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Claims management and expertise are increasingly important as insurance products have become more complex.
Gen Re Claims is committed to partnering with our clients to build and implement claims and risk management solutions, develop products, build relationships, and deliver impactful learning forums. Gen Re has the knowledge and experience to tailor our services to the needs of an organization, market, or specific topic to assist our clients.
Our experienced Claims professionals are available to assist clients on complex claim matters such as new advancements in technology, medicine, and occupational transformation as well as death abroad, contestability, non-disclosure, best-practice sharing on suspicious schemes, and fraud-related matters around the globe. Gen Re’s facultative and consultative claim support, including our forensics and special investigations capabilities, are available on all claim matters. Clients often seek our support with appellate matters, second opinions, and customized claim service delivery approaches. We look forward to customizing our claim service delivery to meet your needs.
Our claims organization encompasses a diverse set of resources with wide-ranging expertise in both clinical and non-clinical professions, among them physicians, attorneys, accountants, therapists, and counselors. We support our clients’ efforts to independently perform segmentation reviews, audits, operational assessments, workflow diagraming, and gap analyses. We perform ad hoc peer review and consistency studies. We also bring our expertise to the table and share our knowledge through Think Tanks and learning forums on hot topics.
As a client of Gen Re, you have access to off-the-shelf products and forms that are ready to help you grow – and experts who can assist in doing so.
Our team of professionals, including physicians, behavioral health specialists, physical and occupational therapists, and rehabilitation counselors, are available to assist clients across the entire spectrum of claims and risk management solutions. From the assessment of individual claims all the way through full programmatic evaluations and strategic planning, our team offers concierge-level service.
Gen Re’s Global Forensics - Special Investigations Unit offers a unique value-added service that will enhance any organization’s Fraud Detection, Mitigation and Prevention, and Claims Risk Management strategies. Our staff leverages a global network of information resources to deliver world-class training, support, and consultation services tailored to our customer’s needs.
High quality, meaningful claims assessment practices are important to us. Our team is available to assist, develop or perform operational assessments, workflow mapping, gap analyses for quality assurance activities, and segmentation review work, or to aid a client’s governance program. Our QA Program includes a spectrum of activities ranging from due diligence through to end-to-end assessment of claims controls and claims risk management practices. The QA activity can be tailored to your needs and the scope adjusted accordingly.
Utilizing the principles of Behavioral Economics, data privacy, lessons learned from litigation, and the various regulatory environments we operate within, Gen Re assists clients in developing and updating claims forms to efficiently elicit information required to manage their claims. We leverage extensive medical expertise across all product lines in the design of claim forms specific to the primary causation claimed. Clients can then elicit information that is most pertinent to the claim, minimizing the need to obtain additional medical reports and resulting in faster decision times.
Our team of professionals, including physicians, behavioral health specialists, physical and occupational therapists, and rehabilitation counselors, are available to assist clients across the entire spectrum of claims and risk management solutions. From the assessment of individual claims all the way through full programmatic evaluations and strategic planning, our team offers concierge-level service.
Gen Re’s Global Forensics - Special Investigations Unit offers a unique value-added service that will enhance any organization’s Fraud Detection, Mitigation and Prevention, and Claims Risk Management strategies. Our staff leverages a global network of information resources to deliver world-class training, support, and consultation services tailored to our customer’s needs.
High quality, meaningful claims assessment practices are important to us. Our team is available to assist, develop or perform operational assessments, workflow mapping, gap analyses for quality assurance activities, and segmentation review work, or to aid a client’s governance program. Our QA Program includes a spectrum of activities ranging from due diligence through to end-to-end assessment of claims controls and claims risk management practices. The QA activity can be tailored to your needs and the scope adjusted accordingly.
Utilizing the principles of Behavioral Economics, data privacy, lessons learned from litigation, and the various regulatory environments we operate within, Gen Re assists clients in developing and updating claims forms to efficiently elicit information required to manage their claims. We leverage extensive medical expertise across all product lines in the design of claim forms specific to the primary causation claimed. Clients can then elicit information that is most pertinent to the claim, minimizing the need to obtain additional medical reports and resulting in faster decision times.
