Claims, Broker & Insurer phase two

Managing Agent playbook – phase two

In this scenario, both the Broker and the Insurer have adopted phase two solutions

Phase two claims four diagram

Step 1: Claims Submission

Actor Broker DefiniteChange

ECOT & API

ACORD-standardised messaging, ECOT, will be available from phase two. In this scenario, the broker who is in phase two triggers the claim submission process via an ECOT message. ECOT specifications can be found here.

Some fields used today do not exist in the EBOT message. The broker can provide these via API or submit them manually through the IPOS portal.

Actor Broker NoChange

ICOS Portal

The claim submission can be made via the ICOS portal, which provides an alternative to ECOT and API.

Actor Central Services NoChange

ICOS

ICOS is the new claims processing platform replacing ECF and CLASS. It will remain unchanged from phase one, although there will now be the option to interact with it via ECOT, EBOT and API.

Actor Broker NoChange

Claim documents

Claim documents will continue to be submitted to the IMR as part of the claim process via the IMR portal or DRI.

Actor Broker Central Services NoChange

IMR / IMR Portal

The IMR will continue to be the platform that will store claim documents. The IMR portal will remain unchanged from phase one.

Step 2: Investigation, Queries (if applicable), Claim Agreement

Actor Central Services NoChange

Reach Back

The Reach Back service will remain unchanged from phase one. It will enable legacy cases to be handled where claim data cannot be found in ICOS. In such situations, Reach Back will pull data from the old systems (e.g. CLASS, ECF) into the new systems, IPOS and ICOS.

If Reach Back is required for a claim, it will be done once only:

1.    At FNOL, ICOS will look for premium information in IPOS. If it's not found, Reach Back will pull the data from LIDS.
2.    If a claim originated in CLASS and a subsequent submission happens in ICOS, then the Reach Back service will get the previous claim history from CLASS.

If there is a future subsequent submission in ICOS after that, there will be no more Reach Back calls because all the information will already be in IPOS and ICOS.
 

Actor Broker Insurer NoChange

ICOS Portal

Both insurers and brokers (regardless of what phase they are in) are able to submit, view and respond to queries via the ICOS portal.

The ICOS Portal can also be used in the investigation process in claims, where insurers and brokers may need to upload and download supporting evidence to a claim. The ICOS portal will orchestrate the process of the agreement parties agreeing the claim. The broker can view the agreement status live in the portal. 

Things that can be done via ECOT & supplementary APIs can be done in the portal. 

There are currently no dedicated roles in ICOS for third parties. Therefore, insurers and brokers will be responsible for managing queries and investigation with third parties out of ICOS.

In this scenario, the insurer is in phase two and has adopted the ECOT process. Therefore, it is expected that their reliance on the portal will be reduced.

Actor Broker Insurer DefiniteChange

ECOT & API

In this scenario, both broker and insurer are in phase two, so they are both able to view and respond to query messages via ECOT and API. ECOT specifications can be found here.

There will be supplementary APIs from ICOS, which will provide information which is not available in the ECOT messages, such as non-fundamental splits. API specs are expected to be published in end Q1 - end Q2 2024.

API specifications were previously expected to be published between Q1 2023 and Q1 2024, but Velonetic (previously London Market Joint Ventures) will provide an updated schedule in Sep 2023. Some APIs have already been published and can be accessed on the ASG website. The API specification schedule, as well as instructions on how to access the API specifications currently available on the ASG website, can be found on the Blueprint Two website here: https://www.velonetic.co.uk/blueprint-two/resources 

Each organisation will have their own notification preferences, which will be unaffected by other organisations on the policy or claim. Therefore, an insurer who has selected ECOT and API as their notification preferences will only receive ECOT and API, even if other insurers on a policy use other formats.

Actor Central Services NoChange

Market Gateway

The Market Gateway (ASG Adept) will remain unchanged from phase one. All ECOT and API messaging will go through the Market Gateway (ASG Adept).

Previous Claims, Broker phase one, Insurer phase two
Next Premium Accounting & Settlement, Broker & Insurer phase one

Managing Agent playbook links