1. Electronic Claims File Update
The Old Library, Lloyd’s
4th September 2006

2. Agenda Introduction and Welcome Trevor Maddison
A Broker’s View Trevor Maddison
ECF and Market Reform Andy Brookes
ECF Underwriter View point Carl Phillips
Electronic Claims Files Steven Matthews
Questions and Close Trevor Maddison

3. A Broker’s View
Trevor Maddison
Marsh and BEFIT

4. Electronic Claims Trading is Simple
Electronic transfer of data and documents, broker desktop to underwriter desktop.
Claims workflow managed from the desktop electronically.
Removal of the paper claim file.
Simple claims – straight through processing, no broker involvement.
Claims advocacy – broking where it matters.
Delivery of a quality client and underwriter service.

5. ECF – Key Messages
Market reform is no longer a set of words. This project is real, ECF is real.
In one weeks time the potential to trade new claims electronically with Lloyds syndicates (day 1 in-scope) will become a reality.
The IUA are catching up fast, pilots have commenced and the commitment is there – we expect them to be live mid 2007.
Reform of the claims process is happening, ECF is the catalyst to a modern market place.
The London market is changing, market reform and electronic trading will work this time.
Are you preparing for change?

6. Key criteria for ECF success
Full commitment of all syndicates to trade claims electronically.
Full commitment of IUA carriers to trade claims electronically.
Full commitment of brokers to move to electronic claims trading within a reasonable timeframe.
All new claims received in the 4th Qtr 2007 traded electronically, all brokers, all underwriters.
Underwriters are making a commitment, brokers need to respond.
There will be issues, this is not Big Bang brokers need to work in partnership with Underwriters to make ECF a London market success.

7. ECF & Market Reform
Andy Brookes
Market Reform Programme Office
Page 7

8. ECF: Key part of the London process reform programme
Overall aim:
A framework of standards for business processes that enables firms to deliver services efficiently to customers at a cost and level of risk comparable with other platforms
Note:
Any costs inherent in a subscription market must be offset to deliver this comparability.
Any changes in business process must be managed in such a way as to avoid undermining the unique qualities/competitive advantages of the London Market.
Page 8

9. ECF is not happening in isolation
Claims beyond ECF
Change requests – no system stays put
Claims infrastructure to include IUA
Protocols (LMP2001); Lloyd’s Claims Scheme
Support Claims Strategy & Minimum Standards
Integration with other reform workstreams
Accounting & Settlement
Repository use; DRI standards; P2P strategy and claims
Contract Certainty
Roles and responsibilities clearly defined
Repositories……..again
Page 9

10. Implementation approach
Lead implementers
Prepare to follow
Commercial
Lloyd’s performance standards
Regulatory
Sponsors; project managers
Page 10

11. E.C.F. Underwriter Viewpoint
Carl Phillips
Amlin & LMA Systems Delivery Group
Page 11

12. Why Do Underwriters Need A Claim File?
Good Business Practice Easy way of supporting / evidencing decisions
Justify Reserves and Payments to Shareholders
FSA Requirements
Lloyd’s Claims Management Principles and Minimum Standards
Claims Agreement for Followers (CAF) - Consistency of information
Goshawk / Tysers
Page 12

13. Why An Electronic Claim File (E.C.F.)?
Concurrent/Contemporaneous Access
Transparent and Auditable Process
Improve service levels to customers
Removal of dead time (transporting files)
Worldwide access to the file 24/7
Data Integrity and Backup
Collaborative Agreement Lloyd’s Claims Scheme/ Claims Agreement for Followers
The Technology Exists in everyday use by all London Market Practitioners
Storage and filing requirements
Page 13

14. To replicate today’s file electronically Based on existing products
LMA ECF Objective
To replicate today’s file electronically
Not a Blue Sky Claims System development
Based on existing products
No changes to CLASS at this stage
Seamless access to CLASS information and documents through an Integrated Repository using Windows
Provide a base product in September 06
To be evolved once experience gained
Post implementation of base product
Strategic review of on-going development
e.g. Third Party Access / Leader Reserves/Web Services etc.
Page 14

15. Broker submits claim electronically
Features
Broker submits claim electronically
Enables parallel presentation to insurers
Reduces data transcription errors
Allow brokers to concentrate on complex claims
Facilitates improvements in claims settlement time
Improves Customer Service
Improved insurer access to information
It’s the insurers’ file
Concurrent access to all subscribing insurers
24/7 access, worldwide
Page 15

16. Overview
Page 16

17. Status today Key Enhancements in 5 Phases
Phase 1 - See all documents in one view
Phase 2 - Leader control of file/improved searching
Phase 3 - ACORD DRI (receipt of documents)
Completed 2005
Phases 4/5 – Merged into a single phase -
Lloyd’s data through GUI, full DRI and
Seamless link with documents in repository
On target for September Roll out Go/No Go Decision 7 Sept
Page 17

