Claims Management Services

Industry experts you can trust

We’re proud of our reputation for being one of the largest, leading legal businesses working within the insurance sector. We understand the challenges you face and the superior service you require for outsourcing claims to be a success.

We have built a market-leading team of experts you can trust. The majority of our claims handlers have worked in law firms, brokerages, insurance companies and Lloyd’s syndicates, blending valuable insurance market and legal experience.

We specialise in the management and administration of all classes of commercial lines claims and have particular expertise in matters concerning Professional Indemnity, General Liability, Property, Directors and Officers/Management Liability, Legal Expenses, Motor, Healthcare, Cyber and Hub/FNOL Bordereaux management.

Get in touch to find out more about our global claims management team

Unrivalled Management Information and IT claims management software systems

We use our own claims management system, EvoClaim, to provide clients with real-time access to full electronic files and comprehensive claims data.

A client dashboard provides instant graphical analysis on losses according to statistics (such as location and loss code), as well as opportunities to investigate varying data sets (such as year of account or period), access a full electronic file (incorporating incoming and outgoing correspondence, internal referrals and all policy documentation), produce in-depth Management Information, capture SLA and KPI data and assess our Claims' conduct objectively.

Global reach with local expertise

All offices have their own management team and back-office functions - such as accounting and compliance, managed centrally. This gives an autonomy that ensures the best results for locally-based clients. In global matters, however, we draw on DWF's global resources to maximise knowledge and draw in cross-border expertise, as needed. For example, we have a multi-lingual service in Canada and France to help bridge cultural gaps.

Key Facts

We log more than 15,000 new claims every year
We are managing claims arising from incidents in 67 different countries
We are managing claims in 17 different currencies
We are currently managing claims with reserves totalling more than GBP 250,000,000

Our specialisms

Care home claims

We have extensive experience of advising on and defending claims stemming from care homes. We deal with medical malpractice claims, disciplinary and regulatory complaints, as well as public liability and employers liability claims.The claims team has a great deal of experience dealing with claims stemming from the care provided to an elderly service user or resident. Working with Insurers who have large portfolios of care homes insureds, our claims handlers are able to give guidance to care home owners on claims trends and feedback on risk management.

Cyber claims

As well as withstanding the advancement of cyber risks resulting from the COVID-19 pandemic, insurers also continue to face more familiar cyber risks such as phishing, hacking, ransomware attacks and large data breaches.

The market leading global Claims team at DWF, in conjunction with our legal experts, has extensive experience in cyber claims for large insurers, supported by cutting-edge methodologies and innovative technology.

Assessing a cyber breach claim is complex; we can provide you with expert knowledge to understand the depth and intricacies of attacks, determination of coverage and expert claims handling solutions. Through our market leading technology we deliver greater cost efficiencies, a streamlined claims process and risk and fraud prevention.

Insurers need a claims process that is:

Data Driven – to produce comprehensive MI for management of risk and reinsurance reporting at the granular level needed by cyber insurers
Streamlined – from hotline to resolution, our process integrates all aspects of cyber claims
Transparent – to avoid extra contractual exposures with state of the art policy integrity measures
Adaptable – to a rapidly evolving cyber environment with the ability to provide bespoke MI and identification of shifts in the cyber underwriting market

Financial Lines

Rather than delivering a standardised claims solution across all lines of business and client requirements, we approach each client relationship as a partnership. We understand the importance of providing claims management expertise in a way and at a cost that delivers the results you need and want. We recognise that across different jurisdictions and lines of business, claims management protocols need to be adjusted to account for the underlying risk and varying legal, social and political environments. Certain fundamental principles, however, underpin the successful mitigation of claim and cost expense in all territories.

Local Authorities

Claims Management & Adjusting is a global claims management business specialising in the management and administration of all classes of commercial lines claims. We have particular expertise in matters concerning Professional Indemnity, General Liability, Healthcare, Legal Expenses, Motor and Property insurance. Rather than delivering a standardised claims solution across all lines of business and client requirements, we approach each client relationship as a partnership. We understand the importance of providing claims management expertise in a way and at a cost that delivers the results you need and want

Corporate claims

DWF offer bespoke services to help you with corporate claims at every stage of the process. Our experienced claims team will help with your claims from inception to conclusion, and call on our large international legal team for specialist legal advice or litigation services if required. We can support you with small or volume claims through to complex claims and will work closely with your insurers to achieve the best outcome. We pride ourselves on ensuring technical excellence combined with a superior service in everything we do.

