Customer service

Newark, N.J. - Horizon Blue Cross Blue of New Jersey and WebMD Health Corp. have teamed up to provide Horizon BCBSNJ's members a new service called My Health Manager. The new online service is a personalized, interactive health application that provides Horizon BCBSNJ members with tools and health information resources they need to better assess, track, and manage their health."Horizon Blue Cross Blue Shield of New Jersey members now have access to reliable health information in the privacy of their own home whenever they need it through My Health Manager," says William J. Marino, president and CEO of Horizon BCBSNJ. "Working with WebMD, we are making health care easier by putting at our members' fingertips a powerful new tool and tremendous health resources."

Washington - At a hearing before the House Ways and Means Subcommittee on Health, Joseph Smith, senior vice president and chief information officer of Arkansas Blue Cross and Blue Shield, urged Congress to adopt a realistic timetable for a major shift in medical coding, moving systems from ICD-9 to ICD-10. Smith testified at the hearing, which focused on health care information technology, on behalf of the Blue Cross and Blue Shield Association (BCBSA).The bill Smith referenced, HR 4157, the Health Information Technology Promotion Act of 2005, calls for the major conversion of diagnostic and procedural codes that providers and insurers must use by 2009. Systems would change from ICD-9 diagnosis codes, which include 13,000 codes, to ICD-10, which includes over 120,000 possible codes.

Hartford, Conn. - Beginning May 3, Aetna will cover online physician-patient communications for members in California and Florida through RelayHealth, a provider of secure online health care communication services.RelayHealth enables online communication between doctors and patients, including clinically based doctor-patient consultations, appointment requests, the ability to get referrals, lab and test results, and electronic prescriptions and medication refills.

Andover, Mass. - CGI's special investigative unit (SIU) operating within Clarendon National Insurance Co. has concluded a probe that resulted in the arrest of four California residents. Six felony charges have been lodged in connection with a fraudulent auto theft claim that was filed with Clarendon.On March 1, 2006, California Insurance Commissioner John Garamendi announced the arrests and added: "These types of false claims cost all of us more in the form of higher insurance premiums. My department will continue to fight this fraud to help ensure a fair, affordable insurance system for all Californians."

El Segundo, Calif. - In response to interest, Computer Sciences Corp.'s board of directors has decided to explore strategic alternatives to enhance shareholder value, including a potential sale of the company.The company has retained Goldman, Sachs & Co. as its financial advisor in this process. CSC cautions that there can be no assurance the exploration of strategic alternatives will result in a transaction, and the company does not intend to disclose developments regarding its exploration unless and until the Board of Directors has approved a specific transaction.

New York - Lexington Insurance Co., a member company of American International Group, Inc. (AIG), has launced a new online site, www.lexaehelp.com, to provide relevant information to professionals carrying architects and engineers (A&E) liability insurance. The new Web site was created to provide insureds with access to ongoing education modules, contractual information and legal information resources."Because of the specialized liability concerns of architects and engineers, we created www.lexaehelp.com to give our A&E insureds resources specific to their field--including online classes that satisfy state requirements--to assist in mitigating risks and liabilities," says Kevin Kelley, CEO, Lexington Insurance Co.

Gilsbar Inc. has had a detailed disaster recovery and business continuity plan in place since 1996. The New Orleans-based third-party administrator, which handles claims for about 150,000 members, employs a certified disaster recovery specialist. And, the company's executives and technical staff go through tabletop disaster recovery scenarios at least twice a year.Like many other insurance companies, Gilsbar is prepared for catastrophes. However, when Hurricane Katrina hit last year, insurance executives were caught by surprise and had to act on their feet and respond to a bevy of unexpected circumstances.

I'm sure you've heard the one about the life insurance salesman who asked his client, "Do you know the present value of your husband's life insurance policy?""What do you mean?" countered the woman.

In a sign of the major benefits to be won by insurance firms that accentuate Web-based and electronic solutions, the Blue Bell, Pa.-based insurer PMA Insurance Group received superlative ratings in customer service in a recent survey conducted by an independent researcher.In the survey, J.P. Murphy and Co., a Malvern, Pa.-based marketing and opinion research firm, asked approximately 500 of PMA's active clients about the quality of customer service that the insurer offered in areas including claims processing, risk assessment, risk management and cost control.

Despite reeling from the worst year in history for claims losses, pundits say the insurance industry plans to increase its spending on claims technology in 2006. For some, the idea of stepping up to new technology sounds like the perfect way to address inefficiencies that continue to plague claims processing. To others, it's yet another Band-Aid that may or may not be effective in solving what has become a hushed, off-the-record issue: claims leakage."Claims leakage is the difference between what you spent on a claim and what you should have spent," says one East Coast health insurance claims executive, who, like many sources interviewed for this story, asked to remain anonymous.

