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Claims

Claims management and expertise are increasingly important as insurance products have become more complex.

Developing an effective claims management strategy is challenging. Our highly qualified team of industry experts provides tailored risk management solutions specific to our clients’ needs.   

Gen Re clients don’t have to go it alone. 

Our Services

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.

Claims Management

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.

Claims Management
Claims Consulting

Claims Consulting

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.

Turn-Key Claims Solutions

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. 

Clinical Expertise

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. 

Forensics

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.

Quality Assurance Programs

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.

Form Design

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 Training

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. 

Claims Academy

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

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Business School

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.

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COMET

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.

Tools

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Claims Reference Guides

Within the Gen Re Claims Academy, reference guides can help you design and build your own claims risk management processes and tools.

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Companion

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. 

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Depression Claims Wizard

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. 

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Financial Guide

Financial training is available through tools such as our Financial Guide to assist clients with understanding market specific financial claim risk assessment processes.

Specialized Assistance for Clients

Specialized Assistance

Global Claims Medical and R&D

Available to assist Gen Re clients looking for medical and R&D expertise

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. 

Global Forensics – Special Investigations Unit

Available to assist Gen Re clients looking for Forensics – SIU expertise

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 Topics

Cancer Pathology
The Impact of Climate Change on Mental Health
Climate change is one of the most significant challenges facing humanity today. However, the impact of climate change on mental health is a relatively new area of research, and it is increasingly gaining attention. We explore the impact of climate change on both the life and non-life insurance industry.
Mary Enslin
Embitterment – The Missing Piece of the Jigsaw in Protracted Claim Management?
The psychological state of Embitterment, is one possible and under-recognised avenue to explore in protracted claim management. We explore the associated psychological problems, how it is often mis-labelled and the possible approaches to resolution.
Dr. Chris Ball
All in a Day’s Work – The Impact of Non-Medical Factors in Disability Claims
Understanding both the medical and non-medical factors impacting a claim remains key to risk management and is necessary for both stay-at-work and return-to-work planning. Here we explore the non-medical determinants of health and options beyond medical management to assist with return-to-work planning and success.
Mary Enslin, Lisa Hall
Everyone Benefits From Better Understanding of Back Injury Risk Factors
Four out of five people experience back pain in their lifetime and nearly one tenth of these injuries result in chronic pain and long-term workplace absence. So, it’s important that claims professionals understand the full range of medical and occupational consideration.
Tahnee Leopold
Fight Against Fraudulent Claims – Highlights From Our South African Survey
Our new South African Fraud Survey shows, both insurers and reinsurers employ several anti‐fraud mechanisms to minimise their exposure to fraudulent claims. We have summarised opportunities and strengths of life insurers, and provide action points.
Shamen Raja

Claims Events & Training

Featured events, conferences, training & education.

Business School

Find an Expert

Contact Pat to put you in touch with the local resources to assist in your needs. 

Supporting the Industry