Huntswood partners with insurers to independently assess and enhance claims and complaints operating models, combining regulatory expertise, outcome-based assurance and industry benchmarking to improve customer outcomes, strengthen control environments and support long-term operational excellence.
The Challenge:
With increasing regulatory scrutiny around Consumer Duty, complaints handling and FOS outcomes, a leading UK insurance provider sought independent assurance to strengthen governance, improve outcome-focused reporting, embed effective learning from complaints and Financial Ombudsman Service (FOS) feedback, and ensure root cause analysis was driving meaningful business improvements.
Our Solution:
Huntswood conducted an independent, regulator-focused review of the insurance provider’s claims and complaints operating model, combining detailed analysis with outcome-based assessment.
Our approach included:
- Reviewing claims and complaints frameworks, policies, procedures, controls, governance arrangements, MI reporting and uphold data.
- Conducting structured interviews with senior leaders, operational managers and frontline colleagues to assess how processes operated in practice.
- Undertaking targeted file reviews across Home, Motor and Travel insurance, including complaints escalated to the FOS, to evaluate real customer outcomes.
- Applying Huntswood’s outcomes assurance methodology, assessing decision quality, harm identification, governance effectiveness, RCA maturity and the effectiveness of FOS learning.
- Benchmarking findings against FCA expectations, Consumer Duty requirements and recognised industry best practice to identify priority improvement areas.
This comprehensive review provided client with an objective view of both organisational strengths and opportunities to further enhance customer outcome delivery.
Outcomes & Impact Delivered
The engagement enabled the insurance provider to strengthen its claims and complaints assurance framework and embed a more outcomes-focused approach across the organisation.
Key outcomes included:
- Outcomes-Focused Governance: Established stronger governance structures that connected claims, complaints, customer risk and FOS insights, with clearer accountability, ownership and escalation pathways.
- Enhanced Management Information: Improved MI and reporting capabilities, shifting focus from traditional volume-based metrics to meaningful measures of fairness, customer experience, value and outcomes in line with Consumer Duty expectations.
- Embedded Learning and Continuous Improvement: Strengthened RCA processes and feedback mechanisms, ensuring complaint and FOS learnings were systematically integrated into quality assurance, reporting and operational change programmes.
- Stronger Controls and Assurance: Enhanced the control environment through outcome-based quality assurance, greater control documentation and the introduction of a more formalised Training & Competence framework.
- Improved Customer Outcomes: Drove greater consistency in decision-making, improved documentation standards and clearer customer communications, helping deliver more positive and sustainable customer outcomes.
Business Impact
By partnering with Huntswood, the insurer successfully evolved from a compliance-led oversight model to an outcomes-by-design approach, strengthening regulatory confidence, improving customer outcomes and reducing future remediation risk while creating a stronger foundation for ongoing operational excellence.