Principle
Disciplined procurement and pro-active management procedures should be employed in the selection and use of third parties.
Minimum standards
Overall:
- Managing agents should proactively and effectively manage their claims including where claims authority is delegated to third parties* and where external experts* are retained to assist with individual claims.
Management of organisations to whom claims management is outsourced:
- All FSA requirements in relation to outsourcing* must be satisfied.
Management of external experts employed on individual claims:
- Managing agents should have a documented process for selection, appointment and monitoring of external experts.
- External experts should normally be selected from a managing agent’s approved panel*.
- The terms on which external experts are retained should be competitive* with their peer group capable of providing the same service for that assignment.
- Managing agents should be able to justify why an external expert* was selected for an individual claim.
- For each claim the insurer should communicate and agree approach and goals with any appointed external expert*, and there should be supporting information indicating what the expert is required to deliver.
- Invoices should be checked against written agreements and non-agreed variances queried and, as appropriate, rejected.
Note: Terms with an asterisk are defined within a separate glossary of terms.
View glossary of terms (22KB, pdf)
