CLAIMS

Harnessing the power of attorneys to streamline claims

The newly formed attorney-led AM Star Claims will provide value to its cedants and international partners, Grant Miller explains to Intelligent Insurer.


When it comes to claims management, each claim is unique, each plaintiff is unique and each attorney representing the plaintiff is unique, so there is no one-size-fits-all approach.

One common factor is that every claim requires a high level of understanding and expertise in order to ensure a fair, efficient and speedy resolution. This is fundamental to profits in the book of business—handled by an inexperienced team, a seemingly low value, uncomplicated case can easily develop into your most drawn-out, expensive dispute.

That’s why AM RE Syndicate has launched AM Star Claims, an attorney-led claims management and litigation consultancy that also offers underwriting review utilising primary and reinsurance underwriters, plus managing general agent (MGA) operational review and oversight.

Forming AM Star Claims is a natural progression for AM RE Syndicate, a specialty programme reinsurance provider which, as a US-domiciled reinsurance agent, supports the domestic US primary market with international reinsurance capacity.

“The company supports grassroots niche domestic programmes by linking that business with globally recognised A-rated international reinsurance partners. In order to properly service those international providers, we are the boots on the ground,” says Grant Miller, the chief operating & compliance officer of AM RE Syndicate and president of AM Star Claims.

That means AM RE Syndicate does the underwriting and sells the programmes it writes on its partners’ behalf—so it has to understand that business inside out.

Three key stages are involved: the underwriting review at the front end before the business is written and throughout the lifespan of the book of business; the operational review to make sure the programme AM RE Syndicate is providing capacity to is operating efficiently and is up to standard; and ensuring that effective claims management procedures are already in place and are implemented. If they are not, AM RE Syndicate will provide the procedures and suggestions moving forward.

“As it stands, we monitor the cedants’ claims from day one of the programme, and we provide authority to settle on behalf of the reinsurers. Not only do we provide our thoughts on strategy, we also take time to understand the clients’ claim structure and settling guidelines and we suggest alternatives as and when required,” says Miller.

“Claims management is a huge beast; it requires specific, dynamic and specialist expertise—so we’ve decided to increase the level of support that we provide to our domestic partners as AM RE’s premium capacity is projected to increase to over $700 million in 2021.”

The result is AM Star Claims. The new claims company will provide a complementary but independent service for the benefit of the entire group, its cedants and supporting securities.

The launch came at the end of a year that was unique for the re/insurance industry in terms of the market uncertainty it generated. Issues such as business interruption, remote working and the resulting cyber exposure, wildfires, and a very active storm season with more hurricanes hitting the mainland US than in previous years, created a potent mix of challenges.

“It’s been a horrible year in the insurance industry,” says Miller. “Effective claims management is essential to a profitable book of business regardless of these difficult times; even in peaceful times, having prompt, effective claims management can be the difference between the profit and loss of an entire programme of business.

“Ultimately, we want to be well-positioned to manage the challenges and protect our interests and our destiny, which in turn will benefit our business partners—and we can use our resources to do that. Our overall aim is to support and provide a cost-effective return on the loss ratio.”

“AM RE Syndicate does the underwriting and sells the programmes it writes on its partners’ behalf—so it has to understand that business inside out.”

Grant Miller, AM Star Claims

Attorneys to lead

AM Star Claims will be based in Dallas and AM RE is already seeing significant demand from existing cedants who want it to become more involved with their claims processes, drawing on its expertise in the area.

Principally, AM Star Claims is attorney-led, drawing on its team’s significant experience in litigating in court in a wide range of injury claims from catastrophic injuries and medical malpractice to low-value road traffic accidents.

Miller himself practised as a senior litigation attorney in high-value, catastrophic injury and medical malpractice lawsuits for several years in the UK. By the age of 25, he had appeared in court in more than 100 cases. After moving to the US in 2018, he passed the New York State Bar Exam and is now licensed to practise law in New York and Texas.

