Customer experience

Denver - Despite some challenges, the health insurance industry continues to focus forward on initiatives that will enable patient-related data sharing in order to help eliminate errors and reduce overall costs. Anthem Blue Cross and Blue Shield in Colorado announced its participation in a voluntary data-sharing program developed by the Council for Affordable Quality Healthcare (CAQH), the company reports. The program, based on rules drafted by CAQH's Committee on Operating Rules for Information Exchange (CORE), is designed to link the data collected by health plans, providers, and vendors so that doctors can electronically verify their patients' insurance information in twenty seconds or less, significantly improving communications between providers and insurers. A report issued in February 2006 by Dublin, Ireland-based Research and Markets notes that insurers will benefit from a trend in widespread adoption of electronic capture of patient data. With solid benefits predicted, there still remain challenges, however. Alluding to the routine capture of documents and data for both regulatory and business intelligence purposes, the Research and Markets holds that "health care in the clinical setting has resisted this industry-transforming technology for nearly 20 years. The reasons: the lack of user-friendly interfaces for busy health care providers, lack of workflow understanding on the part of vendors, the expense and complexity of implementation and maintenance solutions, and the lack of transparent ROI for providers." Empirical data on long-term benefits for a program such as this may not be available yet, but carriers such as anthem BCBS nevertheless have high hopes for initiatives designed to create incentives for providers that will help improve communications between parties and create a "healthier" patient base in the process. The fact that the CORE program is a voluntary, industry-wide collaboration facilitated by Washington-based CAQH, may help the cause. Anthem has been certified as a CAQH CORE health plan and has already completed the Phase I implementation of the CORE rules, which allows for standardized data transfer and quicker response times. Physicians who link to the health plan through electronic data interchange (EDI) will be able to use EDI for this quick verification. EDI is a method for two organizations to confidentially exchange data from one computer to another using standard formats that are HIPAA compliant. Currently, Anthem's EDI is used for claims filing, claims status checks, eligibility verification, electronic remittance advices, and electronic fund transfers back to health care providers. "Anthem is committed to employing the most advanced information technology solutions available to improve both our members' experience and their interactions with physicians," said John Martie, president, Anthem Blue Cross and Blue Shield in Colorado, a subsidiary of WellPoint, Inc. "CAQH has developed an excellent framework for simplifying the administrative side of the health care system, and Anthem has worked diligently to ensure that we are capable of bringing the benefits of CAQH's efforts to our members." "These programs have the potential to transform the way that health care providers and health plans communicate," continued Martie. "But most importantly, they will take much of the confusion out of the health care system for our members." Sources: Anthem Blue Cross and Blue Shield, INN Archives

Kansas City, Mo. - Security, developing Web portals, and going paperless are among the top focus areas for IT staff at surplus lines insurance companies, according to a survey of NAPSLO members conducted in February by the association's communications & technology committee.

Needham, Mass. - The time is right for U.S. property and casualty claims insurers to aggressively exploit the business benefits of an enterprise mobility strategy, according to new research from research and advisory services firm TowerGroup. TowerGroup's report, "Mobile Solutions for US Property & Casualty Claims: Life in the Fast Lane," maintains that while using mobile solutions for settling claims is not new to the U.S. insurance industry, adoption for claims processing has been haphazard at best. Insurance carriers have been slowly bringing on mobile technology solutions to assist field workers with claims operations, yet the process has lacked focus and forward momentum. Given the strides made by mobile technology vendors in functionality, bandwidth and devices, mobility solutions for the insurance industry are increasingly reliable - and can yield significant value if developed within a coordinated strategic initiative, says the report. "Customers are increasingly expecting real-time, any-time service from their insurance carriers," said Karen Pauli, senior analyst in the TowerGroup insurance research practice in Needham, Mass., and author of the research. "While many insurers have various mobility irons in the fire, catastrophes like Hurricane Katrina quickly exposed the limits of the haphazard solutions that are in place. It's time for carriers to step back and create an enterprise strategy for mobility that encompasses all aspects of the claims process." Highlights of the research include: * Mobile initiatives will yield significant value for carriers when the implementation directly impacts the most critical business issues facing carriers today, including: disaster response; business continuity; and meeting regulatory and compliance mandates. The report also highlights the key actions carriers must take in order to create an effective mobile strategy. * Carriers can improve day-to-day claims operations, gaining competitive advantage and saving costs, by using predictive analytics to direct activities in a mobile environment. * Before carriers jump into an enterprise mobility plan, they must carefully review the needs and workflow of their claims personnel. "Today, few carriers leverage the breadth of available mobile technologies that could contribute to claims process efficiency," continued Pauli. "Instead, it's more common to see stand-alone applications that have little to no integration with other claims applications or services. Stand-alones don't scale well, usually lack extensibility and cost too much. Carriers must develop a more holistic approach to claims mobility, one that arms the adjuster with the key devices and applications necessary to get the job done in the most efficient and effective way possible." Source: TowerGroup

