Date of Completion

4-10-2014

Embargo Period

4-8-2021

Keywords

Property and Casualty, Claim Cost, Claim Review, Stratified Sampling, Performance Metric

Major Advisor

Jeyaraj Vadiveloo

Associate Advisor

James Bridgeman

Associate Advisor

Brian Hartman

Field of Study

Mathematics

Degree

Doctor of Philosophy

Open Access

Campus Access

Abstract

Property and Casualty insurance companies looking to manage their risk exposure understand the importance of having a robust claim cost management process in their grasp. Claim cost management as a form of risk mitigation is no simple task. Often, claim managers rely upon findings from retrospective studies of historical claims. Despite P&C insurer's heavy reliance on the findings from claim reviews to make management decisions, academically rigorous techniques have hardly being developed in order to analyze the effectiveness of claim cost management. This PhD thesis fills the aforementioned void to an extent by exploring how claim professionals could utilize actuarial knowhow when evaluating a P&C insurance company for its claim handling effectiveness. The initial part of the thesis introduces several claim sample selection methods suitable for a comprehensive claim review. Proposed sample selection methods are developed on the theoretical foundations of the principle of stratified sampling and credibility theory. The latter part of the thesis describes a GLM based framework for a performance metric designed to benchmark the claim handling effectiveness of an individual company against their competition.

It is important to note that all the steps outlined in this research had to be preceded by the development of new P&C claim review system. This new claim review system is an integral part of this PhD research since it provided an academically and actuarially rigorous way of collecting and analyzing both qualitative and quantitative information in a P&C claim review process.

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