Data and information management

When online insurance marketplaces first appeared on the Internet horizon more than five years ago, they filled an important gap in carriers' online business strategies. At that time, most insurers had Web sites that industry experts mockingly referred to as "brochureware" to describe their informational, non-transactional qualities.Insurance marketplaces attracted the attention of consumers who were surfing the Web to comparison shop for auto, home and even life insurance. Typically frequented by young, Internet-savvy Generation Xers and baby boomers, these online insurance marketplaces provided participating carriers and independent agents with hundreds of leads from consumers who were patient enough to wade through screen after screen of questions before they received their prize: multiple quotes from brand-name insurers.

What are the most important IT considerations for complying with Section 404 of the Sarbanes-Oxley Act of 2002? By July 15, all U.S. companies under $75 million in annual revenue must demonstrate they know the answer to that question, because that's the deadline for complying with Section 404.However, due to the lack of specific directives and knowledge, many companies are struggling with how to reach compliance by that date-let alone wondering how they will afford continued compliance year after year.

New York - Helping members better analyze and report their returns on standards investments, ACORD released a return on investment (ROI) analysis toolset at the 2005 ACORD LOMA Insurance Systems Forum, held in Orlando on May 22-24.

Andover, Mass. - State National Companies, Fort Worth, Texas, has chosen CGI Group Inc., an independent information technology and business process services company, to provide full regulatory and statistical reporting services for their property and casualty book of business. Privately held, State National Companies includes three affiliates: State National Insurance Company, National Specialty Insurance Company and Texas-based State and County Mutual Fire Insurance Company.

Brookfield, Wis. - Fiserv Customer Centered Solutions (CCS), the customer relationship management (CRM) arm of Fiserv, launched its Enterprise Relationship Management Suite (ERM Suite), an integrated product line designed to address service and sales issues facing CEOs.

St. Paul, Minn. - Through aggressive health care fraud investigations and coordination among other states' Blue Cross plans, the Special Investigations Unit (SIU) of Blue Cross and Blue Shield of Minnesota stopped payment on more than $3 million of suspect claims last year, reducing the impact of fraud on premiums in that state. By comparison, Blue Cross stopped $8.7 million in claims in 2003, most of which was due to the rent-a-patient scams now being investigated and prosecuted in Southern California."We saved millions of dollars of our members' premium dollars, because we were able to identify the scam early and stop payment on fraudulent claims," says Dave Bohnenstingel, SIU manager. "In fact, Blue Cross and Blue Shield of Minnesota was integral in bringing the scam to light and the perpetrators to justice," he added.

Kansas City, Mo. - The National Association of Insurance Commissioners (NAIC) met last week to discuss steps to amend disclosure requirements for insurers that utilize reinsurance with limited risk transfer features, also known as finite reinsurance.

Kirkland, Wash. - The National Association of Insurance Commissioners (NAIC) has selected Ubmatrix, a Kirkland, Wash., supplier of software and services, to provide technical support and training in the development of an XBRL demonstration project for use with NAIC's insurance statutory financial reporting data.

Cleveland - The Compliance Consortium, an international membership organization formed in June 2004 to promote effective governance, risk and compliance management (GRC), has published its operational approach for managing GRC requirements within the enterprise. Applicable to both public and private companies, the framework is designed to assist senior management and boards of directors in setting objectives for managing a wide range of compliance-related activities and instituting the programs needed to attain those objectives. This initial version is a "public draft" and is intended to invite constructive criticism and ultimately to build a broad consensus within the hundreds of companies that have registered as part of The Compliance Consortium community over the past year. Leveraging the guidelines set forth by the U.S. Sentencing Commission, the Consortium has defined seven operational concerns to serve as a framework for organizing and managing GRC operations. These range from clearly assigning responsibilities at all levels of the organization to establishing incentives and discipline to promote compliance The Consortium has developed a list of 12 questions that board members and senior management should ask to help ensure organizations are on track with their GRC objectives."Unquestionably, the passage of the Sarbanes-Oxley Act has increased the focus for public companies on the areas of corporate governance, risk management and compliance," says Ted Frank, chairman of the Compliance Consortium advisory committee and president of Axentis. "It's important to remember that, for many companies, Sarbanes-Oxley is just one of hundreds of mandates from the SEC, FDA and other regulatory bodies that they must manage. Our goal with the creation of this framework is to help all organizations define, execute and ultimately profit from low risk and efficient governance, risk and compliance management, regardless of the specific regulation or statute."