The insurance industry can't agree on a definition of the phrase "enterprise content management." Whatever it means, though, there's a consensus that it's improving.Many think of it as combining absolutely every kind of documented information the company owns and putting it into a paperless electronic central repository that imposes business rules, manages distribution and affords virtually unlimited access. That master file would house everything from this morning's jpegs to digitized versions of yellowing old paper-and-ink policies.

"Tiny House," the Geico spot for a fake reality series, has been hailed as the funniest ad on television. The commercial mimics TV's reality genre, seemingly promoting a non-existent show about newlyweds living in a house so small they can't stand up straight.Then there's the Cockney talking gecko who dispenses reptilian wisdom in a series of Geico advertisements. And who could forget the Geico ads with Charo prattling on in a very loose interpretation of a stone-faced policyholder's comments on his experience with a claim?

The customer relationship-it's a touchy subject. How do you make sure you're doing the right thing for each and every customer? How do you know if your follow-up on a lead wasn't duplicated by a coworker?Cottingham & Butler Insurance Inc., a privately held Dubuque, Iowa, insurance company, encounters those dilemmas daily. It's part of the job for a firm that offers employee benefits and risk management services, including property & casualty insurance, casualty claims administration, employee benefit brokerage and consulting, benefit claims administration, medical management services, wellness and disease management, and personal insurance services.

SITE SELLS POLICIES ON GROWNUP TOYSMarkel American Insurance Co., Waukesha, Wis., launched a Web site that provides a single access point to customers seeking to insure motorcycles, boats, personal watercraft and ATV.

AGENTS AND BROKERS ADOPT NEW RPOST E-MAIL SERVICELos Angeles-based RPost U.S. Inc. says independent insurance agencies and brokerages are adopting RPost as a service platform for outbound e-mail. Confronted with errors and omissions (E&O) liability exposures, agents and brokers need technology that enables them to optimize electronic communications while minimizing risk. By shoring up the security gap, RPost Registered E-Mail messages offer speed, security, accountability and personal liability protection in a cost-effective solution that can be used for an average cost of 59 cents per message. The company's services provide the e-mail sender with legally valid evidence of what e-mail content and attachments were sent and received, by whom and when.

What do agents want from their agency management systems? In its "Agency Technology Survey-Executive Summary," ACORD Corp.'s ACORD User Group Information Exchange (AUGIE) set out to answer this question and reveal other agency technology needs."The survey shows that many agents are frustrated with the process of having to go from Web site to Web site to get quotes-a process some liken to the situation 15 or 20 years ago, when we moved within our agencies from one company-provided terminal to the next," says Lisa Leach Goth, vice president of New Bethlehem, Pa.-based Charles P. Leach Agency and chair of the survey working group. She sees the survey findings as encouragement for carriers to support more uniform processes that work through the agent's own system.

Not so long ago, discussions of IT security tended to focus on the need to install firewalls; to tunnel via private networks; to employ encryption keys and digital certificates; to surround servers with multiple layers of access; and to install firewalls, sandboxes and "demilitarized zones" to snag hackers.Those tools and methods remain critical, but many in the IT community are recognizing the importance of addressing physical as well as digital vulnerabilities.

