Claims

Two groups focused on reigning in costs have established a primary care physician practice in North Carolina. Blue Cross and Blue Shield of North Carolina (BCBSNC) and UNC Health Care announced Carolina Advanced Health to eligible BCBSNC customers last month.

A day after the Insurance Information Institute released figures declaring 2011 the costliest year for P&C insurers covering U.S. cat losses, Munich Re and I.I.I. announced global cat figures.

Allstate is putting its money where its mouth is when it comes to claims service.

Looking to round out its core system offerings, Cover-All Technologies Inc. has acquired BlueWave Technology for an undisclosed amount of cash.

Predicting the future can be a fool's game, but planning for it is an operational necessity for insurers.

While expectations are not dwindling in the face of these challenges, respondents also complained that they are being given fewer resources to accomplish performance goals. According to a Towers Watson report, the bulk of 48 claims officers from small, medium and large insurers believe they have the authority to make a difference, but not necessarily "the range and depth of resources" to do so. To sidestep this detrimental trend, technology-in the form of electronic communications and processes-is being looked to as a bridge for the gap left by dwindling resources.

The United States set a record in 2011 in its declarations of federal disasters, and insurers are still playing catch-up with claims payouts. In fact, when all is said and done, insurers will have paid more than $32 billion in claims to help people rebuild homes and businesses damaged or destroyed by natural disasters in 2011, according to the Insurance Information Institute (I.I.I.).

Try as I might, some article assignments just don't elicit a very fevered response in me when first assigned (I'm looking at you, standards). This is never the case when it comes time to write about claims.

A Swampscott, Mass., man was convicted in a Salem Superior Court this week of bilking insurers out of $30K for claims fraud. Owner of two auto repair shops, Robert Giller, 53, plead guilty to 40 counts of fraud, which included 20 counts of filing false insurance claims, 18 counts of felony larceny and two counts of attempted larceny.

The top technologies in use today by P&C insurers today are portal technology, business process management and fraud scoring, according to a new report from Celent. The new study outlines all technologies being used by insurers and lays out their adoption rates.

Encinitas, Calif.-based Work Loss Data Institute (WLDI) released its 2012 State Report Cards for Workers’ Comp this week. The report, which is used to track trends and give states a grade and tier ranking based on their performance, now includes data from a 10-year period. Forty-three states are covered, plus Puerto Rico, Guam and the Virgin Islands.

Recent calculations from ISO and PCI indicate insurers faced extreme headwinds in their core business—underwriting.

With the stroke of a pen on Saturday, President Obama signed a continuing resolution that bought the troubled National Flood Insurance Program (NFIP) another week of funding.

Farmers Insurance was recognized for its claims handling system, which is driven by Pega technology from Pegasystems Inc., a Business Process Management (BPM) and customer centricity software company. The Workflow Management Coalition (WfMC) awarded Farmers a Silver Award as part of its 18th Annual Global Awards for Excellence in Business Process Management and Workflow.

GlobalOptions will serve as the Special Investigations Unit (SIU) provider to Argo Group US Inc., an international underwriter of specialty insurance and reinsurance products to P&C markets, and its subsidiaries.

JEVCO Insurance Co., a specialty insurer, is in production with ClaimCenter, the claims management solution from Guidewire Software, a provider of core system software to P&C insurers.

Keeping property repair rates down requires not only proper initial assessment, but occasional re-evaluations from an underwriting perspective as well.

Emergency Physicians Insurance Company RRG (EPIC) and Echo Ridge Partners have implemented iCatalyst, a policy and claims management system designed to streamline processes and improve customer service throughout an entire policy lifecycle.

From a catastrophe-loss standpoint, 2011 is more likely to be remembered for the variety and frequency of loss events rather than a singular catastrophe.

FINEOS Corp., a provider of claims management software, is including the IBM Insurance Framework in its product. FINEOS says insurance solutions offered by IBM are built on the IBM Framework and aim to create more flexible, responsive insurance companies through the progressive transformation of operational processes. FINEOS, a partner of IBM, offers FINEOS Claims, a solution to manage claims for life and disability, P&C, London market and government insurance.