Pre-Market Sounding: Claims Handling

Tender description

In considering our future Claims Handling operating environment and the services we are seeking, we have explored a range of options that will allow us to perform our statutory function, while working with one or more service providers to help us deliver an outstanding customer experience. Our preferred approach is one that allows us to retain design and ownership of the processes and technology, with a partner or partners delivering agreed operational outcomes. We are interested to hear from potential service providers on how they might deliver some or all parts of our end-to-end claims handling process - from initial customer contact and application, through data gathering from product providers representatives and customers to process claims, to issuing a decision and processing any post-decision correspondence. Lot 1: FSCS's claims handling process can be summarised as follows: Customer Contact Services Email and webchat: The primary channel for customer communication, providing answers to customer queries and handling customer escalations and complaints Phone/helpline: The voice channel for customer service, providing answers to customer queries and handling customer escalations and complaints Post: The channel for processing all incoming post. This includes processing post that is both assigned to a claim, or unassigned, and ensuring that it reaches the correct recipient. Document Management Services Processing, scanning, validation and distribution of inbound mail Outbound mail production Physical storage of documents Claims Processing – which includes: Identity Verification –verifying the identity of the customer Claim creation and electronic file building – setting up claims records on the FSCS system Triage and allocation – including prioritisation of urgent claims and vulnerable customers Data Gathering and Validation – ensuring all material information is available to assess the claim Customer touchpoint - ensuring the customer is kept up to date on their claim including setting out next steps by phone and in writing Assessment – reviewing the material information to determine the eligibility of the customer and the outcome of the claim Decision – reaching a decision and issuing the decision outcome letter Quantification – determining the correct level of compensation Appeals and post decision contact Quality Review – independently verifying the assessment/quantification and the supporting evidence, and providing ongoing feedback, support and training where necessary