Case Study – CCA and DCA Oversight Procedures
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CCA and DCA Oversight Procedures
Delegated Oversight Procedures
Broker Strategic Review
Bordereaux Management Project
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CCA and DCA Oversight Procedures
DA Strategy were contacted by a new market carrier who were looking for a best in class claims procedure for their delegated claims business, whilst maintaining their commerciality.
The project outlined our client’s approach to Delegated Claims Administrator (DCA) management and to ensure that adequate controls and checks were in placing for approving, onboarding and the continuous management and oversight of claims authority arrangements for DCAs and Coverholders with Claims Authority (CCAs).
The DA Strategy team met with the client’s leadership to expand their vision and held subsequent workshops with key stakeholders relating to the major pain points they faced. The workshops enabled DA Strategy to develop procedures aligned to the client’s appetite and streamlined activities.
The workshops held related to:
Approval of New TPAs and Coverholders with Claims Authority (CCA)
Post approval onboarding of TPAs and CCAs including contracts
TPA oversight including Account Management, Desk Top review, Referral, Reporting and Audit
Claims data and reporting including Bordereaux, MI Data and flow with possible support on Management dashboards
Annual sign off for TPAs and CCAs and Termination Procedures
Loss Fund Management
These Delegated Authority Claims Processes and Procedures were designed with a ‘risk-based’ approach to Claims DA Management for both DCAs and CCAs. The procedures and processes focused on a data-led decision making approach creating value through efficient governance and oversight of their DCAs and CCAs. This set our client apart within the delegated claims market and created the base for their DA book to grow whilst managing their claims DA effectively.
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