Claims

Claims are an integral part of an insurance contract. Each policy has its own ‘trigger’ point. Understanding what constitutes a valid claim under the policies it underwrites is essential for any MGA.

MGAs sometimes work with third-party firms to handle claims on behalf of their insurer carriers. Third Party Administrators (TPAs) may be appointed by either the MGA or by the insurer.

Many newly formed MGAs initially choose to leave the task of handling claims to the insurer or Lloyd’s syndicate. As they grow, they may want to look at taking control of the claims function from the insurers.

In June 2015 the FCA published the results of its thematic review on claims handling TR15/6. The MGAA has worked with associate member APPLICCO to produce a best practice guide for the procurement of claims services.