Client Escalation for Insurance
Routes urgent or high-severity policyholder issues to senior leadership for rapid resolution and relationship preservation.
Aligns with ASIC regulatory requirements, General Insurance Code of Practice, and AFSL obligations. Includes audit trail provisions.
Workflow Stages
Escalation Trigger
Identify that the issue meets escalation criteria and initiate the escalation protocol.
Inputs
- Issue details and history
- Escalation criteria matrix
- Policyholder account tier information
Outputs
- Escalation notice filed
- Executive sponsor notified
- Policyholder informed that issue is being escalated
Situation Briefing
Prepare a comprehensive briefing for the executive team covering issue background, impact, and attempted resolutions.
Inputs
- Issue timeline and history
- Previous resolution attempts
- Policyholder account value and relationship context
Outputs
- Executive briefing document
- Recommended resolution options
- Risk assessment
Executive Intervention
Senior leadership engages directly with the policyholder to acknowledge the issue and commit to resolution.
Inputs
- Executive briefing
- Policyholder contact details
- Resolution authority
Outputs
- Executive-policyholder conversation notes
- Agreed resolution plan
- Commitment timeline communicated
Decision Points
- • Is an in-person meeting required?
- • Are concessions or credits needed?
Resolution Execution
Execute the agreed resolution plan with priority resource allocation.
Inputs
- Agreed resolution plan
- Priority resource allocation
- Implementation checklist
Outputs
- Resolution implemented
- Progress updates sent to policyholder
- Quality verification completed
De-Escalation and Review
Confirm the policyholder is satisfied, formally de-escalate, and conduct a post-mortem to prevent recurrence.
Inputs
- Resolution confirmation
- Policyholder feedback
- Post-mortem template
Outputs
- De-escalation confirmation
- Post-mortem report
- Process improvement recommendations
Frequently Asked Questions
How quickly does an executive respond?
Executives are expected to make initial contact with the policyholder within 4 hours of the escalation being raised during business hours.
What criteria trigger an escalation?
Escalations are triggered by service-level breaches, repeated unresolved issues, policyholder requests for management involvement, or issues impacting the policyholder business operations.
Is the policyholder charged for escalation-related work?
No, resolution of escalated issues is provided at no additional cost as part of the company commitment to policyholder satisfaction.
Ready to implement this workflow in your business?
Our team can implement this workflow into your business operations with custom tools and training.