Claims Management, Strategy & Adjustment Sample Clauses

Claims Management, Strategy & Adjustment. 3.1.1 Non-stressed exit principles The Underwriter will, in line with the timelines detailed in the non-stressed exit plans, undertake an assessment as to the claims treatment for the legacy portfolio business. The Underwriter will either: ● Transfer responsibility for claims servicing to a run-off provider or reinsurer ● Bring claims management capability in-house such that there is no break in claims adjustment activity. The Coverholder will provide reasonable exit assistance to the Underwriter, including provision of all data and reporting to facilitate the exit. 3.1.2 Stressed exit contingency plan principles The Underwriter will step-in to existing Coverholder relationships to continue claims activity in the short-term. The Underwriter will then either: ● Transfer responsibility for claims servicing to a run-off provider or reinsurer ● Bring claims management capability in-house. 3.1.3 Resources responsible for implementing the contingency plan The Underwriter COO, in consultation with the Underwriter Head of Claims (if not dual-hatted) is responsible for the contingency plan. 3.1.4 Critical data to be handed over to the Underwriter All data necessary to claims adjustment, being: ● Live policy data ● Claims files for open claims, including any paper copy or off-system claims files 3.1.5 Alternative systems In the event an exit requires the Underwriter to move off the Prequel platform, alternative vendor package claims systems are available and could be procured in the medium-term. Market systems such as ECF2 and TRAX contain the majority of the Underwriter’s claims files and can be interfaced with directly to continue claims adjusting. Manual claims which are not contained within ECF2 or TRAX will need to be dealt with separately. 3.1.6 Alternative third-party support In the event of the exit of the Binder, the Underwriter may step into existing relationships (e.g. ProGlobal, loss adjusters) to ensure continuity of the service. An alternative third-party claims manager may also be appointed.
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