case studies with your staff, click here to see the actual case studies presented and determine for yourself how the situation could be improved for the company and the consumer.

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