Customer service

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.

Hartford, Conn. -ING, a global financial services leader, has begun offering its defined contribution clients many of the regulatory documents related to their retirement plan accounts in electronic form. Clients can choose to receive account statements and disclosure documents such as prospectuses, prospectus supplements and annual and semi-annual reports via ING's secure site."ING is committed to making it easier for customers to manage their financial information," says Jim Pedrick, senior vice president, worksite and institutional marketing, ING. "Many of our customers have told us they prefer not to get as much paper mail from us. It's a question of volume, and many also have an environmental concern. By offering e-delivery, our customers can now choose to receive regulatory documents from us electronically."

Hartford, Conn. - Aetna has enhanced its suite of consumer tools and information designed to enable members to more easily track and manage their health care expenses. Aetna members now can download their claims information to their personal computer via Aetna Navigator, Aetna's password-protected member Web site, enabling them to manage the information in a data file or spreadsheet. The option to keep claims information in a personal file is particularly relevant at tax time, when consumers often need to create a record of their medical expenses for tax deduction purposes."While Aetna members have long had the opportunity to view their claims activity on our Web site, this enhancement allows them to electronically 'grab' the information, save it in a file or spreadsheet, and sort it to best suit their individual needs," says Christine B. Skelly, head of health-related financial solutions for Aetna.

Geneva, Ill. - Professional liability insurer Insight Insurance Services Inc. has launched an upgraded and redesigned Web site with improved functionality designed to enable independent insurance agents to interact easily and quickly with company and better serve their clients.The new site, at www.insightinsurance.com, includes more tools and features to deliver downloadable forms and applications and facilitate paperless policies. The Web site is structured for easy navigation to Insight's three specific areas of professional liability expertise: architects and engineers, accounting professionals and insurance agents.

Columbia, S.C. - BlueCross BlueShield of South Carolina won a bronze World Wide Web Health Award for its online precertification, a feature on the company's Web sites that allows hospitals and physicians a quicker, simpler way to obtain authorizations.The World Wide Web Health Awards recognize the best health-related Web sites for consumers and professionals. The Health Information Resource Center (HIRC), a national clearinghouse for consumer health information programs and materials, organizes the program.

Wakefield, Mass. - Darwin Partners Inc., a provider of a range of IT services to Fortune 1000 companies, and Suzsoft Co. Ltd., a China-based provider of outsourced application development, quality assurance, and localization services, have announced plans to merge.Founded in 2001, Suzsoft is privately held and has grown rapidly to become a leading IT outsourcing platform in China specializing in several industry verticals, including financial services, health care, technology, insurance and telecommunications.

Washington - The National Association of Professional Insurance Agents (PIA), a Washington, D.C.-based national association that represents member insurance agents and their employees who sell and service all kinds of insurance, but specialize in coverage of automobiles, homes and businesses, has reaffirmed its opposition to any proposals that call for a so-called "optional" federal charter for insurers.

Glastonbury, Conn. - Open Solutions Inc., a provider of integrated, enterprisewide data processing technologies for banks and credit unions, today announced that it has completed its acquisition of the Information Services group of New Jersey-based The BISYS Group Inc., a provider of outsourced solutions to investment firms, insurance companies and banks.Open Solutions believes that this transaction will enable it to expand its product offerings, further increase its presence in the financial services marketplace and extend its client base to include the healthcare, insurance and corporate finance industries. Under terms of the completed agreement, Open Solutions purchased the Information Services group for a total cash consideration of approximately $470 million, subject to adjustment.

Brookfield, Wis. - Fiserv Inc. has acquired certain assets of CT Insurance Services and CCH Wall Street, two product lines of Wolters Kluwer Financial Services. The acquisitions, which include Xchange, Securities Registration and Producer Licensing software from CT Insurance Services and the Financial Training product line from CCH Wall Street, will add online application capabilities for insurance licensing and securities registration, along with NASD exam preparation courses to Fiserv's suite of products. Terms of the asset purchase were not disclosed.CT Insurance Services is a provider of enterprisewide systems for insurance licensing and securities registration. The Web-based systems from CT Insurance Services capture data at the origination point, enabling the filer to prepare and submit licensing and registration filings electronically. The Financial Training solutions from CCH Wall Street provide NASD Exam Preparation, including an interactive virtual learning environment, and innovative in-person and self-study solutions.

Denver - InsureMe, an insurance marketing company delivering leads to agents, has unveiled the InsureMe Agent Blog, which is designed to provide industry information to insurance professionals.A Web log, or "blog," is a self-published journal, made accessible to the public via the Internet. Unlike corporate Web sites, blogs are generally less formal and more interactive; the author posts an article and readers can respond with comments and questions.