MASSMUTUAL UPGRADES PRODUCT MACHINE SOFTWAREThe disability income insurance area of Massachusetts Mutual Life Insurance Co. (MassMutual), Springfield, Mass., upgraded to version 3.1 of Product Machine, a set of tools designed to enable users to build, design and publish products.

Washington - America's Health Insurance Plans (AHIP) has collaborated with The Centers for Disease Control and Prevention (CDC) to develop a checklist insurers can use to prepare contingency plans for a flu pandemic.

Rochester, N.Y. – Many Americans are satisfied with how their personal health information is used, but a substantial number express reservations about the confidentiality and security of their health data, a new survey shows.

Washington, D.C. – America needs a public-private partnership to protect families from a devastating, massive hurricane or earthquake, the head of a coalition that includes insurers said in testimony this week before Congress. Such catastrophes have dulled the industry’s appetite for insuring against such events, said another witness, a representative of an agents’ and brokers’ association.

Washington - The National Association of Professional Insurance Agents (PIA) has asked its members to challenge the U.S. Chamber of Commerce’s recent endorsement of optional federal charters for insurers.

Unitrin Direct insurance cos., subsidiaries of Chicago-based Unitrin Inc., are offering a $50 discount in 17 states for customers who use Esignature, an service that lets customers sign policy documents online."One of our main goals at Unitrin Direct is to continually seek new ways to provide a terrific value on outstanding car insurance coverage," says Unitrin Direct President Scott Carter. "With Esignature, consumers not only save money instantly, they do it with the knowledge that they have a trusted company behind them that prioritizes customer service."

Johannesburg, South Africa – Insurers looking to enhance their contact centers may want to consider convergence, primarily driven by the increased acceptance of internet protocol (IP) and improved reliability, scalability and proven benefits that come with maturing product sets. According to the latest findings in Dimension Data plc's "Global Contact Centre Benchmarking Report 2007," more than 60% of contact centers—representing a number of industries across 42 countries and five continents—have introduced IP-based or hybrid IP private branch exchange (PBX)/automatic call distribution systems (ACD), which is an increase from the 50% recorded last year.

Dublin - Research and Markets, a Dublin research firm, released a new offering, “The Life Insurance Carriers Industry Report,” the company reports. The report includes 2007 and 2008 forecast estimates on the size of the industry (sales, establishments, employment) for the 47 largest world countries. The report also includes industry definition, 5-year historical trends on industry sales, establishments and employment and estimates on up to 10 sub-industries, including fraternal life insurance organizations, mutual association life insurance, and life insurance agents.

