Latest news with #claimsmanagement
Zawya
2 days ago
- Business
- Zawya
Health insurance claims management firm established in Oman
The first company specializing in health insurance claims management company, was established today. Green Line Health Insurance Claims Management Company is the first Omani company licensed for this activity, supported by a national vision consistent with the directives of Oman Vision 2040, aiming to provide services with global standards using the latest technologies, and to enhance and empower national competencies to undertake a key role in this new field. Faisal Hamad Al Rashdi, Co-founder and CEO of Green Line Insurance Services, stated that, due to his long experience in the health insurance sector, he observed the operational challenges facing this sector, whether at the level of insurance companies, healthcare providers, or even policyholders. Given a clear gap in claims management, Al Rashdi decided to establish this company, especially with the Financial Services Authority (FSA) announcing the opening for applications to practice health insurance claims management as an independent and regulated activity. This presented a national opportunity to establish a specialized local company that contributes to building this vital sector. He explained that the market lacked a specialized company in health insurance claims management, with a greater reliance on foreign companies managing operations from outside Oman. This affected the speed and quality of services, in addition to the possibility of health data, which is highly sensitive, being leaked through external systems. The Financial Services Authority had taken the initiative to issue clear legislation to ensure the protection of this data within Oman. He noted that the company represents a reliable source managed by national competencies, meeting market needs through its proximity to clients, which directly reflects on work quality and the speed of transaction completion. Faisal Al Rashdi said that it is natural for any sector to face some challenges when entering a phase of change, especially when there are long-standing working relationships between the market and external parties that have managed this activity for decades. However, he stressed the necessity of redoubling efforts to build trust and confirm readiness to provide high-standard services that meet the needs and aspirations of target groups, in addition to full compliance with national regulations. As for the project's nature, he mentioned that the company offers a comprehensive package of services in health insurance claims management that meets international standards. These include accurate and prompt medical claims management, medical and administrative verification using smart systems to detect duplication and errors, as a step towards time management. It also covers medical network management, from contracting with hospitals and clinics to ensuring the quality of service provided to policyholders, in addition to data analysis and smart reporting that helps insurance companies make decisions based on accurate data. He emphasized that the company relies heavily on digital solutions and modern technologies, including artificial intelligence, for faster data analysis and the automation of routine operations using robotic process automation (RPA), which reduces manual errors and saves time and effort. Furthermore, it is fully integrated with the national platform developed by the Financial Services Authority ("Dhamani" platform), which has been approved for fully electronic operations. He clarified that the company handles data confidentially, storing client data on company-owned servers only, without relying on external servers, to ensure complete control over information security. It applies best cybersecurity standards, such as advanced data encryption during transmission and storage, firewalls, and intrusion detection and prevention systems. Additionally, access permissions are granted on a limited and well-considered basis according to the employees' job roles, along with adherence to all local and international laws and regulations related to data protection and periodic reviews to ensure continuous compliance. 2025 © All right reserved for Oman Establishment for Press, Publication and Advertising (OEPPA) Provided by SyndiGate Media Inc. (
Times of Oman
2 days ago
- Business
- Times of Oman
First local company specialising in health insurance claims management established in Oman
Muscat: The first company specializing in health insurance claims management 'Green Line Health Insurance Claims Management Company' was established on Sunday. It is the first Omani company licensed for this activity, supported by a national vision consistent with the directives of Oman Vision 2040, aiming to provide services with global standards using the latest technologies, and to enhance and empower national competencies to undertake a key role in this new field. The move comes amid accelerating growth in the health insurance sector and the increasing need for smart solutions to enhance the efficiency of medical services. Faisal Hamad Al Rashdi, Co-founder and CEO of Green Line Insurance Services, stated that, due to his long experience in the health insurance sector, he observed the operational challenges facing this sector, whether at the level of insurance companies, healthcare providers, or even policyholders. Given a clear gap in claims management, Al Rashdi decided to establish this company, especially with the Financial Services Authority (FSA) announcing the opening for applications to practice health insurance claims management as an independent and regulated activity. This presented a national opportunity to establish a specialized local company that contributes to building this vital sector. He explained that the market lacked a specialised company in health insurance claims management, with a greater reliance on foreign companies managing operations from outside Oman. This affected the speed and quality of services, in addition to the possibility of health data – which is highly sensitive – being leaked through external systems. The Financial Services Authority had taken the initiative to issue clear legislation to ensure the protection of this data within Oman. He noted that the company represents a reliable source managed by national competencies, meeting market needs through its proximity to clients, which directly reflects on work quality and the speed of transaction completion. Regarding the market's reception of this project, Faisal Al Rashdi affirmed that it is natural for any sector to face some challenges when entering a phase of change, especially when there are long-standing working relationships between the market and external parties that have managed this activity for decades. However, he stressed the necessity of redoubling efforts to build trust and confirm readiness to provide high-standard services that meet the needs and aspirations of target groups, in addition to full compliance with national regulations. As for the project's nature, he mentioned that the company offers a comprehensive package of services in health insurance claims management that meets international standards. These include accurate and prompt medical claims management, medical and administrative verification using smart systems to detect duplication and errors, as a step towards time management. It also covers medical network management, from contracting with hospitals and clinics to ensuring the quality of service provided to policyholders, in addition to data analysis and smart reporting that helps insurance companies make decisions based on accurate data. He emphasised that the company relies heavily on digital solutions and modern technologies, including artificial intelligence, for faster data analysis and the automation of routine operations using robotic process automation (RPA), which reduces manual errors and saves time and effort. Furthermore, it is fully integrated with the national platform developed by the Financial Services Authority ("Dhamani" platform), which has been approved for fully electronic operations. He clarified that the company handles data confidentially, storing client data on company-owned servers only, without relying on external servers, to ensure complete control over information security. It applies best cybersecurity standards, such as advanced data encryption during transmission and storage, firewalls, and intrusion detection and prevention systems. Additionally, access permissions are granted on a limited and well-considered basis according to the employees' job roles, along with adherence to all local and international laws and regulations related to data protection and periodic reviews to ensure continuous compliance.
