Claims

Roughly a decade after insurance carriers began adding customers' credit scores to the stew of statistics used to set premiums for auto and homeowner's coverage, negative reaction and feedback appears to be waning.Opponents still contend that credit scoring tends to raise premiums overall, that it doesn't correlate directly with risk and that it may serve as a proxy for racial and ethnic discrimination, because some minority groups have lower incomes and are more likely to have credit problems.

BANKS SHOULD SET SIGHTS ON RELATIONSTo entice customers to buy more financial products and services, financial services companies need to focus on improving their relationship strategies, according to Gartner Inc., a research firm headquartered in Stamford, Conn.

ISTREAM TO INCLUDE NEW FUNCTIONALITYWhitehill Technologies Inc., Moncton, New Brunswick, announced new functionality in the IStream document automation suite, including IStream Publisher and IStream Document Manager. The IStream suite is designed to enable business users to create 'model documents' that control the language, layout and look of complex files, such as policies and contracts. IStream can be used to create and control virtually any kind of insurance document, from contracts to welcome kits to group booklets. New functionality includes add-ins for Microsoft Word and Adobe Reader, letting users create complex documents in a familiar, easy-to-use, interactive environment. As data or standard wordings change, users can automatically update their documents to reflect those changes. Leveraging industry-standard applications gives insurers the power to create and update documents easily as part of their normal processes.

An accident or catastrophe brings the moment of truth between a carrier and a policyholder. All too often, it's the only interaction between the two parties. The result is a relationship vulnerable to unwanted surprises.For example, a policyholder suffering a loss because of a fire may find a policy failed to cover enough of the current value of the property to make it whole again. Years of appreciation as well room additions and remodeling may not have been updated in the policy.

XL GLOBAL TO USE INTERCEPT TO MANAGE PROCESSESStamford, Conn.-based XL Global Services Inc., a part of the XL Capital Ltd. group of companies, will use Intercept Studio, a flagship product from Baltimore-based AVIcode, to manage business processes worldwide.

Converting a book of business to a new system can be viewed by some as the riskiest part of a new system implementation. However, with proper time and resources, conversions need not be feared. They are all part of the system migration, which is to enable the company to improve its ROI and competitiveness. Each company needs to assess the cost, time and benefits, and if sufficient resources and time are allocated, success is manageable.In single-phase conversions, all data is converted at one time with two options. Sufficient history levels (number of years) are converted that enables the discontinuance of the existing system. And the latest versions of data are converted to allow the new system to be used for all future transactions. The existing system is retained for a period of time for inquiry purposes into past transactions.

Boston, Mass. – Insurers around the country are making changes to their technology areas with the naming of new executives. Three such examples are Liberty Mutual Group, The Guardian Life Insurance Co. of America and NYMagic.James McGlennon has been appointed vice president and CIO for Liberty Mutual Agency Markets, a strategic business unit of Boston-based Liberty Mutual Group that consists of property/casualty and specialty insurance carriers that distribute their products and services primarily through independent agents and brokers.