18. Systems Processes & Procedures
Systems Processes and Procedures Guide
Broker & Underwriter Collaborative Approach
High-level guide
NOT a systems user manual or adjusting manual
Focuses on process
Workshops have been convened to review generic process and class of business variations
Confirmed generic process
Confirmed little variation by class of business
Many Issues identified and documented for resolution.
Page 18

19. Types of claim
The majority of all new claims can be processed via ECF. However there are certain circumstances that ECF has not been required to support and some other instances where system change or further definition of market processes is required to enable full support.
Business or Claims types that ECF has never been required to support
Claims on unsigned risks
General Average
Proportional treaties
Scheme Canada
Direct Livestock
Claims Payable Abroad
Letters of credit, loss reserves and Outstanding Cash Advance (OCAs)
Bulk Settlements
Business or Claims types excluded from the current implementation of ECF
Solution is currently being developed
Delegated Lead to XCS (other than 100% Delegation, which is in scope)
Binding Authorities, Cover Collections and other Bordereaux Claims
Require further analysis
Political Risk
Aviation verticals
Certain Multiple OSND claims
Third Party Access to ECF
Existing paper claims files
Page 19

20. Delivers first version
Next Steps
GO LIVE – September 2006
Delivers first version
of an integrated electronic claims service for Lloyd’s
replicating existing file electronically
with improvements where possible
companies and syndicates can see the same claim
BUT a step-change for the London Market
There will be more issues and enhancements
Legacy claims
Issues recorded and initial plan for resolution
Things change and we won’t have thought of everything
Page 20

21. ECF is here and we’re ready
MAT approaching completion
Staff training underway
16 Managing Agents participating from next month
Representing about 60% of Lloyd’s Market Capacity
5 Brokers submitting ECFs next month
Representing about 40% of Lloyd’s Market Capacity
There won’t be a paper file!
Increasing commitment every week
A Partnership Approach that Benefits all - But not least the Policy Holder.
Page 21

22. Amlin’s Approach Experience and extracting maximum benefit
Have built experience in ECF through 7 pilots across 7 classes of business with 7 brokers over 2 years
All claims teams have been engaged in ECF, some since April 2004; claims handlers now looking forward to going live with Electronic Claims.
Implemented new repository workflow system specifically to handle all claims electronically
It works!

23. Amlin have begun internal training in preparation for live date.
Amlin’s Approach
Preparedness
Amlin have begun internal training in preparation for live date.
Little change for those that have used CLASS before
Amlin confident that 80% of their new claims can be handled through ECF now without impediment.
There will be pain to get the gain!

24. Electronic Claim Flies
Stephen Matthews
Tim Lovick
Date: 4 September 2006

25. Agenda What is ECF? Process Overview Roles and Responsibilities
Validation Checks
Mandatory Rules
Roll Outs
Lessons Learnt
System Overview
Practical Help

26. …combination of new systems and procedures
What is ECF?
Market Repository
Converged CLASS
ECF
Tracker
Workflow
…combination of new systems and procedures

27. ECF Process Overview MARKET XCS ECF System XCS CLASS
(XCS Internal System)
Once all agreement Parties ‘Accept’ claim
Document storage system
Supplement claim details e.g. i. FIL ii. NAIC iii. TF codes
Broker
4. CLASS
CLASS Database
Agreement Party
SCM & BSM