Medical malpractice

Our claims team has extensive experience of advising on and defending clinical negligence, medical malpractice and disciplinary and regulatory complaints and claims.We advise on and defend clinical negligence, medical malpractice and disciplinary and regulatory complaints and claims. We act in relation to a wide spectrum of clinical risks matters, ranging from claims made against hospitals arising out of surgical interventions, through to those against individuals arising out of non-surgical treatments. We have particular experience in claims arising out of surgical procedures (including cosmetic surgery), non-surgical cosmetic procedures, chiropractic treatment and complementary therapies.

Motorsport

We have provided investigation and claims services to some of the largest organisations in international motorsport for over fifteen years. Our clients include governing bodies of motorsport, governing associations who organise international events under FIM and FIA licence, several large amateur motorsport organisations, a number of F1 teams, a number of international circuits and numerous karting event schemes.

Australia

Our claims team in Australia is part of a global claims management and adjusting business, working with both Lloyds (UK-based) syndicates, as well as domestic insurers and specialising in the management and administration of all classes of commercial lines claims. We have particular expertise in matters concerning Professional Indemnity, General Liability, Marine Liability, Financial Institutions, D&O, Management Liability, Legal Expenses and Property Insurance.

What we do

We recognise that across different jurisdictions and lines of business, claims management protocols need to be adjusted to account for the underlying risk and varying legal, social and political environments. Certain fundamental principles, however, underpin the successful mitigation of claim and cost expense in all territories. We are also well positioned to provide claims management solutions to the corporate environment within Australia.

During 2019, the Australian office went through a significant restructure designed to ensure that we kept pace with the demands of the market, and further enhance our reputation for excellence and being a point of difference. Our approach to managing claims is centred around ensuring each client can choose a way of working that suits them. We offer First Notification of Loss cradle-to-grave claims management under a delegated authority; hub management as a centralised point for collation of data from multiple service providers; as well as deductible claims management and excess layer/follow market claims administration.

Why instruct our claims team in Australia?

All offices have their own management team and back-office functions - such as accounting and compliance, managed centrally. This gives an autonomy that ensures the best results for locally-based clients. In global matters, however, we draw on DWF's global resources to maximise knowledge and draw in cross-border expertise, as needed.
Our fee structure is dependent on the services, line of business and location. We strive to ensure a fee structure that is mutually beneficial to DWF and to our clients so that we are incentivised to add value and mitigate claims costs and legal services included in one contract. We are also keen to link KPI and service level performance to fee structures.
Claims management and Adjusting is part of our Connected services division which brings together a range of products and business services that enhance our legal offerings.
DWF is a leading global provider of integrated legal and business services.

General Insurance Code of Practice

DWF Claims (Australia) Pty Limited manages claims on behalf of insurer clients, many of which are members of the Insurance Council of Australia and subject to the General Insurance Code of Practice (the Code).

Read our notice

Australia

Andrea Mulchrone - Director, Connected Services (Australia & Asia Pac) & Interim Claims Director, Claims (Australia)
M: +61 456677008
T: +61 (2) 9030 0700
E: Andrea.mulchrone@dwf.law

Office address:

Level 29, 85 Castlereagh Street Sydney 2000 NSW

Canada

Our claims team in Canada is part of a global claims management and adjusting business, we work with both Lloyds (UK-based) syndicates, as well as domestic insurers and specialising in the management and administration of all classes of commercial lines claims. We have particular expertise in matters concerning Professional Indemnity, General Liability, Healthcare, Legal Expenses, Motor and Property insurance.

What we do

Our national, fully bilingual service supports insurer clients with claims across the country and provinces, and in both of Canada’s official languages.

