Customer experience

San Mateo, Calif. - Siebel Systems Inc. is stepping up efforts to tackle the rise in fraudulent claims, the San Mateo, Calif., provider of customer-facing solutions reports. Analysts estimate that fraud in the U.S. has jumped 63 % in the past four years, and more than 25% of current U.S. insurance claims contain some element of fraud, contributing to an annual cost of at least $44 billion.

While CRM systems can get an organization 90 percent of the way toward reaching its customer relationship management objectives, the systems do not answer the key question of "why," according to CRMDirectory.com, a customer management website.

Alexandria, Va.-During the past year, the Agents Council for Technology (ACT), working closely with ACORD and agency management system user groups, has undertaken a major initiative to make commercial lines download more accurate and effective for independent insurance agencies and brokers.ACT's commercial lines download work group, which drew broad participation from carriers, vendors, agents, and user groups, has released a series of important recommendations toward this end.

Oakland, Calif.-A review of hurricane trends by EQECAT Inc. shows a more than a one in three chance of large hurricane catastrophe losses in the United States in the current season, based on current forecasts by the National Hurricane Center (NHC)."Although the current season might not be as severe and unusual as the 2004 season, the potential for large losses in 2005 is likely to be troubling to insurers and reinsurers, which will have to cover the potential hurricane damage claims," says Tom Larsen, senior vice president of EQECAT.

Columbus, Ohio - Healthcare Transaction Processors Inc. (HTP), Columbus, Ohio, announced it is integrating claim overpayment protection services (COPS) into its HTP Transaction Manager suite, which serves health insurers, HMOs, TPAs, IPAs and other medical payment organizations. COPS leverages ClaimsGuard technology from Bloodhound Inc., a Research Triangle Park, N.C., software company. The enhancement will enable real-time editing of claims before they are entered into the client's claim system. Through a series of business and clinical rules and other algorithms, COPS identifies anomalies in clients' claims data, such as potential overpayments, overutilization, duplicate claims and questionable provider billing practices.

Hartford, Conn. - The Innovation Group (TIG), a UK-based provider of policy, claims and conversion technology products and services, will partner with Document Sciences (DocSci), a provider of real-time content publishing products, to automate claims reporting.

Austin - United Teacher Associates Insurance Co. (UTA) is launching an initiative to Web-enable Medicare supplement insurance enrollment as well as routine agent services. The company recently signed with Cleveland-based IdeaStar Inc. to design, develop and host a state-of-the-art Web site for UTA-appointed agents. The site is targeted for launch this Fall. The site represents UTA's first foray into online, electronic signature-based enrollments for senior health and life products. Top producing UTA agents are eager to obtain online processes as they seek to stay competitive with market forces. The vision of UTA's President Billy Hill is to automate agent enrollment, agent servicing and the Medicare supplement insurance education and enrollment process. The new Web site is expected to process several thousand Medicare supplement applications per month in a paperless fashion. Senior life enrollment and other products will be added in the future.In addition, the new capabilities will help attract other agents into UTA's fold. "Site design and architecture, creating an enjoyable yet efficient and accurate agent experience, are critical in the effort to recruit and retain agents," says Mike Wise, vice president of IdeaStar Insurance Technologies. "The seamless integration with Lifepro, UTA's back-end administration system, will complete the workflow and enable high-speed policy issuance."

For insurers, handling claims is not only costly in terms of paying for damages, it ultimately can cost them customers: A poor claims experience will motivate angry policyholders to switch carriers.Processing paper-based claims creates bottlenecks that prevent effective communication between the affiliates in the claims value chain, a condition that inflates claims cycle time and impairs customer relations. As business leaders of claims departments huddle with their information technology counterparts, automating claims to more effectively assign, manage and close claims files has become the order of the day.

A national life settlement broker is taking an eBay-like approach to the secondary life insurance market, linking cash-strapped policyholders with institutional investors.In April, Life Settlement Insights drew a handful of institutional investors online to test the open-forward auction format of a new venture called LifeX, an electronic communications network that runs on a proprietary auction platform from HedgeHog Inc. Executives with Cleveland-based Life Settlement Insights claim they've created the life settlement industry's first online exchange and are considering extending the capability to other life settlement brokerages.

When executives for MetLife Retirement & Savings were considering how to make retirement planning easier for customers to understand, Chris McCloy decided to take matters into his own hands.In late 2004, the New York-based insurer had its eye on technology developed by San Francisco-based Macro-media Inc. Using Macromedia's Breeze technology, MetLife could offer plan sponsors and their employees customizable, online multi-media presentations-supported by Flash Player and delivered in a high-impact PowerPoint presentation.