Simon Burley ACII FCILA Director, Camford Sutton & Associates

1. Simon Burley ACII FCILA Director, Camford Sutton & Associates “The Challenge of the proposed new timescales for Adjusters and other practical concerns or opportunities that arise.”

2. What do Adjusters do under the current regime? • What are the main changes in the new regime that will impact Adjusters? • What do Adjusters need to change? • What impact will the changes have on claims handling generally? • Key messages Agenda

3. There are known knowns; there are things we know that we know • There are known unknowns; that is to say there are things that we know we know we don’t know • But there are also unknown unknowns: there are things we do not know we don’t know United States Secretary of Defense, Donald Rumsfeld Warning:

4. Investigate & Report on PL & EL? • Cradle to Grave claims investigation and claims handling • Site visit followed by desktop claims handling Or • Desktop handling from start to finish • Specific tasks What do Adjusters currently do?

5. 1 day to acknowledge receipt of Claims Notification Form (CNF) • 30 days to reach a decision on liability on an EL case. • 40 days to reach a decision on liability on an PL case. • Removal from Portal of claims where contributory negligence is argued • New rules for Part 36 offers • QOWCS We are concerned with EL & PL claims under £25k in England & Wales

6. If Defendants can meet all the deadlines and not dispute liability then claimant costs will be limited to the new fixed scale. • Various analysis suggest that Claimant Solicitors Costs will reduce by between 25% and 50%. • By volume 90% of UK EL and PL claims fall within the < £25k bracket. • There is significant savings to be made if we get it right. Why does it matter?

7. The good: The not so good: Rushed and/or poorly organised visits. Sometimes challenged by the 90 day protocol investigation periods. Need to “consider” evidence before committing thoughts to paper. Use of “tactical” denials – often as a consequence of being removed from the final impact of such decisions. • Experienced eyes and ears on site. • Experience to review available evidence and see the way forward. • Direct communication with policyholder and ability to “sell” the liability decision. • Form an overview of risk i.e. approach to H&S generally. • Opportunity to build or protect the Insurers brand. What do Adjusters do well and what do they find challenging in the current regime?

8. For all claims handlers and adjusters: To work closely with the Insured/Self Insured to comply with the new processes and shorter timescales whilst ensuring that only valid claims are compensated “Simples” Strategy for the future?

9. Cultural change • Need for speed • Seeking solutions not complications • Prioritisation of first appointment • Initial data review • Triage • Diary management • Use of historical records What is key in the new world?

10. Use of initial visit • Well organised – witnesses and documents • Willingness to spend longer on site • Gathering of witness evidence • Gathering electronic documents • Explaining position to policyholder • Speed of reporting • Triage – different models for different decisions • Report from site • Back office support • Changed reporting formats What is key in the new world? (2)

11. Consideration of liability arguments and use of contributory negligence • Understanding your principals’ end game • The end of the use of “tactical” denials • What is a valid “contrib” argument? • Claims Handling post visit • Use of the Portal • Ability to handle Stage 2 and respond to claimant offers to settle • Tactics around Part 36 offers made by claimant • QOWCS & Part 20 proceedings What is key in the new world? (3)

12. Awareness of the “floodgates” argument • What can be done pre loss • Policyholder awareness • Pre loss reviews of documentation • Establishing good internal investigation procedures • Agreeing good procedures for central collection of information • Reserving • Different rules for different losses • Different considerations for different liability decisions • Conduct during claims handling • Likely to be a key consideration if the claim litigates Other issues to consider?

13. Number of claims? • In general? • For Adjusters? • Claimant solicitor tactics? • No Success Fee might change approach? • Farming for “payers” instead of speculative claims? • Lifecycle • It is a human process – not an IT process • Triage and decision making is critical. Other issues to consider? (2)

14. Adjusters doing more desktop investigation? • Notification of losses by policyholder • EL • ELTO • PL? • Importance of notification of “incidents” • Policyholder understanding of process • Does policyholder advertise his PL Insurer? Other issues to consider? (3)

15. Adjusters can deliver an added value service • Having the right eyes and ears on site can make a difference • They can enhance brand and operational delivery by providing pre loss services • Talk to your Adjusters about exactly what you need • Review at an early stage to see how the theory is working • Be alive to some of the old failings of the adjusters and the need for cultural change – are your Adjusters fit for purpose? Key Messages?

16. Questions