Our approach to managing claims is centred around ensuring each client can choose a way of working that suits them. We offer First Notification of Loss cradle-to-grave claims management under a delegated authority; hub management as a centralised point for collation of data from multiple service providers; as well as deductible claims management and excess layer/follow market claims administration.

Why instruct our claims team in Canada?

We are one of the few TPA firms in Canada that is fully licenced across all provinces
We offer a fully bilingual service - ensuring that all and any claims in Canada (including Quebec) can be managed under one roof
Best of both worlds - all offices have their own management team and back-office functions - such as accounting and compliance, managed centrally. This gives an autonomy that ensures the best results for locally-based clients. In global matters, however, we draw on DWF's global resources to maximise knowledge and draw in cross-border expertise, as needed.
Our fee structure is dependent on the services, line of business and location. We strive to ensure a fee structure that is mutually beneficial to DWF and to our clients so that we are incentivised to add value and mitigate claims costs and legal services included in one contract. We are also keen to link KPI and service level performance to fee structure.
Claims management and Adjusting is part of our Connected services division which brings together a range of products and business services that enhance our legal offerings.
DWF is a leading global provider of integrated legal and business services.

Canada

Richard Darke
M: 604-806-3557
E: Richard.Darke@DWFadjusting.com

Office address:

605 - 1185 West Georgia Street
Vancouver
British Columbia
V6E 4E6
Canada

France

Claims Management & Adjusting is a global claims management business working with both Lloyds (UK-based) syndicates as well as French brokers and insurers.

What we do

We understand that claims management protocols need to be adjusted to work with the underlying risk and varying legal, social and political environments of different jurisdictions. We provide our clients with a unique claims handling experience where claims handlers and lawyers collaborate in a single structure.

Our approach to managing claims is centred around ensuring each client can choose a way of working that suits them. We offer three claims services: claims management; legal services; and loss adjusting. You can pick one, two or all three services, as well as using us as a third-party administrator.

Thanks to our understanding of French insurance law and insurance conventions we effectively handle claims by always keeping our client’s interests in mind. Working with local brokers has proven to be a successful starting point, to a market new to the concept of outsourcing claims management. We now handle claims for several Lloyds Syndicates, dealing with personal injury and property with a range of clients.

We offer First Notification of Loss, cradle to grave claims management under a delegated authority, hub management as a centralised point for collection of data from multiple service providers, as well as deductible claims management and excess layer/follow market claims management.

Why instruct our claims team in France?

Our collaborative approach to working with our legal teams in our French office, enables us to represent our clients before any national court whether in a civil or criminal matter, or in an arbitration case.
All offices have their own management team and back-office functions - such as accounting and compliance, managed centrally. This gives an autonomy that ensures the best results for locally-based clients. In global matters, however, we draw on DWF's global resources to maximise knowledge and draw in cross-border expertise, as needed.
Our fee structure is dependent on the services, line of business and location. We strive to ensure a fee structure that is mutually beneficial to DWF and to our clients so that we are incentivised to add value and mitigate claims costs and legal services included in one contract. We are also keen to link KPI and service level performance to fee structures.
Our claims handlers are fully bi-lingual, in both written and oral, French, English and Spanish. Local claims correspondence is in French, while claims data capture and reporting are in English (if required).
Our claims team have a wide understanding of the local insurance market, and a demonstrated experience in claims management.

France

Fousiya Bouklata, Claims adjuster
T: +33 (0)1 40 695416
E: Fousiya.Bouklata@dwfclaims.com

Office address:

Paris
137-139 rue de l'Université
75007 Paris
France
Toque K0165

Ireland

Our claims team in Ireland is part of a global claims management and adjusting business, working with both Lloyds (UK-based) syndicates, as well as domestic insurers and specialising in the management and administration of all classes of commercial lines claims. We have particular expertise in matters concerning Professional Indemnity, General Liability, D&O, Employment Liability, Motor and Property insurance.

What we do

Working for a large number of insurer clients, we are particularly known for our work in delivering robust settlement strategies, as well as working with underwriters and key stakeholders to anticipate and address trends across the book and industry as a whole.

