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August 24, 2016

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Claims: A health, safety and risk management issue

Michael Abbott, ACII Chartered Insurer an insurance claims consultant at MA Claims Support Limited, looks at how a liability claims review should be undertaken, and what a business can learn from this process.

In an organisation, the role of risk management is to look at its overall risks, while health and safety looks to ensure working practices are safe and comply with relevant legislation.

Health and safety practitioners should be aware of the underlying risk management approach to the business, as they focus on the day-to-day working practices, and vice versa.

Both risk management and health and safety roles are complementary with each other, and will have regard to share knowledge, experience, data and historic practices of the organisation.

Effective engagement between both roles is necessary to ensure that a focused approach is adopted and no areas are overlooked.


Access to the organisation’s overall claims record offers valuable insight, helping towards providing this focus and clarity.

Does your organisation regularly review your employers’ and public liability claims, as well as your motor and property claims?  If so, how effective are they?

Here are some thoughts on how a liability review should be undertaken: In most organisations, when a liability claims review has to be undertaken, it is treated as a paperwork exercise: another unwanted necessity.

Treating reviews in this way is a wasted opportunity. Each one has the potential to be financially beneficial to your organisation.

A more productive approach to the liability claims review process

Think about the way you are currently undertaking your reviews, and ask yourself the following questions.

Does the review:

  • Help to minimise the potential for future claims?
  • Seek to open discussions on working practices and encourage you to look for improvements?
  • Do anything to improve your chances of defending compensation claims?
  • Streamline the claims process, leading to more effective use of staff time?
  • Have the potential of reducing your insurance premium and budgets?

Making claims reviews more useful involves a bit more work, but the payoff can be significant

A well-documented claim report for review should give a much clearer picture. It needs to include a number of key indicators such as:

  • Open and closed files
  • Details of types of claim
  • Causes of injuries
  • Descriptions of any injuries
  • Focused areas where incidents are happening, with Cost Centre details if appropriate
  • Progress of claims – particular stage
  • Costs of claims – paid and open reserves
  • Summary of ‘open’ claims, successfully repudiated, and admitted, with reasons

The review should:

  • Be open and discuss actively progressing claims, anticipated costs and defensibility
  • Go on to identify areas in which improvements are deemed necessary
  • Include feedback on any amended post risk assessment, or any actions that may be needed
  • Include a review of policy, processes and practices
  • Take into account any change in legislation or practices
  • Identify any issues with claim service
  • Examine trends – often, as well as keeping in touch with the market, these can stem from addressing general complaints, near misses, or day to day activity events and considering if they may lead to future claim challenges
  • Review of the ‘risk management’ fund, and awarding of funds

Often, departmental colleagues will be best placed to help identify causes, as well as foresee future risks that could be negated early or managed better when they do arise.

Bringing claims to a conclusion effectively and containing costs is paramount, and benefits your business in many ways.

Importantly, this information should not just go upwards to the executive, but be communicated to all staff.

Ensure H&S officers, insurance officers, risk managers, operations directors, managers, team leaders, first aiders, property managers and fraud officers are kept up to date with your claims situation.

Learning from claims

Health and safety is everyone’s responsibility, and by helping each individual be more aware of the incidents you are experiencing, they are more likely to be vigilant and have ideas about ways to avoid such instances in future.

Communicating claims outcome to everyone helps to reinforce a positive message as well as negative: that by taking the right approach you can defend against claims – or at least help contain certain costs. Such communication also helps keep people properly focussed on the potential for claims (and how to reduce the potential for same).

A review can also work to help prevent unwanted staff absences through accidents, or the possibility of staff being caught up in time consuming discussions with your insurer and, in some cases, the legal processes.

You might be thinking, “That all makes sense. But how should we go about it?”

All you need to do is put aside an hour or so every month to review incidents, near misses, claims and complaints. This helps avoid repeat incidents, but also puts you in a better position to be able to manage any incidents that do occur in the most effective way.

In order to make these meetings productive, it helps to have guidance from someone who knows the claims culture inside out, and has experience of dealing with insurance claims in your sector.

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For over 30 years, Michael has worked in various Insurance Company claim roles.  Michael is a claims consultant offering his extensive knowledge ‘direct’ to businesses helping them improve ‘claims awareness’, help, advice, and support with effective reporting and progressing of Insurance claims.



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