Claims management
What the risk actually cost: notification, reserving, handling and settlement.
01 What it holds
The data inside it
Claims, reserve movements over time, payments, recoveries and the handler decisions that shaped each one.
Claim, Reserve movement, Payment, Recovery, Peril, Handler, Litigation flag
02 Getting the data out
Extraction, and the keys that decide whether it joins
APIs and extracts, but the analytical unit is the reserve movement rather than the current reserve — development over time is the whole point.
Claims join to policy and to party; the policy link is usually reliable and the party link usually is not.
03 What goes wrong
The failures that look like success
Each of these produces a number that is plausible, reconciles to something, and is wrong. They are worth reading before the first extract, not after the first dispute.
Current reserve hides development
Only the movement history shows whether reserving is proving adequate, which is the honest audit of pricing.
Handler variation is real and unreported
Settlement amounts vary systematically by handler and region for similar claims, and that variation is recoverable cost.
Reopened claims
A closed claim can reopen, which breaks naive cohort analysis and understates ultimate cost.
Recoveries and subrogation lag
Gross and net of recovery differ materially, and the recovery arrives long after the claim is judged.
04 Joins that matter
What this system is worth joining to
| Join to | What it lets you answer |
|---|---|
| Policy administration | loss ratio by cohort, peril and rating factor |
| Actuarial | development triangles built from the same movements |
| Party record | cross-policy patterns, both fraud and genuine multi-policy exposure |
05 Metrics it feeds
The numbers that come out of it
06 Questions
Frequently asked
What is claims leakage and how is it measured?
The difference between what a claim should have cost and what was paid. It is measured by comparing settlements for similar claims across handlers, regions and time — which requires claim characteristics to be coded consistently.
Why does reserving matter to the pricing team?
Because reserve development is the feedback loop on last year's prices. If it reaches pricing only through the annual actuarial cycle, the same mistake is written for another year.
Connect this system without replacing it
SCIKIQ reads it in place, resolves the entities inside it and governs what the fields mean.