Our approach to managing claims is centred around ensuring each client can choose a way of working that suits them. We offer First Notification of Loss cradle-to-grave claims management and loss adjusting under a delegated authority; hub management as a centralised point for collation of data from multiple service providers; as well as deductible claims management and excess layer/follow market claims administration.

Why instruct our claims team in Ireland?

All offices have their own management team and back-office functions - such as accounting and compliance, managed centrally. This gives an autonomy that ensures the best results for locally-based clients. In global matters, however, we draw on DWF’s global resources to maximise knowledge and draw in cross-border expertise, as needed.
Our fee structure is dependent on the services, line of business and location. We strive to ensure a fee structure that is mutually beneficial to DWF and to our clients so that we are incentivised to add value and mitigate claims costs. and legal services included in one contract. We are also keen to link KPI and service level performance to fee structures.
Claims management and Adjusting is part of our Connected services division which brings together a range of products and business services that enhance our legal offerings.
DWF is a leading global provider of integrated legal and business services.

Ireland

Aidan Leonard, Claims Director – Ireland
T: +353 (0) 1 790 9465
M: +353 (0)87 7980531
E: aidan.leonard@DWFClaims.com

Office address:

DWF, 2 Dublin Landings, North Wall Quay, North Dock, Dublin, Dublin 1

Italy

Our claims team in Italy is part of a global claims management and adjusting business, working with both Lloyds (UK-based) syndicates, as well as domestic insurers and specialising in the management and administration of all classes of commercial lines claims. We have particular expertise in matters concerning Professional Indemnity, General Liability, D&O, Employment Liability, Motor and Property insurance.

What we do

Why instruct our claims team in Italy?

We have in-depth geographical and legal knowledge of Italy, to ensure the right external third parties are sued where and when appropriate and that the right strategy for resolution is selected on every claim.
We have a claims management expertise in General liability, Professional indemnity, D&O, Healthcare, Legal expenses, Motor and Property Insurance. Each of our claims handlers are fully bi-lingual qualified in both English and Italian. Local claims correspondence is in Italian while claims data capture& reporting are in English.
Each of our adjusters are lawyers or paralegals with a demonstrated experience in the insurance market.
Each member of our staff has significant experience in the London market (i.e. Lloyds brokers, TPAs, coverholders and/or Syndicates).We have good relationship with local brokers and coverholders and we know how to approach the claimants in order to promptly assess the expected liability and the uncertainty around that estimate.
We proactively settle claims quickly in order to minimise insurer costs and take into consideration the litigiousness of the specific locale.
We are experienced in both helping insureds manage the claims below the self-insured retention; and helping insurers manage claims above the self-insured retention.
All offices have their own management team and back-office functions - such as accounting and compliance, managed centrally. This gives an autonomy that ensures the best results for locally based clients. In global matters, however, we draw on DWF's global resources to maximise knowledge and draw in cross-border expertise, as needed.
Our fee structure is dependent on the services, line of business and location. We establish fee structures that aligns our compensation with your goals (e.g. mitigate claims, costs and legal services). We are also keen to link KPI and service level performance to fee structures. Our close working relationship with DWF Legal in Milan gives us a competitive advantage over other local TPAs operating in the Italian insurance market.

Italy

Enrico De Micco, Claims Director – Italy
T: +39 0230317973
M: +39 3427008841
E: enrico.demicco@dwfclaims.com

Office address:

Milan
Via dei Bossi 6
20121 - Milano
Italy

US

Our claims team in the USA is part of a global claims management business, working with insurers, brokers and policyholders and specialising in the adjustment and administration of all classes of commercial lines claims. We have particular expertise in matters concerning Professional Indemnity, Architects & Engineers, Directors & Officers, Employment Practices, and Financial Lines Insurance.

What we do

Our claims team in the USA currently employs twelve specialist staff. While our claims staff is made up of licensed attorneys, we focus on resolving claims; not litigating liability or coverage disputes.

