Entrusting claims handling to a third party acting for the insurer, which remains answerable for what its delegate does.
Delegated claims handling entrusts a third party, a wholesale broker, a specialist platform or an independent administrator, with settling claims for the account of the insurer carrying the risk. The model took hold in high volume, low average cost lines, where the delegate's scale makes the difference, and in niche risks where the technical skill does not exist in-house. Its point of tension is alignment of interests: the delegate is usually paid per file or as a percentage of premium, not on settlement quality, and it is the insurer that bears the cost of a badly reserved file or a recovery never pursued. Supervision therefore requires the insurer to keep control of what it outsources, to check the quality of reserves opened in its name and to be able to take handling back. The chain can stretch to three intermediaries, each taking a margin, a situation regulators have flagged in several markets. The problem solved is skill and scale, which a risk carrier cannot rebuild for every niche.
The Insurance Distribution Directive, applicable since October 1, 2018, and article 49 of the Solvency II directive frame the outsourcing of important activities: the insurer stays fully answerable for what its delegate does, including the quality of case reserves opened in its name, and must be able to show it genuinely controls that chain.
délégation de gestion, plateforme de gestion pour compte