Claims Audits

The 2011 Southern Rock and Markerstudy court cases were one of the most dramatic examples in recent years of how critical it is to have an effective proactive regular claims audit programme.

Too often claims audits take place because something has gone wrong. This should be the exception. Claims audits should be regarded as an integral and essential part of a well run claims operation.

At CWMC we believe in learning audits - positive learning experiences for your business.

Effective internal audit programmes can be the best solution for many. However they can carry a high cost overhead, and auditors may not be aware of all the issues being identified in the rest of the market. An annual external review can therefore help deliver the best overall results.

Read our '5 Golden Rules for effective claims audits'.

An effective audit programme is a regular MOT or health check. It’s about prevention, learning and identifying trends and patterns so that action can be taken:

  • Improving knowledge
  • Staff learning and development
  • Identifying areas for enhancement or where corrective action is required
  • Spotting new business opportunities

CWMC's experienced auditors can look at all aspects of a claim, from First Notification of Loss and cover validation, through to reserving, payments, supplier performance, open and closed file reviews, operations and data integrity.

We provide fast analysis, pragmatic recommendations and incisive reports.

We have completed more than 10,000 motor claim reviews for insurers and their suppliers over the past six years alone. Our decades of experience in handling claims as well as conducting audits mean we work fast, efficiently and have an unerring eye for potential issues.

Insurers value our flexible approach to pricing and always find the modest cost of our audit services is recouped many times over.

CWMC’s claims auditing service for insurers, reinsurers and suppliers includes:

  • Reviewing claims objectives and operational and regulatory strategies
  • Precise and targeted identification of main issues of concern
  • Review and analysis of individual claims files, including open, closed and reopened cases
  • High value injury reserve reviews
  • Reserve development reviews
  • Fraud reviews
  • Data integrity reviews
  • Setting up new internal audit operations
  • Full report and practical recommendations



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