The Role of Loss Adjustment Practices on the Performance of Insurance Sector

Abstract

Purpose: The purpose of this study was to determine the role of loss adjustment practices on the performance of insurance sector
 Methodology: A desktop literature review was used for this purpose. , a systematic search was carried out using Google Scholar, Semantic Scholar, and Research Gate. The study included relevant sources that were published between 2015 and 2022.
 Findings: It was found that sound loss adjustment practices are a prerequisite for optimal financial and non-financial performance of insurance firms. It was concluded that having a clear policy approved by senior management, with regards to ex-gratia claim payments reduced the financial risks. It was also concluded that insurance firms can enhance their financial performance by regularly reviewing their claims handling guidelines to factor in new developments and trends. The study further concluded that non-financial and financial performance of insurance firms in influenced by quality reviews of claims to assess whether they are handled professionally and resolved appropriately. One of the performance measures could be the number and nature of complaints against the insurer with respect to their claims settlement decisions. The performance is also influenced by monitoring the level of claims which should not have been paid or are overpaid and the severity of delays in claims registration and case reserves revision.
 Unique Contribution to Theory, Practice and Policy: Based on the study findings, it was recommended that insurance firms should endeavor to set case reserves accurately for each claim in a timely manner, especially in respect of general insurance business. The components of case reserves should also be captured in sufficient details to provide useful statistics for in-depth analysis. For example, a single claim file could have separate components for own property damage, third party liabilities and fees payable to external parties. Another recommendation is that the insurer should have a clear policy, approved by senior management, with regards to ex-gratia claim payments. The authority to approve such payments should also be clearly specified and the rationale for the approval should be properly documented.