United Kingdom

Insurance  

The insurance sector regulatory landscape is shifting, driven by intensive scrutiny and initiatives such as Solvency Two. New and evolving risks are emerging, and more 'familiar' risks are increasing. 

 

Our dedicated team assists insurance clients to manage their risks and meet their regulatory demands, whether it is in the area of financial crime, sanctions, financial modelling, capital adequacy measurement, assessing liabilities or regulatory reporting.

What's on your Mind?

 

  • Draft bribery and recent Aon fine increases exposure of Insurers to bribery and corruption violations - how is this mitigated?
  • Current economic environment has reduced internal spend - how can insurers evaluate the quality and value for money of anti-fraud controls in place?
  • How can data across different business areas be used to enhance fraud prevention in the business.
  • Solvency 2 has created a plethora of new demands on insurers. Do they understand exactly what is required, and will they meet expectations and deadlines?

 

Bringing you Peace of Mind

 

We can help clients across a wide range of services:

 Actuarial 

  • Modelling guidance, reviews and benchmarking
  •  Finance function transformation
  • Capital adequacy assessment
  • Risk and liability assessment and projection

Fraud and misconduct

  • Fraud and financial investigations
  • Asset misappropriation
  • Financial misrepresentation
  • Fraud risk management, training and awareness
  • Data analytics fraudulent claims detection

 

  

 Compliance and regulatory

  • Anti-money laundering and other financial crime-
  • Anti-Bribery and corruptione.g. in relation to insurance licenses in high risk countries and marine insurance issues
  • Regulatory risk reporting and negotiation

 

Contract compliance

  • Review of claims handling by lead insurer or reinsurer
  • Review of completeness of premiums reported to insurer (adjustment premium)
  • Review of asset manager's compliance with mandate

 

 

Claims

  • Claims handling process and procedures
  • Claims and loss calculation audits (business interruption, property liability, public liability, products liability)
  • Claims arbitration

 

Our aim is to help clients not only achieve compliance and avoid potentially damaging situations, but also to plan for the future and improve overall business performance.

 

What's in it for you?

 

  • We can identify methods to help improve anti-fraud controls thereby increasing bottom line profits
  • Improved controls to help reduce risk of bribery and corruption violations and possible subsequent investigations and fine
  • Application of data analytics and fuzzy matching has allowed us to detect and investigate frauds early, reducing future losses
  • Improved sustainable profitability, increased capital efficiency, lower costs and greater understanding of risk landscape

 

Why KPMG

 

  • We have a proven track record of securing large recoveries for clients including numerous cases involving upwards of US$100m.
  • KPMG is a global market leader in checking compliance with the financial terms of complex contracts.  At any one time we have more than 1,200  reviews of counterparties in progress around the world.
  • We have undertaken, for numerous organisations across all industries, bribery and corruption investigations, including those involving simultaneous inquiries by regulators around the globe. We have also assisted corporates in proactively developing and executing anti-bribery and corruption (AB&C) compliance programmes in order to comply with laws in a variety of jurisdictions.
  • In one instance of proactive assistance, we aided a client in obtaining a refund of approximately £100m as a result of bribery and corruption issues identified within an acquired entity.

 

Case Study

 

We were engaged by our insurance client to conduct a review of third party anti-fraud controls and processes in its direct household insurance business. 

 

We facilitated a fraud workshop with stakeholders to agree potential fraud risks and existing controls to mitigate those fraud risks.

 

Existing controls were then compared to leading industry practice and any improvement opportunities were highlighted to our client's management for consideration.

 

We identified process and control improvement opportunities that could deliver a financial benefit to our client of up to £1.6m per annum through increased premiums from the identification of non-disclosure by applicants at the inception of a policy and a reduction in fraudulent claims paid out to policy holders.

 

  • We identified one improvement opportunity that related to a significant lack of segregation of duties around one of our client's payment systems, responsible for processing approximately £1.5m of claims per annum.