THE ROLE OF LOSS ADJUSTMENT PRACTICES ON THE PERFORMANCE OF INSURANCE SECTOR
DOI:
https://doi.org/10.47672/ijbs.1181Keywords:
Role, Loss Adjustment Practices, Performance, Claims, InsuranceAbstract
Purpose: The purpose of this study was to determine the role of loss adjustment practices on the performance of insurance sector
Methodology: A desktop literature review was used for this purpose. , a systematic search was carried out using Google Scholar, Semantic Scholar, and Research Gate. The study included relevant sources that were published between 2015 and 2022.
Findings: It was found that sound loss adjustment practices are a prerequisite for optimal financial and non-financial performance of insurance firms. It was concluded that having a clear policy approved by senior management, with regards to ex-gratia claim payments reduced the financial risks. It was also concluded that insurance firms can enhance their financial performance by regularly reviewing their claims handling guidelines to factor in new developments and trends. The study further concluded that non-financial and financial performance of insurance firms in influenced by quality reviews of claims to assess whether they are handled professionally and resolved appropriately. One of the performance measures could be the number and nature of complaints against the insurer with respect to their claims settlement decisions. The performance is also influenced by monitoring the level of claims which should not have been paid or are overpaid and the severity of delays in claims registration and case reserves revision.
Unique Contribution to Theory, Practice and Policy: Based on the study findings, it was recommended that insurance firms should endeavor to set case reserves accurately for each claim in a timely manner, especially in respect of general insurance business. The components of case reserves should also be captured in sufficient details to provide useful statistics for in-depth analysis. For example, a single claim file could have separate components for own property damage, third party liabilities and fees payable to external parties. Another recommendation is that the insurer should have a clear policy, approved by senior management, with regards to ex-gratia claim payments. The authority to approve such payments should also be clearly specified and the rationale for the approval should be properly documented.
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References
Adhikari, S. (2021). Customers' Satisfaction Towards Claim Settlement of Life Insurance Policies in Nepal (With Reference to Nepal Life Insurance Corporation and Life Insurance Corporation Nepal) (Doctoral dissertation, Department of Management).
Afolabi, T. S. (2018). Effect of Claims Payments on Profitability in the Nigerian Insurance Industry.
Akintayo, L. A, (2018). Introduction to general insurance underwriting, (CSS Bookshops Limited). 2055-0286. 19
Akotey, J. O., & Abor, J. (2016). Risk management in the Ghanaian insurance industry. Qualitative Research in Financial Markets.
Albert, K. (2017). The certification earnings premium: An examination of young workers. Social Science Research, 63, 138-149.
Angima, C. K. (2017). Effects of underwriting and loss adjustment on performance of property and casualty insurance companies in East Africa, no issue. European Scientific Journal 13(13);358
Barth, M. M., & Eckles, D. L. (2015). An Empirical Investigation of the Effect of Growth on Loss Reserve Errors. Journal of Insurance Issues, 96-123.
Benyoussef, S., & Hemrit, W. (2019). Measuring the relative efficiency of insurance companies in Saudi Arabia: The case study of Takaful vs cooperative industries. Cogent Economics & Finance, 7(1), 1590818.
Bhatia, M., & Bansal, A. (2018). Factors Influencing Customer Satisfaction in Health Insurance Services in India. UNNAYAN: International Bulletin of Management and Economics, 9, 29-37.
Biard, R., & Saussereau, B. (2014). Fractional Poisson process: long-range dependence and applications in ruin theory. Journal of Applied Probability, 51(3), 727-740.
Blong, R., Tillyard, C., & Attard, G. (2017). Insurance and a Volcanic Crisis"”A Tale of One (Big) Eruption, Two Insurers, and Innumerable Insureds. In Observing the Volcano World (pp. 585-599). Springer, Cham.
Boodhun, N., & Jayabalan, M. (2018). Risk prediction in life insurance industry using supervised learning algorithms. Complex & Intelligent Systems, 4(2), 145-154.
Brooks, P. J, Popow, D. J., and Hoopes, D. L. (2015). Introduction to claims, (Pennsylvania): American Institute for Chartered Property Casualty Underwriters
Capgemini, E. (2019). Claims transformation: Enhancing brand value by delivery on customer commitments, capturing efficiency gains, and optimizing indemnity expenditure
Chaudhuri, K., Kumbhakar, S. C., & Sundaram, L. (2016). Estimation of firm performance from a MIMIC model. European Journal of Operational Research, 255(1), 298-307.
Coad, A., Frankish, J., Roberts, R. G., & Storey, D. J. (2013). Growth paths and survival chances: An application of Gambler's Ruin theory. Journal of business venturing, 28(5), 615-632.
Collie, A., Sheehan, L., Lane, T. J., Gray, S., & Grant, G. (2019). Injured worker experiences of insurance claim processes and return to work: a national, cross-sectional study. BMC Public Health, 19(1), 1-12.
Cummins, J. D., & Rubio-Misas, M. (2016). Deregulation, consolidation, and efficiency: evidence from the Spanish insurance industry. Journal of Money, Credit and Banking, 323-355.
Diacon, S. R., Starkey, K., & O'Brien, C. (2017). Size and efficiency in European long-term insurance companies: An international comparison. The Geneva Papers on Risk and Insurance. Issues and Practice, 27(3), 444-466.
Dickson, D. C., dos Reis, A. D. E., & Waters, H. R. (1995). Some stable algorithms in ruin theory and their applications. ASTIN Bulletin: The Journal of the IAA, 25(2), 153-175.
