Forensics Today

PwC perspectives on the newest risks drawing investigator scrutiny

Streamlining and securing your settlement claims program

  • Administrators of complex claims, class-action and mass tort settlements face stakeholder pressure and documentation challenges as they attempt to deliver efficient, fair and equitable payouts.
  • Stringent controls and documentation requirements, while important to safeguarding settlement funds from fraud, can also delay payouts and cause undue hardship for claimants.
  • Claims administrators should strike a balance between diligence and efficiency, establishing clear, streamlined documentation requirements, integrating advanced technologies and analytics, and leveraging third-party data into their claims review processes.

Running a settlement claims program can be a challenging balancing act, especially in high-profile class actions, mass torts and victim compensation funds. Claims administrators can face intense pressure to provide timely payouts to injured parties, many of whom may have waited years for compensation. That pressure can escalate quickly in these settlements — involving victims of wildfires, flooding, terrorism, environmental contamination, workplace injuries, harmful consumer products, sexual abuse, etc. — once they’ve captured the public’s attention.

At the same time, administrators have a duty to carefully vet the eligibility of claimants and guard against excessive, unsupported or fraudulent claims. This typically requires more stringent review and supporting documentation, which can delay payouts to injured parties.

How can administrators find the right balance between diligence and efficiency to achieve a fair, equitable result for all stakeholders? It starts with leveraging advanced technology, data analytics and third-party data to verify and stratify claims, thus accelerating processing times. Ample communications, stakeholder engagement and process transparency can bolster trust and operational excellence. Clear and streamlined documentation requirements can help claimants demonstrate their eligibility without undue burden. Taken together, these steps can help build integrity and efficiency into a process that’s otherwise at risk for delays, frustration and abuse.

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Ryan Murphy

Partner, Global Investigations & Forensics Leader, PwC US

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