Auditing Case Studies

Image

InsuranceRescue has completed thousands of profitability and process audits.  Remember that outsourcing your quarterly audits is affordable, will ensure compliance and allows management to focus on other critical priorities.

Some of our projects are summarized below:

Underwriting Audit

National insurer, XYZ Insurance, had unacceptable financial results.  XYZ contracted IR for profitability and premium leakage audits.

The first phase of the project was to 100% of company's Auto, Property and Ancillary lines Expert System Rules and underwriting requirements.

Review Findings:

  • +19% with problems
  • System issuing unprotected risks
  • High performance automobiles incorrectly issued by system
  • Referrals not firing when expected
  • Agents finding system work-arounds to issue policies
  • Processing efficiency problems
  • Cross-rule inconsistencies
  • System rules not matching filed agent and operations manuals

Process Audit

Super-regional insurer, ABC Insurance, was piloting a new sales channel. The company created a detailed operations manual which included specific steps for all work and processes handled by staff. Management expected this pilot to be equally or more efficient than current channels and more easily replicated.

We were contracted to build process audit procedures based on their operations manual and then to conduct file audits and agency training.

What we discovered and did

  • Documented actions being missed and forgotten by staff members.
  • InsuranceRescue and ABC’s internal team completed additional training and built new checklists until the new processes became second nature to the employees.
  • After InsuranceRescue's audit support, ABC implemented internal quarterly audits to assess efficiencies and compliance with the new processes.

 

Underwriting Audit

A regional insurer, ABC Insurance Company, wanted an outside assessment of their underwriting, sales and pricing practices.

The project scope included their Automobile; Homeowners; Ancillary policies. IR completed a multi-month comprehensive review and intensive auditing process.

  • 5,000+ policy files audited
  • +20% of the audited files had some type of "issue" identified
  • Conducted numerous client interviews with management and line employees
  • Visited agents and agencies
  • Discovered numerous expert system problems
  • Benchmarking showed opportunities to adjust guidelines to be more competitive
  • Much more

Forms Projects

Policy Forms Rewrites (national insurer). Some findings:

  • Benchmarking study
  • Retrieving competitor filings from DOI websites
  • Review and compare client's policy forms with selected best-in-industry competitors
  • Rewrite policy forms integrating the most current ISO/AAIS and competitor language

Policy Forms Review (regional insurer). Some findings:

  • Reviewed 100% of company's forms as being issued by their systems.
  • Pulled department of insurance filings to confirm compliance.
    • Filed forms not in agent and processing manuals
    • Active forms not found in DOI filings
    • Form number, edition date, and formatting inconsistencies