Claims education is the foundation of excellent risk management. Best-in-class claims organizations require knowledgeable, responsive, client-centric claims professionals with strategic and critical thinking skills. Gen Re is pleased to lend support to our clients’ continuous learning needs through global and regional offerings – which are customized to the local markets we operate within and ensure our clients stay abreast of and respond to changing global situations.
Training through the Gen Re Claims Academy is designed for claims professionals crossing all skill levels to navigate the complexities of Life & Health claims work. The Claims Academy supports claims professionals through building skills and knowledge by providing:
Access to industry-leading tools to confidently apply in the claims management process
Self-paced, interactive sessions that provide reference guides and case studies as a means to assist with covering the basics – and complexities – of claims management
The Gen Re Business School provides clients around the world with training opportunities and programs that meet the needs of individuals in their workforce.
Programs cover a broad spectrum of topics and are designed to upskill insurance professionals from across different business functions, helping them master day-to-day tasks and reach future goals.
The COMET training program provides a range of medical and non-medical training modules for insurance executives and underwriting and claims professionals.
The core modules cover a broad and comprehensive range of subjects including medical, claims and actuarial topics. The elective modules can be customized to your needs, to help develop theoretical knowledge and practical expertise. Our short courses cover topical issues in the industry, relevant to your day-to-day work.
Within the Gen Re Claims Academy, reference guides can help you design and build your own claims risk management processes and tools.
Available today, clients in the German market have access to this flexible software for the digital performance regulation of biometric risks. Specific technologies and processing automation options enable fast and consistent performance decisions. If this tool is of interest to you, please reach out to your local market resource.
The Depression Claims Wizard digital tool can assist claims assessors in deepening their understanding of mental health claims related to depression. The user is provided with a detailed overview of the clinical aspects of the claimed condition and useful recommendations to help the claims profession understand the insured’s functional status.
Financial training is available through tools such as our Financial Guide to assist clients with understanding market specific financial claim risk assessment processes.
Having held leadership positions in clinically integrated networks, health plans, and consulting firms, Jonah works closely with clients and regional chief medical officers to optimize clients’ clinical, strategic, financial, and risk management goals and outcomes.
With 25 years of SIU experience, Jason collaborates with clients around the globe to assist in increasing the awareness of and mitigation of potential fraud and known schemes. He has overseen thousands of claim investigations involving multiple lines of business and various regulatory environments.
Featured events, conferences, training & education.
Contact Pat to put you in touch with the local resources to assist in your needs.
Sharon Coetzee, Sr. Claims Executive, is on the Claims Standing Committee for the Association for Savings and Investment South Africa (ASISA).
Nathan Flaus, Claims Manager, is a Board Director for the Australasian Life Underwriting and Claims Association.
Dr. Jonah Fox, Chief Medical Officer Global Claims, serves on AHIP’s Chief Medical Officer Committee as well as ACLI’s Disability Income Committee.
Jason Weesner, Head of Global Special Investigations (Forensics), is a member of the International Association of Special Investigative Units, Association of Certified Fraud Examiners, and the Global Insurance Fraud Summit’s Steering Committee. Jason has collaborated with a number of other anti-fraud industry groups during the course of his career.
Catherine Schoppee, Assistant VP, Claims, serves on the Disability Committee of the International Claims Association (ICA).
Jodie Sweetser, Claims Executive, is a member of the ICA Disability Committee.
Claire Henshall, Segment Chief Claims Officer, serves on the UK's ABI Critical Illness Working Group.
Clio Lawrence, Claims Manager, is a member of the UK's Health Claims Forum Committee.
Kim Phan, Sr. Claims Specialist, is Committee Member on the Wellington New Zealand branch of the Life and Disability Underwriting and Claims Association (LADUCA).
Shamen Raja, Claims Manager, is on the Cape Town organizing committee of the South African Society of Life Underwriters and Claims Assessors (SASLUCA).