According to the coalition Against Insurance Fraud, insurance fraud is an $80-billion crime wave. Unfortunately, most insurance carriers have neither the processes nor technology they need to stop fraud.Even so, as fraud schemes become more sophisticated, insurance carriers must examine an even wider array of data to identify fraud trends and detect fraudulent claims. To do this, they must institute a set of technology best practices and techniques to automatically detect fraud and abuse early in the claims process.

Seoul, Korea - In what is being called the largest deal of its kind for the financial services industry in Korea, Kyobo Life Insurance has contracted IBM to operate and manage its IT infrastructure.Under the terms of the 10-year agreement which has a total contract value of approximately 340 million U.S. dollars, IBM will provide IT strategy consulting services to help develop and advance Kyobo's IT vision and strategy. IBM will also manage the company's servers, storage systems, network and desktop computers and operate its data and disaster recovery centers. Additionally, IBM will provide IT skills development and IT management training services, called 'IT University', for Kyobo's employees.

New York and Emeryville, Calif. - After the completion of a successful 18-month pilot, Empire Blue Cross Blue Shield and RelayHealth Corp. are expanding the RelayHealth webVisit service to all members of Empire's HMO plan.Beginning July 1, 2006 more than 400,000 HMO members will have access to RelayHealth's Web-enabled doctor visits. As part of the expansion agreement, Empire will also make RelayHealth available to all of its national Administrative Services Only (ASO) accounts as a new benefit.

New York City - The National Association of Insurance Commissioners (NAIC) has launched a comprehensive public education program to assist consumers with information about insurance issues.Under the banner of "Insure U," the campaign has two objectives: to help consumers get smart about insurance as their needs change at different life stages, and to educate them about how to avoid being scammed by fake insurance companies. The program includes an online education site and public service announcements in English and Spanish.

Okemos, Mich. - Sircon Corp. and Efficient Forms LLC, Littleton, Colo., have formed an exclusive partnership designed to build on each other's products and customer bases to create an online platform for agent hiring, contracting and licensing for insurance agents, carriers and regulators. The partnership is a step toward creating a single online community where insurance carriers and their distribution partners can collaborate through an integrated, coordinated network, according to the two companies."This combination provides online capabilities that can transform processes between insurance carriers and their distributors," says Gary Gummig, vice president of business development at Sircon. "By integrating online services that will automate transactions and workflow, and virtually eliminate paperwork, this creates opportunity for unprecedented process breakthroughs."

Bettendorf, Iowa and Edison, N.J. - Fraud Resource Group, a business, insurance and identity fraud investigative and consulting firm, is using StrikeForce Technologies' products to launch a Web-based identity validation and authentication service, called the Trusted Customer program, which is designed to help prevent fraudsters from setting up fraudulent accounts and stealing high-value vehicles, goods and rental equipment.Construction equipment theft is a $1 billion annual problem, according to the National Insurance Crime Bureau, and only 10% to 15% of stolen equipment is ever recovered, according to the National Equipment Register. Fraudsters, posing as customers and contractors, use false credentials and stolen credit card data to "rent" vehicles, tools, and construction equipment. The rental stores lose equipment and potential income until a replacement arrives, and the legitimate credit card holder is left to dispute the charge.

Jersey City, N.J. and Oakland, Calif. - ISO and InsureWorx have formed an alliance to integrate ISO's Workers Compensation Information Services (WCIS) solution modules with the policy and claims administration software applications from InsureWorx.Under the agreement, customers of ISO's workers' compensation products and the InsureWorx PowerComp offering will be able to access and exchange policy and claims data seamlessly between the two companies' applications. This combination of InsureWorx's workflow processing software with ISO's data management and analytic tools is designed to provide workers' compensation carriers with a more comprehensive end-to-end solution.

Warren, N.J. - Property/casualty insurance and risk management increasingly play a role in financial planning, according to a survey by the Chubb Group of Insurance Companies.Fifty-seven percent of the 102 financial planners surveyed indicated that they evaluate their clients' asset protection through property/casualty insurance. An even higher number, 72%, said they determine if their clients have an appropriate level of liability insurance.

Edison, N.J. - More than 90% of insurance agents want 24/7, Web-based access to the information technology (IT) systems of U.S. insurance carriers, according to a survey of independent producers conducted by research firm Celent LLC.Technology tools that improve efficiency, communication and customer service also are highly desired by insurance producers, said the majority of the 215 producers surveyed by Celent for MajescoMastek, a software solutions provider to the insurance industry.

New York - At more than $40 billion in insured losses, Hurricane Katrina is the costliest hurricane on record. Insurers have tallied most of the property damage and business interruption losses, but Katrina's financial effects will continue to be felt for a very long time.Floodwaters in the aftermath of Hurricane Katrina bathed New Orleans and surrounding areas in a "toxic soup" of infectious organisms and hazardous chemicals. Ruptured oil tanks and pipelines covered portions of the area and nearby waters with an estimated 8 million gallons of oil. A resulting large number of environmental-related lawsuits have been filed, potentially exposing the insurance industry to billions of dollars in addition losses.