Working for insurer clients including the leading syndicates at Lloyds', we are particularly known for our work in relation to:

Architect & Engineers Liability
Accountant Liability
Agents
Real Estate
Employment Practices Liability
IT/Media coverage
Environmental claims
Home Inspectors/Appraisers
Insurance Agents & Brokers
Lawyers Liability
Securities Brokers/Dealers
Management Liability/Directors & Officers
Medical Malpractice
Municipal Liability
Property Losses
Business Interruption/Product Recall
Defamation/Invasion of Privacy
Financial Institutions
Commercial Crime/Financial Institution Bonds
Property/Spectie

Why instruct our claims team in the USA?

The benefit of Claims Management & Adjusting over an in-house claims team (aside from the obvious cost implication), is that we have specialized legal and insurance backgrounds and therefore have a detailed working knowledge of insurance policies and their impact on claims. This allows us to view claims not only from a technical perspective, but also from a commercial viewpoint. We excel in helping insurer clients identify underserved markets and writing insurance products to serve those markets.
We work for each client in a unique way, tailoring everything we do to your specific needs. DWF's structure, however, allows us to offer a number of tailored services, in addition to our claims work. These include audits(regulator, claims, underwriting), risk management services(contract reviews, pre-claims assistance, seminars/briefings, complete risk reviews) as well as governance and compliance services.
All offices have their own management team and back office functions - such as accounting and compliance, managed centrally. This gives an autonomy that ensures the best results for locally-based clients. In global matters, however, we draw on DWF's global resources to maximise knowledge and draw in cross-border expertise, as needed.
Our fee structure is dependent on the services, line of business and location. We strive to ensure a fee structure that is mutually beneficial to DWF and to our clients so that we are incentivised to add value and mitigate claims costs.
Claims management and Adjusting is part of our Connected services division which brings together a range of products and business services that enhance our legal offerings.
DWF is a leading global provider of integrated legal and business services.

USA

Reed Millsaps, President, DWF Claims
T: 847 607 9023
M: 262 496 3945
E: Reed.Millsaps@DWFClaims.com

Office address:
Chicago
740 Waukegan Road
Suite 340
Deerfield, IL 60015
USA

United Kingdom

What we do

Working for a large number of insurer clients, we are trusted to deliver a bespoke claims management and support service on a global level.

Why instruct our claims team?

We are the only commercial SME Third Party Administrator with a global footprint in all the major international insurance hubs.
Multiple classes of business or territories can be catered for under one global contract.
All operational and accounting functions are centralised a tour London HQ, allowing all other offices to concentrate on service delivery to their client base.
Simple but flexible pricing structure.
Claims management and Adjusting is part of our Connected services division which brings together a range of products and business services that enhance our legal offerings.
DWF is a leading global provider of integrated legal and business services.

United Kingdom

Paul Cowen, Head of Claims Management and Adjusting
T: +44 (0)20 7645 4219
E: Paul.cowen@dwfclaims.com

Lisa Heathcote, Head of UK Claims
T: 0117 428 9557
E: lisa.heathcote@dwfclaims.com

Office address:

20 Fenchurch Street
London
EC3M 3AG

Enabling Underwriters to make informed decisions

Background

ClaimsView is our proprietary claims management system developed in consultation with our Claims team and tailored to our clients various needs.

Underwriters are able to directly access reports and detailed information on individual claims, risks or entire portfolios and to quickly view losses on their account according to metrics such as location, loss code and business type.

The system provides full access to the electronic claims file for clients and effectively allows Underwriters to feel as though they have an in-house claims team.

The Situation

Our Claims team began to see a number of notifications relating to fire safety concerns on high-rise buildings.

An Underwriter client wanted to understand the exposure they had in respect of cladding related matters.

How we helped

Using the ClaimsView data, the Claims team was able to provide detailed Management Information for the Underwriter. This focused on Construction Professionals and the data was further broken down by business type.

The data was analysed and we were able to show the notifications received in relation to cladding and compare this to other losses occurring on the account.

In addition, we could show specifically which types of professional were receiving the highest numbers of these types of claims.

Outcome

The information allowed us to show that whilst the cladding related matters were a significant issue, they did not actually represent the biggest risk for all construction professionals.

