FCA’s Multi-Firm Review on Insurance Claims: Are you ready for the spotlight on your delegated claims handling arrangements?

The FCA’s multi-firm review of insurance claims handling has cast a sharp spotlight on the industry, and this is not a drill. If your firm isn’t fully prepared, regulatory intervention could follow. With the regulator honing-in on how claims are handled. Insurers cannot afford to be complacent—particularly if you rely on delegated claims handling through Third Party Administrators (TPAs).

What Is the FCA Looking For?

This review is more than a cursory glance. The FCA is dissecting several key aspects of claims handling, and failing to meet their standards could land your firm in hot water if not responded to carefully.

Here’s what we think they’ll be scrutinising your business and asking you to demonstrate how you comply:

1 Fair treatment of customers: The FCA demands that claims are handled promptly and fairly, without unnecessary barriers.

Policyholders should always feel like their claim is being processed with care and transparency.

2 Communication: Is your communication with policyholders clear, timely, and honest throughout the claims process?

The FCA will not tolerate poor communication that leaves customers in the dark.

3 Claims performance and speed: Slow claims handling is a red flag.

The FCA will assess how efficiently claims are processed, and delays will be viewed as a sign of inadequate customer care.

4 Governance of Third-Party Administrators (TPAs): If you use TPAs for delegated claims handling, you cannot overlook your governance and oversight responsibilities.

The FCA will be checking that you have robust frameworks in place to manage and monitor the performance of your TPAs. Are they acting in the best interests of your policyholders? Are their actions aligned with your firm’s standards of fairness and customer care?

5 Data and reporting: Accurate, timely claims data is essential.

The FCA will expect to see that your data capture and reporting systems provide full transparency into claims processes, including those managed by your TPAs.

The Governance Gap: Don’t Let Your TPAs Become a Liability

Firms need to remember that relying on TPAs/DCA’s can be efficient, but only if they are properly managed. The FCA is increasingly concerned about delegated authority models, and firms that fail to oversee their TPAs effectively could be hit hardest. This means you need more than just a good working relationship—you need the right governance framework that ensures you are fully in control of every claim, even when it’s being handled by a third party.

How GreenKite Can Help

With this review, the stakes are higher than ever and getting governance wrong could lead to serious consequences. That’s where GreenKite comes in. Our team specialises in helping insurers not only prepare for regulatory reviews but also establish robust oversight of delegated claims handling. We work with you to ensure your claims processes—including those managed by TPA’s/DCA’s—are fully compliant, efficient, and customer-centric.

We can help you:

• Help you draft your response to the FCA
• Cast a critical eye over your response
• Audit challenge your claims handling processes and governance
• Strengthen your oversight frameworks to fill in the gaps
• Ensure your reporting and data management meets FCA standard

Don’t wait for the FCA to knock on your door—be proactive.

Contact GreenKite today and let us guide you through your response.

Claire Carpenter – GreenKite Director of Regulation and Assurance

[email protected]

GreenKite: Helping insurers stay compliant, improve governance, and avoid the pitfalls of FCA sanctions.