Chicago - The Blue Cross and Blue Shield Association (BCBSA), Chicago, has established physician and employer advisory groups to further enhance the market development of its Blue Health Intelligence (BHI) initiative, the nation's premier healthcare database comprised of de-identified claims information from up to 80 million lives. "The addition of these groups will help BHI maintain its leadership in healthcare informatics," said BCBSA President and CEO Scott Serota. "We look forward to working with this esteemed group of employers and physicians. Their hard work will result in a database that will enhance the quality of information available to consumers, providers and employers." Launched in 2006, BHI will provide sharper insight into healthcare trends, delivery and best clinical practices, and information about the efficacy of treatments and new medical technologies. BHI compiles, analyzes and organizes data, which can then be used as benchmarks to conduct comparative analyses across a range of healthcare components. The first sets of benchmark data were released to participating Blue Cross and Blue Shield companies in December 2006. "The advisory groups will provide high-level strategic counsel and recommendations that will help us provide insight into important health issues," said Bob Greczyn, Jr., president and chief executive officer, Blue Cross and Blue Shield of North Carolina, and co-chair of the BHI board. The employer and physician advisory groups will be responsible for contributing research-based insights into issues critical to the public's health. In addition, they will monitor new market initiatives in the areas of healthcare costs and quality data, and track healthcare literature and trends in practice and technology. With this knowledge, these advisory groups will help identify opportunities for BHI to form new healthcare solutions in quality and transparency for employers, providers and consumers. "This input from the groups will guide BHI as it continues to establish itself as the most comprehensive collection of healthcare information in the industry," added Alice F. Rosenblatt, executive vice president, integration and information management officer and chief actuary, WellPoint Inc., and co- chair of the BHI board. The groups will meet separately with the first meetings convening this summer. Members will serve one, two-year term. The following is a roster of BHI's employer and physician advisory groups. BHI Employer Advisory GroupMember / Title / Company-- Delia Vetter, Senior Director of Benefits, Employee Services & Programs, EMC Corporation-- Bill Greer, Vice President, Benefits, Kellogg Company-- Mike Stoll, Vice President, Benefits, The Kroger Co.-- Greg Heaslip, Vice President, Benefits, Pepsico-- Bob Ihrie, Vice President, Compensation and Benefits, Lowe's Cos. Inc.-- Steve Lampkin, Vice President, Benefits Department, Wal-Mart Stores Inc.-- Mark Cullen, M.D., Professor of Medicine & Public Health, Yale University School of Medicine; Senior Medical Director, ALCOA-- Jeanne Denz, Director, Global Benefits, General Mills-- Martin Storey, Director of Benefits, Michelin North America-- Tom Jecklin, Manager, Healthcare Benefits, State Farm-- William Strahan, Vice President, Compensation and Benefits, Comcast-- Daniel Green, Deputy Associate Director, Center for Employee and Family Support Policy, Office of Personnel Management-- Anna Fallieras, Program Leader, Health Care Initiatives, GE Company-- Pascale Thomas, Director, Benefits, Corporate Human Resources, Verizon Communications Inc. BHI Physician Advisory GroupName / Employer / Contact, Title / Company-- H. Frank Farmer, Jr., M.D., Chairman and Practicing Physician, Florida Board of Medicine-- David Blumenthal, M.D., MPP, Samuel O. Thier Professor of Medicine and Health Policy, Harvard Medical School; Director, Institute for Health Policy, Massachusetts General Hospital/Partners HealthCare System-- Thomas Henry Lee, Jr., M.D., Professor of Medicine, Harvard Medical School, Network President, Partners HealthCare System-- Joel Bender, M.D., Ph.D., Corporate Director of Health Services, General Motors Corp.-- James R. Claflin, M.D., Specialist, Oklahoma Allergy and Asthma Clinic-- Kelly Kelleher, M.D., MPH, Professor, Ohio State University; Vice President for Health Services Research, Children's Research Institute, Columbus, Ohio-- David Filipi, M.D., MBA, Vice President, Medical Affairs for Methodist Physicians Clinic, Methodist Physicians Clinic, Omaha, Neb.-- William L. Roper, M.D., MPH, Dean, School of Medicine and CEO, UNC Health Care System, University of North Carolina-- Alan M. Garber, M.D., Ph.D., Henry J. Kaiser Jr. Professor; Director, Center for Health Policy; Director, Center for Primary Care and Outcomes Research, Stanford University; Staff Physician, Department of Veterans Affairs-- Jonathan B. Perlin, M.D., Ph.D., MSHA, FACP, Chief Medical Officer and Senior Vice President for Quality, Hospital Corporation of America (HCA)-- Frederick L. Brancati, M.D., MHS, Professor of Medicine & Epidemiology; Director, Division of General Internal Medicine, Johns Hopkins University-- Mark Cullen, M.D., Professor of Medicine & Public Health, Yale University School of Medicine; Senior Medical Director, ALCOA-- Allan Korn, M.D., Senior Vice President and CMO, Office of Clinical Affairs, Blue Cross and Blue Shield Association Source: Blue Cross Blue Shield

London - Guy Carpenter & Company LLC, a New York-based global risk and reinsurance specialist and part of the Marsh & McLennan Companies, will mandate the use of electronic claims file (ECF) for in-scope claims for all Lloyd's markets from Jan. 1, 2008. This decision follows the successful implementation of Guy Carpenter's ECF initiatives and underscores the firm's commitment to further market reform, according to the company.

