Resilience in Insurance

Resilience in insurance is about a policyholder being helped at the moment a loss has already happened. The central services are buying and renewing cover, reporting a claim, having that claim assessed, and receiving payment or repair. When those services stop, the harm compounds an existing hardship. A household with a damaged home cannot arrange repairs. A driver whose car is off the road cannot travel to work. A business with interrupted trading cannot restart. The customer is not inconvenienced in the abstract. The customer is already coping with damage, and the service failure adds delay, uncertainty, and cost on top of it.

The claims journey is the service customers judge, and it has several stages that can fail independently. Reporting a claim might fail if phone lines or digital intake are down. Assessment might fail if the claims platform cannot retrieve the policy, or if loss adjusters cannot be assigned. Payment might fail if the payment system or the banking partner is disrupted. Repair might fail if a supplier network cannot receive instructions. Each stage needs its own description, because a customer whose claim is reported but not assessed is in a different position from a customer who cannot report at all, and the communication each one needs is different too.

Policyholders are harmed by delay and by uncertainty. A household waiting on a claim decision cannot commit to repairs, cannot plan temporary accommodation, and may pay out of pocket without knowing whether the cost will be reimbursed. A business waiting on a business interruption payment cannot pay staff or suppliers with confidence. A claimant who cannot reach the insurer at all may assume the claim has been refused, when in fact it has never been recorded. The harm is therefore not only financial. It is the stress of an unresolved loss, extended by a service failure that the customer did nothing to cause.

Insurance depends on its claims platform and policy administration system, on telephony and digital intake, on payment partners, and on a network of adjusters, repairers, and suppliers who are often independent firms. It also depends on data: policy records, claims history, and pricing information that must be accurate for a claim to be assessed. A corrupted or unavailable policy record can halt assessment even when every system is running, because the assessor cannot establish what cover applies. Data accuracy is therefore a resilience question in insurance, not only a data quality question.

A useful insurance test follows a claim from first report to payment under strain. One example is a storm surge combined with a claims platform outage: can claims still be reported by another route, can urgent claims be identified and prioritised, and can payments still be made for claims already assessed? Another is a payment partner disruption: can the insurer tell claimants honestly when payment will arrive, and can it prevent duplicate payments when the partner recovers? A third is a policy record problem: can assessment continue from a backup record, and how is any uncertainty about cover communicated to the claimant?

Check whether the plan follows the full claims journey, stage by stage, and whether each stage has a fallback that has been tested under surge conditions. Check whether triage criteria are written down and fair, and whether the plan names the customers for whom delay causes the greatest hardship. Check whether repair and assessment partners are in the recovery sequence, not only in a supplier list. And check which regime is being applied: DORA, which applies from 17 January 2025, and the UK regime under FCA PS21/3 and PRA PS6/21 are labelled separately in this guide.