Overview​

A leading UK pet insurer engaged Procurato to evaluate its claims handling performance and establish a baseline for assurance. With increasing regulatory focus on Consumer Duty outcomes, the insurer sought to ensure that its operations adhered to service level agreements (SLAs) while delivering positive customer outcomes. Procurato provided a tailored solution to audit claims handling and deliver a thematic review of operational performance.​


Objectives​

To meet the client’s needs, Procurato aimed to:​
• Audit claims handling performance to assess quality, SLA adherence, and compliance with Consumer Duty requirements.​
• Reconcile bulk fee invoices with processed claim volumes for greater financial oversight.​
• Establish a baseline for ongoing assurance activities and identify areas for improvement.​
• Provide actionable insights to enhance operational efficiency and customer outcomes.​


Key Activities​

Conducted a detailed audit of a sample of claims to evaluate quality, SLA adherence, and opportunities for process improvement.​
Delivered an in-depth thematic review of key operational metrics, focusing on:​
• Indemnity spend analysis to detect potential leakage or anomalies.​
• Claims process adherence and KPI performance.​
• Complaints handling to uncover systemic issues and risks.​
• Good outcomes assessment, emphasizing vulnerable customer management under Consumer Duty requirements.​
• Provided the client with comprehensive reports detailing findings, recommendations, and actionable next steps.​


Benefits Achieved​

Collaborating closely with the client’s teams, Procurato delivered:​
• A clear baseline for claims handling performance, enabling the client to monitor and improve operational outcomes.​
• Insights into potential inefficiencies and risks in indemnity spend and SLA adherence.​
• Enhanced operational oversight through reconciliation of financial and claims data.​
• Recommendations for process improvements to better align with regulatory expectations and customer needs.​
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