Core systems

Branchville, N.J. - Selective Insurance Group Inc. announced that its principal subsidiary, Selective Insurance Company of America, made several management changes as part of its leadership development process that created new roles for existing officers.

Lansing, Mich.–A new Web-based sales and training tool from Jackson National Life Insurance Co. (Jackson) is designed to help simplify the process of selecting an optional living benefit within Jackson’s family of variable annuities. The Living Benefits Selection Center (LBSC) enables registered representatives to get instant, client-approved output based on a client’s profile information after answering a handful of qualifying questions. The tool also features multimedia presentations, fact sheets and side-by-side comparisons of Jackson’s optional living benefits.

Menlo Park, Calif.—Fourteen percent of chief information officers polled for the Robert Half Technology IT Hiring Index and Skills Report expect to add IT staff in the fourth quarter of 2007, while 2% anticipate cutbacks. The net 12% hiring increase compares to net increases of 15% projected last quarter and 10% projected last year. The majority of respondents, 83%, foresee no change in fourth-quarter hiring.

Stamford, Conn.—A recent release from Pitney Bowes Inc. announced its Pitney Bowes Group 1 Software and Pitney Bowes MapInfo business units, acquired separately, will combine into a single software company. The move is effective immediately, and the businesses will merge operations over the next several months.

Warren, N.J.–The Chubb Group of Insurance Companies has created ePolicy, a secure electronic insurance policy, to streamline the delivery of personal insurance policies and reduce environmental waste.

Washington, D.C.—Life insurance producers could save hundreds of millions of dollars annually in licensing fees if Congress enacts legislation creating an optional federal charter (OFC) system for the insurance industry, according to a new study by Dr. Laureen Regan, associate professor with Temple University’s Fox School of Business and Management

London - Karen Clark, considered the founder of modern day catastrophe risk modeling, has received the Review Worldwide Reinsurance Awards' Lifetime Achievement award for outstanding long-term contributions to the reinsurance industry.

New York - Insurers of all sizes hoping to take a proactive approach to cracking health claims fraud seem to understand the stakes: According to estimates from the federal government and issues-based groups such as the National Health Care Anti-Fraud Association, as much as 10% of all healthcare expenditures in the United States, or $170 billion, may be lost each year to fraud, waste and abuse. Carriers still struggling to keep up with claims fraud may also do well to recognize that there is yet another piece of ammunition available. From its research laboratories in New York, IBM has pooled data mining and analytics technologies to create a software-as-a-service product designed to identify potentially fraudulent and abusive behavior before a claim is paid, or retrospectively analyze providers' past behaviors to flag suspicious patterns. Non-profit provider Excellus Blue Cross Blue Shield in Rochester, N.Y., which counts two million members, is the latest carrier to contract with Big Blue to thwart fraud. The company will use IBM's on-demand Risk Identification Analysis Service to review pharmacy-related claims to uncover complex schemes. Some of these schemes may include collusion, inappropriate billing practices, prescription forging, prescription pad theft and members who are "doctor shopping." "Make no mistake about it-someone who knowingly commits insurance fraud is no different than any other person who steals," says Flora Allen, corporate director, special investigations unit, Excellus BlueCross BlueShield. "Fraud affects everyone's bottom line, so we aggressively and proactively pursue recoveries and convictions because we are protecting our members' premiums." Although the stakes are high for Allen and her organization, which processed somewhere between 51 and 52 million claims in 2006, there is no real way to calculate the hard and soft costs, she says. "We are only as good as what we can find," she told Insurance Networking News. "Adding the Risk Identification Analysis Service from IBM to our existing investigative arsenal improves the analytical capabilities we need to find and identify the most egregious offenders." That arsenal includes a fraud hotline, which is available to all members, and a link on the company's Web site where anyone can provide anonymous tips. The insurer also participates with law enforcement task forces, and shares that information the U.S. attorney's office. Based on IBM's Fraud and Abuse Management System (FAMS) technology, which was developed by IBM Research and consultants in collaboration with leading healthcare organizations, the Risk Identification Analysis Service uses a combination of data mining capabilities, visualization techniques and reporting tools to identify questionable behavior before a claim is paid. It replaces traditional manual processes by sorting though tens of thousands of providers and tens of millions of claims in minutes-ranking providers as to their degree of potentially fraudulent, wasteful, abusive or questionable behavior. Allen says their company does not consider whether, as a whole, fraudulent claims are on the rise or may be decreasing. "When it comes to fraud, it's an issue that always appears larger than life and we are getting better at discovering it." IBM hopes that by designing the offering as an on-demand service, it will appeal to insurers of all sizes. "By providing these powerful data mining and advanced analytical capabilities as an on-demand service, we are able to offer this investigative capability to smaller healthcare payor organizations, or government healthcare insurance entities, which may prefer to use this advanced analytic capability as a service, because of the lower demands on their staff and IT capabilities," says Mark Ramsey, global data analytics leader, IBM Center for Business Optimization. "It can also easily be used by larger, private payors looking to use this capability as a service instead of implementing the FAMS solution internally." In addition to pharmacy claims, the service can analyze approximately two dozen other specialties such as cardiology, home health care, gastroenterology and durable medical equipment suppliers. Sources: Excellus Blue Cross Blue Shield, IBM