28. Roles & Responsibilities of ECF Parties
Broker
Lead Lloyd’s Underwriter
XCS
Agent of the (Re)Insured
Collate and present claims data / information to Insurers - will include first and subsequent claim advices
Collection of claim monies on behalf of (Re)Insured
Review claims information provided by broker and other parties
Represent the interest of Leading Lloyd’s Syndicate in any claims handling decisions, including coverage, recovery, litigation etc
Review claims information provided by broker and other parties
Represent the interest of Following Lloyd’s Syndicates (if CAF or Peer Review, will include claims handling decisions including coverage, recovery, litigation)
Advise claim details to Lloyd’s Syndicates and process claims, recoveries and/or fees via Lloyd’s Market claims system
Role
Create / update claims data in Lloyd’s in a timely fashion. Will include:-
Claims
Refunds
Fees, if included in indemnity amount (optional for brokers if not))
Upload correct supporting claims documentation onto Market Repository. Will include (but not limited to):-
Slip with OSND and policy, if available and all relevant endorsements (including AP/RP and Non Premium)
Cover Note / Certificate / Declaration, where applicable
Preliminary and subsequent loss details
Expert reports
Release Form / Proof of Loss
Correspondence from (Re)Insured
Supporting claim documents (e.g. bordereau, shipping documents, invoices receipts, etc)
Convey instructions to experts on behalf of Insurers
Calculate claim adjustments, including application of any applicable deductibles, orders, reinstatements - where applicable etc
Arrange payment of claim funds to (Re)Insured on behalf of Lloyd’s syndicates
Arrange payment of expert’s fees on behalf of Lloyd’s syndicates, if included in indemnity amount (or broker elects to collect fees if not)
Confirm broker has uploaded correct claim documents and review same. Will include:-
Slip with OSND and policy, if available and all relevant endorsements (including AP/RP and Non Premium)
Cover Note / Certificate / Declaration, where applicable
Expert reports, invoices, receipts, shipping documents etc
Check coverage details and confirm:-
Certificate / Insured / interest / declaration attaches to policy and sum insured
DOL / DCM falls within policy / certificate period
Claim falls within available policy / certificate limits
Applicable coverage type
Deductible / excess / franchise correctly applied
Loss location
Review and assess claim documentation. Will include (but not limited to):-
Identity of Insured / Coverholder / Cedant / Reinsured
Preliminary and subsequent loss details
Expert reports
Release Form / Proof of Loss Form etc
Review broker loaded financials
Update Lead Underwriter comments on Lloyd’s entry
Route claim to other agreement parties, as necessary
Instruct and manage experts in conjunction with XCS
Manage disputes with insured in conjunction with XCS. Will include:-
Arbitration hearings or court cases
Depositions etc
Manage “Direct Report” claims files and agree any applicable “Direct Settlements”
Determine and execute claims handling strategy in conjunction with XCS
Confirm broker has uploaded correct claim documents and review same. Will include:-
Slip with OSND and policy, if available and all relevant endorsements (including AP/RP and Non Premium)
Cover Note / Certificate / Declaration, where applicable
Expert reports, invoices, receipts, shipping documents etc
Check coverage details and confirm:-
Certificate / Insured / interest / declaration attaches to policy and sum insured
DOL / DCM falls within policy / certificate period
Claim falls within available policy / certificate limits
Applicable coverage type
Deductible / excess / franchise correctly applied
Loss location
Review and assess claim documentation. Will include (but not limited to):-
Identity of Insured / Coverholder / Cedant / Reinsured
Preliminary and subsequent loss details
Expert reports
Release Form / Proof of Loss Form etc
Review broker loaded financials
Update XCS comments on Lloyd’s entry
Route claim to other agreement parties, as necessary
Instruct and manage experts
Manage disputes with insured in conjunction with Leader. Will include:-
Arbitration hearings or court cases
Depositions etc
Manage “Direct Report” claims files and agree and process any applicable “Direct Settlements”
Determine and execute claims handling strategy in conjunction with Leader
Provide Technical Processing or CAF service, as required
Process corrections
Determine and create XCS CLASS entries in line with:-
Regulatory requirements
CAT code splits
NAIC splits
Trust Fund
State Code requirements
Create XCS CLASS entries and send SCM / USMs to Syndicates
Offer an Enhanced Claims Review service
Pursue recoveries, where appropriate
Responsibilities

29. Lead Lloyd’s Underwriter Getting the data right first time
System Validation
Broker
Lead Lloyd’s Underwriter
XCS
XCS release XCS CLASS
and send SCM / USM
to market
Lloyds
Lloyds
Lloyds
Broker loads
Lead agrees
XCS agrees
Claims
Data
XCS CLASS
SCM & USMs
Mandatory Fields in - 25
(Entered by Broker)
UCR (includes Original Broker)
TR (includes Payee Broker)
Bureau
LMP Indicator
First Advice Indicator
Advice to include Settlement
- UMR
- Broker Phone No.
- Bureau Lead
- Insured
- Policy Period or Period Narrative
- Slip Order 1 or Narrative
- Loss Name
- Loss Date From
- Loss Details (Narrative)
- Original Currency
O/S amt or O/S Qualifier
Order Settlement (if Settlement)
- Settlement Currency (if Settlement)
- Settlement Amount (if Settlement)
- Original Signing No. & Date
- Settlement Exchange Rate
Editable & Updateable Fields in - 5
(Data originally entered by Broker)
Risk Code
CAT Code
PCS Code
Further Agreement Parties
Cause Codes (not used at the moment)
Editable & Updateable Fields in - 5
(Data originally entered by Broker)
Risk Code
CAT Code
PCS Code
Further Agreement Parties
Cause Codes (not used at the moment)
Non-Editable Fields in XCS CLASS - 17
(Data originally entered by Broker)
- UCR
- TR
- Advice / Settlement
- UMR
- Syndicates on Risk (including Bureau Lead)
- Slip Order
- Original Currency
- O/S Amount or O/S Qualifier
- Settlement Currency
- Settlement Amount
- Original Broker (Calculated from UCR)
- Payee Broker No. & Pseud (Calculated from TR)
- Original Signing No. & Date
- Settlement Exchange Rate
Broker Claim Reference 1 & 2
Interest
VAT amount
Editable Fields in XCS CLASS – 16
(Data originally entered by Broker)
- Broker Phone No.
- Insured
- Pol / Cert Period From & To
- Loss Name
- Date of Loss From & To
- Loss Details (Narrative)
- Reinsured
- Original Insured
Perils
SI Limits
SI Currency
Excess
Loss Location
Vessel / Aircraft
Lawyer
Adjuster
NB. Editing these fields will cause discrepancies
between and SCM/USMs sent to Syndicates
Optional Fields in - 42
(Entered by Broker)
Broker Claim Reference 1 & 2
Reinsured
Interest
Perils
Location / Voyage
SI Limits
Excess
Loss Location
Vessel / Aircraft
Lawyer
Adjuster
Previously Paid
VAT amount etc
Additional Fields in XCS CLASS - 72
(Entered by XCS on XCS CLASS)
- Presentation Date
- Charge Type
- Peer Review Indicator
- Market Code etc
Getting the data right first time

