Mosaic’s Doroff: Paying claims is an essential part of an insurer’s identity

Since its launch in 2021, Mosaic Insurance has set itself apart by making claims an integral piece of its identity, according to the firm’s head of Americas claims Elissa Doroff.

“We employ a holistic approach; we work very closely between claims and underwriting,” Doroff told The Insurer TV.

“That means that at all stages of the process, before an insurance policy is bound, before there's a claim potentially, we really work with our underwriters.”

Mosaic wants to understand what exact wording directly mirrors the needs of an insured, and how they can best work with companies end to end, she explained.

“At the time of the initial meeting, claims is brought in, and they understand exactly what to do when and if a claim arises. [So] if a claim does come in, this is not the first time they're meeting us on the claims team.”

Because the company is relatively new in the space, it doesn’t have to deal with antiquated processes or sluggish legacy systems that need tweaking, Doroff explained. This means that Mosaic is able to create claims processes from the ground up for each client, using what’s most efficient.

“It’s really [about] doing away with a lot of the bureaucracy that some of the larger, older carriers may have and really being able to be nimble, and employ new techniques and procedures and policies to really respond the quickest when our insureds need it most,” said Doroff.

Top of mind for claims professionals currently are global cross-class issues that are impacting many industries, such as the use of AI, according to Doroff.

“This is not just one industry class per se. You're seeing this with financial institutions, you're seeing this with professional organisations, for example. We're seeing that a lot of employers are potentially using AI to screen potential applicants.”

While this can help efficiency, Doroff said caution must also be taken around new technologies, and proper protocols must be in place.

“Do we know that they're not exhibiting any bias and what controls and procedures do they have in place to ensure that AI isn't the only one making that decision?”

Another concern is making sure bias is kept out of lending.

“We need to make sure that this is not just an AI system, an algorithm, that's making the determination [and] that there really is a human component behind that.”

Doroff said Mosaic thinks about such issues seriously, and has a seasoned workforce capable of addressing these types of conundrums with confidence. While Mosaic is a young firm, its employees have dozens of years of collective experience behind them.

Dorroff started her career in claims, then moved on to the broker side, and also worked on the underwriting side as well, giving her a thorough understanding of every facet of the business.

But she realised her calling – the greatest value she could offer to companies and potentially insureds and their clients – was in claims.

“Really, just being the first call when there's an incident and being able to partner and say, ‘This is why you bought a policy and we're here to help you’, is really just my favourite part of insurance overall and working in claims.”

Being at a younger company offers Doroff more agency to take ownership of the claims process and make it her own.

“I made the decision that I want to be more involved at all facets and all times,” said Doroff.

Her wealth of experience has taught her that communication is key to the process.

“It's not meant to be an adversarial process, it's meant to be a partnership and an open dialogue.”

“If we need more information to adjust the claim and help the insured understand – help us both understand – how to get to the right result. That's where it's most important and the clarity is really what we're looking for and making that process as efficient as possible is really important,” said Doroff.

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