The other directors—Shevawn and Simon Barder—are Lloyd’s of London-trained industry experts. Shevawn is an accomplished entrepreneur with a proven track record of creating and leading businesses in the re/insurance industry. She is chief executive officer and founding principal of AM RE Syndicate and AM Star Hold Co and was previously president of Ironshore Marine Re.

Simon is a Lloyd’s-trained underwriter and was an active underwriter at his family-owned syndicate, bringing traditional training and unrivalled hands-on experience to AM Star Claims. He is chief underwriting officer and founding principal of AM RE Syndicate and AM Star Hold Co and was previously chief executive officer of Ironshore Marine Re. He has held roles at Gerling, Cologne Re, and Barder & Marsh.

“Our experience tells us that expertise and prompt decision-making are essential,” says Miller. “We need to respond to claims quickly, professionally and fairly. One thing the company won’t do is dodge or try to avoid valid claims—we won’t try to be belligerent and waste time money and effort on endless procedure. Rather, we will be proactive.

“We will think like plaintiffs’ attorneys—if we know what we are facing from the very beginning, we know how to nip that in the bud.

“The company will work with third-party adjusters, instructed counsel and cedants to create and implement the reserving guidelines and settlement procedures to provide settlement authority in individual circumstances so that claims can be decided quickly, maybe even without our getting involved to ensure prompt and cost-effective settlement in certain cases,” says Miller.

“If we set the standard and have clear communication, the adjusters will know exactly what we expect of them in order to settle the claim.”

“We see the MGA oversight offering as the final piece of the puzzle to the full service we want to provide.”

Group structure

Along with the creation of AM Star Claims comes a group structure for AM RE with a holding company and also a direct insurance company further down the line. Miller will remain a director of the holding company and be involved in the management of AM RE.

“It’s important to create an overall gold standard procedure for the whole group and also claims management which can be rolled out to our partners and offered to new clients as well,” he says. “We want to work with our cedants to implement these procedures in a way that suits them and their business needs.

“If we can take some of that burden from smaller niche programmes of the day-to-day claims management, so that many of them can then focus all their efforts in underwriting and other aspects of their business, we are only going to improve the overall service we provide.

“Our responsibility is to analyse every claim to ensure that valid claims are identified and paid fairly in the most cost-effective manner. We identify and deal with fraudulent claims promptly, not only using our expertise, but combining this with new technology such as telematics in cars, cabs and motion detection devices on trucks that we re/insure.”

As well as focusing heavily on claims in order to ensure optimal results for the supporting securities, AM Star Claims will concentrate on underwriting in order to ensure the risks being written on the front end fit within AM RE’s risk appetite and overall guidelines.

“We will be using experienced primary underwriters who have been retrained in reinsurance underwriting to achieve tighter control of the business we write on behalf of our international partners,” says Miller.

“We can then go back to them and say we know the operation is working smoothly, there is tight control, and we are providing the partners with the full service that’s mutually beneficial for all concerned.”

The third service provided by AM Star Claims is MGA operational oversight.

“We see the MGA oversight offering as the final piece of the puzzle to the full service we want to provide,” says Miller. “This will protect our group, it will protect the securities and it will protect the cedants, new clients and existing clients.”

This aspect of the firm’s work will harness the directors’ long experience in the excess and surplus space in the US to ensure AM RE’s business operates smoothly and efficiently and benefits all parties down the line.

“It’s about looking at what procedures they have in place for setting their underwriting guidelines and claims procedures and looking at which attorneys and third-party adjusters they instruct, and on what terms,” says Miller.

“We’ll find out what decisions are made and why, and see whether we can bring any changes and advantages to that from our own experience.”

The result will provide, as Miller puts it, a “three-step, gold standard underwriting, claims and operational” service that boosts confidence and provides real financial benefit.

“It’s a great opportunity for our overall insurance group to harness our expertise and provide added value through a new independent and complementary service offering,” he says.

Grant Miller is the chief operating & compliance officer of AM RE Syndicate and president of AM Star Claims. He can be contacted at: grant@amresynd.com


Image: Shutterstock / Kaspars Grinvalds


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