Yahoo
3 days ago
- Automotive
- Yahoo
FCA finds external cost pressures driving motor premium hikes
The Financial Conduct Authority (FCA) has confirmed this week that a steep rise in UK motor insurance premiums has largely been driven by rising external costs, not inflated insurer profits, but has warned of persistent shortcomings in how some insurers are managing claims. In an analysis, the FCA revealed that the increasing cost of settling motor claims, driven by higher prices for vehicles, parts, labour, energy, and more complex supply chains, is the main cause behind recent premium hikes. Additional pressure has come from rising costs for hire vehicles, a surge in theft claims, and an increase in uninsured drivers. Despite these external factors, the regulator flagged concerns around poor claims handling practices that may be compounding the problem. In particular, referral fees from credit hire firms and claims management companies were linked to slower claims processing and higher costs for both consumers and insurers. While the FCA observed good practices in parts of the home and travel insurance sectors, its investigation also exposed worrying failings across the industry. These include: Weak oversight of outsourced services, leading to delays and high volumes of complaints; Inadequate management information, resulting in unresolved claims issues; A low payout rate for storm damage claims in 2024, with only 32% of claims honoured in a sample of firms; and Over-reliance on cash settlements, often without assessing whether they were in the customer's best interest. The FCA said it is addressing poor practices directly with individual firms, including taking regulatory action where necessary. It is also feeding its findings into the Government's motor insurance taskforce to help drive coordinated action between regulators, industry, and policymakers to tackle rising costs. The regulator stressed, however, that while such collaboration could help mitigate price increases, it will not be able to prevent them entirely. Premium finance market under FCA spotlight Also released this week was an interim update from the FCA's ongoing market study into premium finance — the additional cost consumers face when they choose to pay their insurance monthly instead of annually. While premium finance can offer greater affordability and flexibility, the FCA warned that some firms are profiting disproportionately from offering this service, charging significantly more than the cost of providing it. The next phase of the study will delve deeper into these concerns, using the Consumer Duty to ensure firms deliver fair value. A final report is due by the end of 2025. Sarah Pritchard, deputy chief executive of the FCA, said: 'Insurance provides peace of mind but people must be confident they can get a fair deal and be treated right when the worst happens. "External cost pressures are primarily to blame for recent motor premium increases, not increased firm profits, but there is some more work to do on claims handling, particularly in home and travel. That's why we're stepping up — making sure claims are handled promptly and fairly and pushing for a coordinated effort to tackle the root causes of rising motor premiums.' The FCA also published a review of its pricing reforms, which showed they have successfully narrowed the price gap between new and existing customers in both motor and home insurance. The reforms have curbed the practice of 'price walking,' where loyal policyholders were penalised with higher renewal premiums. "FCA finds external cost pressures driving motor premium hikes" was originally created and published by Motor Finance Online, a GlobalData owned brand. The information on this site has been included in good faith for general informational purposes only. It is not intended to amount to advice on which you should rely, and we give no representation, warranty or guarantee, whether express or implied as to its accuracy or completeness. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content on our site. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
The Independent
22-07-2025
- Automotive
- The Independent
Regulator finds ‘concerning' evidence of poor handling of insurance claims
Insurers have been told by the Financial Conduct Authority (FCA) to improve their claims handling, following 'concerning' evidence of poor practices in some cases. The regulator said that, while rising motor insurance premiums are largely driven by external cost pressures, shortcomings persist in how some insurers handle claims. FCA analysis indicated that increases in the cost of motor claims – due to higher prices for cars, parts, labour, energy and more complex cars and supply chains – have contributed to premium increases. The cost of hire vehicles, the number and cost of theft claims and uninsured drivers have also risen significantly. This confirms that increased costs outside of firms' control, rather than firm profit, were the biggest cause of recent premium rises in motor insurance. But the FCA did identify that referral fees from credit hire firms and claims management companies were associated with slower claims processing and increasing costs. Where it has seen poor practice from firms, the regulator said it is addressing it directly with them, including taking action against specific firms where necessary. The regulator said that 