Columbia, S.C. - BlueCross BlueShield of South Carolina plans to electronically integrate personal health records with medical care plans and make these available in real time to BlueCross members and their health care professionals.

Needham, Mass. - As the insurance industry becomes more immersed in service oriented architecture (SOA) technologies, few outside organizations are available that provide peer review, guidance and cross-industry advice. Penn National Insurance, a Harrisburg, Penn., mutual company that provides a wide range of insurance, however, seems to find such an organization. Penn is among 31 others joining the newly formed SOA Consortium since it's inception on May 1, signaling the onslaught of business organizations across vertical markets requiring SOA-related information.

AGENTS DEMAND REAL-TIME SERVICEIndependent insurance agencies are poised for a major service breakthrough with the proliferation of real-time transactions, says a prominent participant in the industry-wide push to double real-time transaction volume in a year.

PPS SOFTWARE SUITESkywire Software, a Frisco, Texas-based provider of software products for the insurance industry, announced the availability of a reporting tool for PPS, its policy production system for managing general agencies and wholesalers.

VALUATION SOLUTION REDUCED CLAIMS SETTLEMENT CYCLEPlymouth Rock Assurance Corp., Boston, selected San Diego-based Mitchell International Inc.'s, Total Logic Valuation as the company's total loss valuation solution to deliver a customer-centric loss claims process.

Westlake Village, Calif. - Policy retention is critical to the financial success of auto insurance carriers, and a customer's experience with their provider is the most important element—outweighing brand image—in generating policy renewals, according to the "J.D. Power and Associates 2007 National Auto Insurance Study."The study measures customer satisfaction with auto insurance carriers across five factors. In order of importance, they are: interaction, policy offerings, billing and payment, price and claims.

Boulder, Colo. — IT risk management is no longer strictly about mitigating the negative threats surrounding IT, a new study finds. The study was published by Boulder, Colo.-based independent IT management research and consulting firm Enterprise Management Associates (EMA).

New York – Two life insurers recently appointed a number of executives. ACE Life Insurance Co., a business of Bermuda-based ACE Ltd., named Jim Gibbs as vice president and chief underwriting officer and Bruce Horton as vice president and chief marketing officer. Gibbs joins ACE from Optimum Reinsurance Co., Dallas, where he was senior vice president, underwriting. His previous experience includes positions at SCOR Life US Re, Dallas, and Munich American Reinsurance, Atlanta. He is a past president of the Southeastern Home Office Underwriters Association, and he has been a speaker at many industry gatherings, addressing both underwriting and actuarial groups on various topics.

Chicago – A new study evaluates the home pages and usability of 14 major auto insurance providers’ Web sites to examine customer expectations and discover where companies succeed or fail in attracting and retaining customers.

Armonk, N.Y. - U.S. consumers want insurance companies to more effectively communicate new products and services available to them, provide customized policies to better meet their needs and bring their customer experience up to par with other industries, according to an IBM study of more than 3,000 P&C insurance policyholders. Yet, despite boasting one of the largest demographics of loyal and satisfied customers of any industry, few insurance companies are looking for new and innovative ways to connect with their customers to enhance their experience and drive organic growth.

Boston – Liberty Mutual Group has made its acquisition of Ohio Casualty Corp. official. Liberty first announced its intention to purchase the Fairfield, Ohio-based carrier for $44 per share in cash in May.

Washington – The heads of two insurance industry associations have issued a joint letter urging the National Governor’s Association to drop their opposition to the National Insurance Act.