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Apr 2, 2014
Insure the Box has confirmed that it intends to use CWMC's market leading claims management and audit software system, eClams.
Feb 5, 2013

Are you going to the insurance industry's motor claims event of the year on 13 February? Get in touch and let's meet up.

Nov 8, 2012

What do you think about when you hear the word 'audit'? Humourless drones in grey suits who invade your office and get all nitpicky with a default assumption that everything is wrong?

Oct 30, 2012
In response to client requests for guidance on the best way to approach claims audits, CWMC offers these 5 Golden Rules...
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Insurance, Claims and Audit experts

Oct 30, 2012

5 golden rules for an effective claims audit programme


In response to client requests for guidance on the best way to approach claims audits, CWMC offers these 5 Golden Rules...

  1. Why - Decide what it is you want to achieve from audits and the type(s) of audit required, eg. leakage, forensic. Know what are the most critical issues for your business, and know where to focus your attention on what matters most.
  2. What - Decide what you are going to do with the results especially if problems are identified. Think about how you will follow up (ensure results are seen by appropriate decision makers).  There should be a willingness to learn, to do things better in future, not just to use the audit as a way to beat people up.
  3. Contracts - Ensure contracts with external suppliers allow and specify full audit rights.  Do ensure you have effective technical audit procedures and programme in place. Don't rely on the usual supplier management/procurement systems.
  4. Programme - Establish a timely programme of regular frequency audits and ensure they include a forensic claims-led review of all the data/management information which you hold.
  5. Authority - Ensure audits are seen as an integral part of normal business. The audit team must be experienced in the areas they are to audit and have the authority to 'command' responses. Use a mixture of internal and external people in audits, not just one or the other. In particular, inhouse auditors will benefit hugely from the experience and range of knowledge of external people, and this can build skills inhouse for the future.

 Read more about CWMC's approach to claims audits.

 

 

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