'concerning' evidence of poor claims handling practices included a lack of oversight of outsourced services, resulting in poor customer outcomes, delays in settling claims and high complaint volumes. It also found evidence of insufficient management information, resulting in failures to promptly identify and resolve claims handling issues. Cash settlements were also being used in some cases without sufficient consideration of whether they are most suitable, the regulator said. The FCA also highlighted high rejection rates for storm damage claims, saying only 32% of such claims made to a sample of firms in 2024 resulted in a payment. The regulator is also providing evidence for coordinated action from Government, industry, and other regulators, as part of the Government's motor taskforce, to help drive down the cost of motor premiums. This could help limit cost increases but it cannot prevent them, the FCA said. It has also published an interim update of an ongoing premium finance market study investigating whether consumers receive fair value when choosing to pay for insurance in monthly instalments. While premium finance allows customers to spread costs, making them affordable and providing flexibility, the regulator has found some firms earn much more money than it costs to provide the service. It will explore these concerns further in the next phase of the study. The FCA said it will seek to tackle any issues it finds first through the Consumer Duty, publishing a final report by the end of 2025. Sarah Pritchard, deputy chief executive of the FCA, said: ' Insurance provides peace of mind but people must be confident they can get a fair deal and be treated right when the worst happens. 'External cost pressures are primarily to blame for recent motor premium increases, not increased firm profits, but there is some more work to do on claims handling, particularly in home and travel. That's why we're stepping up – making sure claims are handled promptly and fairly and pushing for a coordinated effort to tackle the root causes of rising motor premiums. 'A well-functioning insurance market helps consumers navigate their financial lives and supports growth by building people's resilience to financial and personal shocks.' The FCA also said that evaluation of previous pricing reforms showed they are having the intended impact on the price gap between new and existing customers in both the motor and home markets. This means its reforms were effective in curbing 'price walking' where loyal customers were charged more at renewal, the regulator said.
Yahoo
21-07-2025
- Business
- Yahoo
Insurers should implement AI across the entire value chain
Underwriting and risk profiling is the area of the insurance value chain most positively impacted by AI, according to a GlobalData poll of industry insiders. However, the proportion of respondents selecting this area has declined from 2023–2025, suggesting growing interest in other applications of AI across the sector. GlobalData's poll run on Verdict Media sites in Q3 2025 has found that 45.8% of industry insiders believe underwriting and risk profiling is the area of the insurance value chain most positively impacted by AI. This was followed by claims management (20.3%) and customer service (17.6%). However, compared to Q3 2023, the proportion selecting underwriting and risk profiling fell by 9.6 percentage points (pp), and those selecting claims management dropped by 1.4pp. In contrast, customer service saw a 6.2pp increase, while product development rose from 1.9% to 7.2%, indicating a broadening perception of AI's potential across the value chain. Which area of the insurance value chain will most positively impacted by AI? Q3 2023 - Q3 2025 The shift in perceptions likely reflects the growing maturity and broader application of AI across the insurance value chain. While underwriting and risk profiling remains a key area, adoption has plateaued somewhat as insurers face challenges around regulatory compliance, data quality, and fairness concerns in risk models. At the same time, significant improvements in AI-powered automation, especially in customer service—such as faster response times, better triaging, and improved satisfaction—have led to increased confidence in its impact there. Similarly, the rise of product development reflects insurers using AI to analyse market trends, identify coverage gaps, and accelerate innovation in new offerings, which has become a bigger strategic focus as competition intensifies. To stay competitive, insurers should invest in developing AI capabilities across the entire value chain. This includes enhancing customer service with intelligent automation, using AI-driven insights to guide product innovation, and improving claims efficiency. Crucially, they must also ensure transparency, fairness, and regulatory compliance in all AI applications to build trust and long-term value. "Insurers should implement AI across the entire value chain" was originally created and published by Life Insurance International, a GlobalData owned brand. The information on this site has been included in good faith for general informational purposes only. It is not intended to amount to advice on which you should rely, and we give no representation, warranty or guarantee, whether express or implied as to its accuracy or completeness. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content on our site.