New York - A National Association of Insurance Commissioners personal lines working group expressed mixed feelings recently concerning a draft proposal that would authorize insurers to ignore current filed rates and competitively bid on applicants seeking coverage thorough a proposed electronic insurance exchange system. The "Alternative Recommendation for a Pilot Project Testing Pricing Freedom" draft, which was presented via conference call on February 22 to the Personal Lines Market Regulatory Framework Working Group, is based on the use of a technology platform called the "Insurance Exchange," sources at NAIC confirmed. The insurance exchange technology, first publicized by the Council of Insurance Agents and Brokers and reported in Insurance Networking News, March 2007, p. 6), is designed to streamline the underwriting process, says the NAIC draft proposal. The premise of the technology is to enable an insurance producer to complete a single application for a variety of insurance products and to submit that single application to multiple insurers. Insurers respond with a quote if they are interested in the risk. Once the applicant selects the insurer, the producer uses the insurance exchange to inform the insurer and the insurer issues the policy to the applicant. According to the draft proposed to the NAIC Working Group, which functions under the auspices of the NAIC's Speed to Market Committee, "In exchange for providing easy access to multiple quotations, the insurers could be offered pricing freedom through a pilot project that is enabled by interested insurance regulators." The proposal states that participating states use discretionary authority contained in current rating laws to enable a pilot project that: *Applies to personal auto insurance and homeowner insurance coverages (other products could be added); *Authorizes insurers to ignore current filed rates and competitively bid on applicants seeking coverage thorough the electronic insurance exchange system; *Allows an insurance producer selected by the applicant to assist the applicant with completion of a single application that is submitted through the system to all interested insurers; *Requires insurers to disclose coverage terms and conditions to the applicant, through the insurance producer, along with the competitive bid detailing the cost for the coverages requested by the applicant; *Provides insurance regulators with statistical information needed to evaluate whether the pricing freedom is providing applicants with sufficient information and broad selection among a variety of insurers and insurance products; and *Leads to a formal evaluation of the success or failure of the pilot project by participating states. The introduction of the draft, says Working Group chair D. David Parsons, Deputy Commissioner, State of Alabama Department of Insurance, was merely that: a simple introduction to the Working Group of the topic as "floating option" for possible consideration for a larger agenda of "developing a system that would be less intrusive, and that would allow carriers to get their products out to consumers in a more efficient manner." "We didn't have an official vote count or even a quorum," Parsons told INN, "but we did hear a number of states express disapproval [about the pilot], and a few that expressed positive feedback." Parsons attributes the disparate responses to the insurance industry's culture. "In some ways state regulation is cumbersome to the industry," he said. "There are so many diverse opinions. Our working group's charge is to try to improve that... get to the public more efficiently... at less cost to them and with good protection." Parsons admitted that the industry faces several large hurdles, including differences in filing issues, licensing issues and more. "There is a lot to be worked out," he said. "But this is a good group and they are passionate about their positions. We would like to see, at a minimum, flex rating come out of this," he said. Source: National Association of Insurance Commissioners

Kansas City, Mo. - Recent statistics show that while consumer complaints decreased for the third consecutive year, the reasons behind those complaints have remained relatively the same for the past five years: Consumers want faster customer service. According to data collected by the National Association of Insurance Commissioners (NAIC), the top three reasons consumers filed formal complaints against their insurance companies in 2006 were delays, denials of claims and unsatisfactory settlement offers. Rounding out the top five sources of consumer complaints were policy cancellations and premiums/insurance rating issues. The NAIC maintains a centralized electronic Complaint Database System (CDS), through which states voluntarily report “closed” complaints. A closed complaint is a complaint that has been investigated and resolved to the satisfaction of the state or jurisdiction in which it is filed. First established in 1990, the CDS was significantly expanded in 1998 and now houses more than 2 million complaints. A total of 190,572 consumer complaints were reported to CDS in 2006, a 7.8% decrease from the previous year. This information is based on the submission of data to the NAIC from the state insurance departments. The NAIC does not collect all complaint data from all states. Aggregate data compiled from the CDS can be accessed on the NAIC’s Web site through the Consumer Information Source link. By accessing this program, consumers can obtain company–specific complaint ratios (the ratio of the company’s market share of complaints compared to the company’s market share of premiums for a specific policy type), as well as aggregate counts of complaints by state and by type of coverage for specific companies. Below is details the top five types of complaints and the top five complained about insurance coverages for 2006. Included is the total number of complaints (for complaint type and line of coverage), followed by the percentage of overall complaints each type represents. (Example: “Delays” make up 21.9% of all complaints received by the NAIC in 2006.) Top 5 Types of Complaints in 2006: Delays: Total number reported: 41,647; Percentage 21.9% Denial of Claim: Total number reported: 3,601; Percentage 18.7% Unsatisfactory Settlement Offer: Total number reported: 26,556; Percentage 13.9% Cancellation: Total number reported: 12,467; Percentage 6.5% Top 5 Complaints by Type of Coverage in 2006:Auto: Total number reported: 71,302; Percentage 37.4% Accident & Health: Total number reported: 62,954; Percentage 33.0% Homeowners: Total number reported: 24,785; Percentage 13.0% Life & Annuity: Total number reported: 16,939; Percentage 8.9% Commercial Multiperil: Total number reported: 3,521; Percentage 1.9%