Our Underwriter client was able to adapt their placement strategy and strengthen their underwriting criteria in relation to certain construction professionals.

Having this detailed view of their account and the nature of risks that were presenting themselves, the Underwriter felt able to continue to place risks in an environment where their competitors were withdrawing.

Expertise where it matters - Claims Trends

The Situation

Our client had a sudden influx of claims on their architects & engineers programs with respect to piling issues/ errors. The client asked for some guidance with respect to the cause of these issues and overall risk management.

How we helped

As a first point of notification, we can easily identify developing claims trends. These trends are then reported to Underwriters with a view to assessing risks. We have a bespoke claims system and measures in place to ensure that such trends are handled robustly. We source the best experts to handle the claims in a streamlined manner.

Outcome

With particular reference to piling claims, we took steps to speak to insureds on several claims to identify the underlying problem. Once we identified the common issue, we reported back to our client and provided some guidance and instruction. Early insight into such trends enable us to review strategies in advance so as to prevent a particular trend from growing. In addition, we were able to identify “high risk” programs and regions where such claims were likely to occur.

Helping the food industry recognise allergens as a risk

Background

Our claims team receive hundreds of food related claims per year. A significant proportion of those claims stem from food providers, and in turn, a significant proportion of the claims relate to allergens and the risks of customers receiving the wrong order, or simply not being aware that their food contained an allergen. With recent high profile cases showing that allergen cases can have tragic outcomes this is a key area of concern for our clients.

The Situation

Our client, a pan Asian restaurant chain, received a significant number of allergen claims relating to customers receiving food that contained an allergen they were unaware of. Given the type of food served (shellfish) and the risk to both the restaurant and the customer, the insurer and the restaurant chain asked us to intervene.

How we helped

We provided bespoke training to the managers of the restaurants, and suggested that simple changes to their practices could result in a reduction of allergen cases. The restaurant now asks all customers whether they have a food related allergen. If they do, the customer is provided with a red placemat. Their food choice is then discussed in detail, and checks made that the customer is not allergic to any of the ingredients. The food is placed on a different coloured plate, and again the customer is asked before the food is given to them, that they are not allergic to any of the food on the plate.

Outcome

By putting these simple changes in place, the restaurant has reduced its exposure significantly. If the customer has a red placemat, they should have a yellow plate. If they don’t, the employees of the restaurant can recognise this immediately. These changes have reduced the exposure of allergen related cases significantly - so much so, that for the first year in a long time, insurers have offered a reduction in premium at renewal! More importantly, customers are safe in the knowledge that their food will not cause an allergic reaction that could lead to a tragic outcome.

Taking a collaborative approach in complex accountancy issues

Background

Our claims team are well versed in all areas of Professional negligence matters and recognise the need for effective and commercially robust solutions when dealing with disputes.

We work closely with DWF Law to deliver tailored solutions which are identified at the outset and throughout the life of matters, ensuring claims costs are kept to a minimum.

The Situation

An insured who carried out payroll and accountancy services for law firms notified that their client has been defrauded by a rogue employee. Whilst it was acknowledged the activities were not carried out by the insured's firm, they faced allegations of failing to identify the fraud. It was also suggested that the Insured facilitated the fraud. A total £1.7m was claimed.

How we helped

Our claims handler swiftly identified that the insured were not the only party to have provided pay roll and accountancy services during the period in which the fraud took place. On reviewing insured's papers, it was felt that even if the insured were found to have breached their duty, the Claimant's own action/inaction should be challenged. Early in to the lifecycle of the matter, DWF Law were instructed to investigate the allegations and redirect the claim, where appropriate, to the other parties involved.

Outcome

DWF Law were in agreement and worked in tandem with our Claims team to put forward a robust defence to the claim. The matter progressed toward a mediation involving all the parties, including the insured.

Owing to the representations made and the agreed strategy at mediation, we were able to reduce the overall quantum and the insured was able to extricate themselves from the matter with a contribution of only £33,000 against the claimed sum of £1.7m.

This was an excellent result and showed the importance of early identification of potential strengths and weaknesses.

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Claims Management

Find out more about our Claims Management solution.