Doherty, N. Tinic, M., Seha (2016). A note on reinsurance under conditions of capital market equilibrium, Journal of Finance 36: 94
Eling, M., Jia, R., & Schaper, P. (2022). The magic triangle: growth, profitability and safety in the insurance industry. The Geneva Papers on Risk and Insurance-Issues and Practice, 47(2), 321-348.
Franke, U. (2017). The cyber insurance market in Sweden. Computers & Security, 68, 130-144.
Hashem M. Mehany, M. S., & Grigg, N. (2016). Delay claims in road construction: Best practices for a standard delay claims management system. Journal of Legal Affairs and Dispute Resolution in Engineering and Construction, 8(3), 02516001.
Huddleston, M. (2021). Use and Abuse of Claims Experts in Bad Faith Litigation. The Brief, 50(2), 32-41.
Iqbal, H., Rehman, M. U., & Shahzad, S. J. H. (2020). Analysis of change in profitability due to reinsurance utilization and leverage levels, Evidence from Non-Life Insurance Sector of Pakistan. JISR-MSSE 12(1); 16
Isimoya, O. A., & Olaniyan, M. S. (2020). Impact of relationship marketing dimensions on word of mouth communication in the insurance industry in Nigeria. Acta Universitatis Danubius. Å’conomica, 16(3).
Jacob, T. (2017). Claims processing, Meeting the challenges of today and tomorrow. Whitepaper. (UK: Microsoft Corporation)
Jerry, R. H. (2019). Vade Mecum: Mediators and Disputes Involving Insurance. J. Disp. Resol., 25.
Kaijage, E., & Ogutu, M.(2017). Actuarial Risk Management Practices, Underwriting Risk and Performance of P & C Insurance Firms in East Africa.
Karami, A., & Pendergraft, N. M. (2018). Computational analysis of insurance complaints: Geico case study. arXiv preprint arXiv:1806.09736.
Kim, J. M., Ha, K. C., Ahn, S., Son, S., & Son, K. (2020). Quantifying the third-party loss in building construction sites utilizing claims payouts: A case study in South Korea. Sustainability, 12(23), 10153.
Levin, J. M., Lewis, W. R., Raschke, H. H., Phillips, C. M., Burke, S. R., Crawford, A. B., ... & Stutzman, A. G. (2019). Recent Developments In Property Insurance Coverage Litigation. Tort Trial & Insurance Practice Law Journal, 54(2), 707-736.
Mahlow, N., & Wagner, J. (2016). Evolution of strategic levers in insurance claims management: an industry survey. Risk management and insurance review, 19(2), 197-223.
Mahlow, N., & Wagner, J. (2016). Process landscape and efficiency in non-life insurance claims management: An industry benchmark. The Journal of Risk Finance.
McMillan, D. D., & Lowhurst, D. (2017). Unshrouding the Mysteries of Builder's Risk Insurance, Part 2: Negotiating and Drafting Contractual Requirements and Pursuing Coverage for a Loss. Constr. Law., 37, 28.
Mouatassim, H., & Ibenrissoul, A. (2017). Proposal for an implementation methodology of key risk indicators system: Case of investment management process in Moroccan asset management company. Journal of Financial Risk Management, 4(03), 187.
Mwangi, M. (2017). Effects of underwriting and claims management on performance of property and casualty insurance companies in East Africa.
Nebo, G. N., & Okolo, V. O. (2016). Effects of the strategies for customer satisfaction on the performance of insurance firms in Enugu Metropolis. IOSR Journal of Business and Management (IOSR_JBM), 18(5), 78-90.
Njegomir, V. (2018). Marketing in insurance: The importance of efficient insurance claims management. Civitas, 8(2), 30-39.
Ostrager, N. (2020). Handbook on insurance coverage disputes. Wolters Kluwer Law & Business.
Oyedokun, G. E., & Gabriel, F. G. (2018). Effects of claims management on profitability of listed insurance companies in Nigeria. American Journal of Management, 18(5), 37-45.
Paulsen, J., & Gjessing, H. K. (1997). Ruin theory with stochastic return on investments. Advances in Applied Probability, 29(4), 965-985.
Prajapati, A. K., & Rane, S. (2018). Smart Underwriting System: An Intelligent Decision Support System for Insurance Approval & Risk Assessment. In 2018 3rd International Conference for Convergence in Technology (I2CT) (pp. 1-6). IEEE.
Putra, N. & Dharma, D. (2017). Influence growth of income, assets, ratio of claim and risk based capital on the profitability of life insurance companies in Indonesia. International Journal of Business and Commerce 6(9) 24
Sandada, M., Manzanga, N., & Shamhuyenhanzva, R. (2015). How do Board Characteristics influence business performance? Evidence from non-life insurance firms in Zimbabwe.
Shaheen, R., AÄŸa, M., Rjoub, H., & Abualrub, A. (2020). Investigation of the pillars of sustainability risk management as an extension of enterprise risk management on palestinian insurance firms' profitability. Sustainability, 12(11), 4709.
Taouab, O., & Issor, Z. (2019). Firm performance: Definition and measurement models. European Scientific Journal, 15(1), 93-106.
Yusuf, T. O., Ajemunigbohun, S. S., & Alli, G. N. (2017). A critical review of insurance claims management: A study of selected insurance companies in Nigeria. SPOUDAI-Journal of Economics and Business, 67(2), 69-84.
Yusuf, T.O., & Dansu, F.S. (2020) Effect of claim cost on insurers' profitability in Nigeria. International Journal of Business and Commerce. 3(10); 01-20
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