Kansas City, Mo. - The National Association of Insurance Commissioners (NAIC) is taking steps to amend disclosure requirements for insurers that use reinsurance with limited risk transfer features, also known as finite reinsurance. The use of so-called finite reinsurance has received considerable attention over the past several months, because of its misuse by some high-profile insurers. State insurance regulators, working in a coordinated fashion through the NAIC, have been evaluating existing relevant statutory financial reporting since last fall. The latest proposed disclosures would require an insurer to report to state insurance regulators any agreement that has the effect of altering policyholders' surplus by more than 3%, or representing more than 3% of premium or losses. The new disclosure is also designed to identify any reinsurance contract that has been accounted for differently under statutory accounting principles compared to general financial statement purposes. Additional reporting requirements regarding contract terms and management's intention in entering the contract have been included to improve transparency. The provisions include that there are no separate agreements between the insurer and the reinsurer that could serve to modify the actual or potential losses under the contract, and that the insurer complies with all requirements of NAIC's statement of statutory accounting principle (SSAP) No. 62, "Property and Casualty Reinsurance."Source: NAIC

Fireman's Fund Insurance Co. Novato, Calif., has taken a third major step in its total IT transformation by awarding IBM a ten-year $94 million contract to modernize a major portion of the property/casualty insurer's application, development and maintenance software into an On Demand infrastructure that could reduce the number of major applications by 70 percent while improving customer service. When completed, the work could save Fireman's Fund $200 million, more than double the project's actual cost.With IBM's assistance, Fireman's Fund will shift its IT operations to an Internet-based computing model known as a "service-oriented architecture" (SOA) that enables consolidation of costly, redundant applications. Under Fireman's Fund direction, IBM will sift through mission-critical applications using a unique IBM Business Consulting process called Component Business Modeling to determine which applications deliver the most value to the business and which processes can be refined, consolidated or eliminated.

The National Association of Insurance Commissioners (NAIC) May 2 launched pilot project with five states to store electronic fingerprints of licensed insurance producers.

Quincy, Mass.--eStudentInsurance.com, a service of the Edvisors Network announced this month a new partnership with Worldwide Insurance Services. The Edvisors Network, a multi-national education services company, teamed up with Worldwide Insurance Services, a global leader in travel insurance, to create a new insurance policy for students traveling anywhere in the world. Global Student Health plans from eStudentInsurance.com are designed specifically to benefit international and domestic students by offering optimal affordable coverage, anywhere in the world.

Moncton, N.B. Canada--Whitehill Technologies Inc., a provider of document composition and data transformation software, has acquired the technology assets of Metaserver Inc. With this deal, Whitehill now owns the patented technology platform behind Metaserver's suite of business process integration (BPI) software and solutions for the insurance industry.

As director of MetLife Auto & Home's special investigations unit, John Sargent knows that eliminating fraud is an unachievable goal. But that hasn't stopped his company or other industry leaders from trying."Our goal is to pay what we owe, and not a penny more or a penny less," Sargent says. "The more efficient we are at identifying and preventing fraud, the better we can be at writing business at a more competitive rate."

In some ways, insurers' fraud-fighting efforts are similar to this nation's so-called war on drugs: Both endeavors require the right mix of people, technology and information to identify the criminals. Also, public awareness campaigns are part of the effort to change consumer behavior, whether it's to prevent drug use or prevent policyholders from filing bogus claims. And both involve elements of organized crime that use sophisticated tactics and technology to perpetrate their crimes.However, despite all of the resources that have been dedicated over the past decade to fighting drugs and fraud, we're no closer today to eliminating either problem. There have been many high-profile successes for each campaign, whether it's the seizure of a ton of cocaine on a ship at sea, or the combined work of insurance fraud investigators and law enforcement officials to uncover a multi-state, staged-accident fraud ring. But the fact remains that insurance fraud continues to cost the insurance industry $30 billion a year-and that's just counting fraud perpetrated against property/casualty insurers.

Industry experts often criticize insurers as being "laggards" in adopting new technologies. But carriers are leading most other industries when it comes to adopting scanning and imaging technologies, a new study concludes.For example, 86% of insurers surveyed by AIIM, an enterprise content management association based in Silver Spring, Md., are using scanned documents and images to answer inquiries from customers, compared with 73% of companies across all industries. Furthermore, 60% of carriers use scanned documents to respond to litigation, compared with 45% of all survey respondents.

As Web services continue to move closer to mainstream acceptance for application development, new research indicates performance concerns now exceed network security issues as a factor that's limiting adoption.A recent study by RESolution Market Research found that service-oriented architectures and Web services, supported by XML, are regarded as a key choice for application development because of ease of programming and data interchange.

At Erie Insurance Group, the foundation for fighting fraud is a business strategy that defines objectives, quantifiable goals, and tactical and operational plans: What is the company trying to accomplish? Does the company have enough resources to react to instances of fraud? How is Erie going to get better referrals to its special investigations unit and become more proactive in identifying fraud?"Erie is keenly aware that our experienced people-our claims adjusters, field investigators, intelligence analysts and information specialist-coupled with our use of fraud detection technology and investigation tools, have made our anti-fraud program so successful," says David Rioux, assistant vice president and manager, corporate security and investigative services for Erie Insurance Group, Erie, Pa.

In the aftermath of the terrorist attacks in 2001, many property/casualty insurers are now reassessing risk assessment strategies in metropolitan areas. As they do, the process involves looking deeper beneath the surface-literally.For example, how does an underground parking garage in Midtown Manhattan impact an insurer's risk position? Years ago, insurers that write commercial automobile insurance might have considered an underground parking facility to be a safe haven because autos were assumed to be better protected beneath street level.