30. Contractual Framework – Mandatory Rules
Licence to use and access to Documents
Unintentional disclosure of Documents and Privilege
True, fair and complete copies
Use of ECF and A&S
Response Buttons/Response Codes (for Lloyd’s only)
Recording Transactions (ECF and A&S)
Authentication of Users
Governance
Compliance
Law and Jurisdiction

31. 74 Lloyd’s Early Implementers
Brokers
Carriers
Karl Ross
Joe Hayward
Stephen Matthews
Ninette Fernandes
David Price
Heather Loane
Tabir Shah
Niall Wapshott
Dave Warren
Claire Musson
Sean Finneran
Matt Shelton
Matthew Nicholas
Georgie Burrows
Tim Lovick
Darren Moles
Barbara Stuchberry
Mark Harrison
Rob Casserly
Simon Davies
Bernard Levy
Kennedy Paryag
Matthew Taylor
Nick Miller
Robin Morgan
Joy Lowry
Darren McEwan
Dean Gardiner
John Merrett
Clive Campbell
Rob Pearce
Shelley McCormack

32. Lessons Learnt
To assist the efficient management of your ECF transactions and reduce rejections, the following points are important:
Check the risk/class of business is applicable for ECF
Check the data listed in the ‘Validation Checks’ (see previous page) is included in
the presentation
Ensure the correct signing number is presented
Check a signed Slip is loaded on to the Repository (along with other relevant
policy documentation such as schedules, breakdowns, APs, Endorsements etc.)
Correct Slip order

33. Lessons Learnt are completed or left blank)
Ensure both the currency of limits and SI/limit amounts are entered (e.g. either both fields
are completed or left blank)
If a bordereau presentation includes a newly added US tax state or a Canadian province
which requires a payment, this needs to be loaded as an advice prior to the settlement
Check the Settlement currency is the same as the first and subsequent advice
When a first advice with settlement is presented, the advise must be loaded on the first
transaction then the settlement on the second transaction

34. Practical Help
XIS are running a number of familiarisation
sessions across September 06.
(Contact Graham Sheppard)
XCS are planning a number of face-face
procedural workshops and demonstrations
with Brokers commencing September 06.

35. Tim Lovick Date: 4 September 2006
System Overview
Tim Lovick
Date: 4 September 2006

36. Homepage Search

37. Awaiting Action List

38. Transaction Summary

39. Transaction Summary (cont…)

40. Market Summary

41. Market Response

42. Market Response (cont…)

43. Xchanging ECF Project Teams – Key Contacts
Graham Sheppard
Tel:
XIS Project Team
Stephen Matthews
Mob :
Kennedy Paryag
Tel:
Mob:
XCS Project Team
Tabir Shah
Tel:
Mob:

44. Questions

45. Questions & Close
Trevor Maddison
Marsh and BEFIT

46. How Do I Get Involved – What Do I Need?
To submit claims electronically you must have:
Lloyds access either online or batch
The ability to load scanned claims documents to the Xchanging hosted market repository either via DRI auto load or direct load
Both Class and the ability to put documents in the repository are pre requisites to eclaims trading with underwriters

47. Key Contacts – Getting Started
Market Reform Programme Office
Ben Sayles:
Claire Bulman:
Xchanging
Geoff Kennard:
Graham Sheppard:
LMBC
Matthew Bateson:

48. www.marketreform.co.uk Market Reform Website
The website for all market reform matters is:
Please pay a visit