Los Angeles - Farmers Insurance Group of Companies opened its second ServicePoint operation. The new call center is based in Austin, Texas and is dedicated to providing service and care to Farmers agents and their customers. The other center is in Olathe, Kansas.

Dublin, Ireland - The lack of a structured prioritization model for allocating risk and fraud budget resources is hindering many financial institutions in their fraud mitigation efforts, according to Research and Markets, which has announced the addition of new Javelin Strategy report "Risk & Fraud Budgeting Model: Prioritizing the 2008 Budget for Effective Fraud Mitigation" to their offering.

Washington, D.C. - The Department of Justice and FBI announced the results of an ongoing cyber crime initiative called "Operation Bot Roast," which has identified more than one million victim computer IP addresses.

Boston - AIR Worldwide Corp., (AIR) released Version 9.0 of its U.S. Hurricane Model, which includes enhanced methodology for estimating business interruption (BI) losses, which accounts for both building and business characteristics when estimating total BI downtime and includes indirect losses from sources other than physical damage to the insured building. The release also includes enhancements to the model’s demand surge function, the vulnerability of residential contents and pool enclosures, and incorporates research by AIR meteorologists and climate scientists into the link between elevated sea-surface temperatures (SSTs) and U.S. landfall activity. “In the aftermath of the 2004 and 2005 hurricane seasons, AIR undertook an intensive research and development effort to improve the way catastrophe models estimate business interruption losses,” according to Dr. Jayanta Guin, senior vice president of research and modeling at AIR Worldwide. The software also estimates indirect business interruption losses—those stemming from sources other than physical damage to the insured building—such as utility service interruption, actions taken by civil authorities, dependent building damage, and extended period coverage. The new model has been validated using detailed claims data from 2004 and 2005 hurricane seasons. Boston-based AIR is also providing an update to Version 9.0 of the U.S. Hurricane Model’s near-term catalog, which incorporates an additional 12 months—and several man-years—of research by AIR meteorologists and climate scientists into the link between elevated SSTs and U.S. landfall activity. Rather than relying on highly uncertain point forecasts of sea-surface temperatures, the Version 9.0 near-term catalog is instead conditioned on the assumption that currently elevated SSTs are likely to remain elevated for the next five years. As a result, the inclusion of one additional hurricane season will not significantly change estimates of near term risk. However, uncertainty in near-term estimates of landfall frequency remain significant, so AIR is once again releasing the near-term catalog as a supplement to, rather than a replacement for the standard catalog, which is based on more than 100 years of historical data. Analysis of claims data from recent hurricane seasons has revealed that contents vulnerability for single-family homes has decreased significantly in recent years. The updated model accounts for this trend. The model has also been enhanced to explicitly account for the impact of hurricane winds on pool enclosures, structures that—according to AIR’s latest research—show a higher vulnerability to wind damage than previously estimated. Finally, the impact of demand surge—the increase in material, services, and labor costs due to increased demand following a catastrophic event—was fine-tuned and validated using high resolution construction cost time series data for the 2004 and 2005 hurricanes taken from XactAnalysis, a reporting tool created by ISO subsidiary Xactware. Research at AIR shows higher levels of demand surge for time element, including BI. A state-of-the-art model alone is not sufficient for generating accurate BI loss estimates, notes the company. AIR’s analyses also revealed significant issues with the accuracy and completeness of insurers’ business interruption exposure data. For many companies, large numbers of locations have very low BI exposure values. In most cases, business interruption limits, which reflect part-year business income exposure, have been set equal to annual BI exposure. AIR also found evidence that companies are using general “rules of thumb” to determine the BI limit, rather than the use of BI worksheets for each location in multi-location policies. Finally, the number of locations that may sustai damage in a catastrophe is often underestimated. Together, these issues regarding the quality of BI exposure data lead to significant underestimation of modeled BI losses by many companies. “Modeled loss estimates are only as accurate as the exposure data input into the catastrophe model,” continued Dr. Guin. “Insurers must continue to put an emphasis on improving the quality and completeness of their BI exposure data to improve the accuracy of the catastrophe risk information used by company management.” Source: AIR Worldwide Corp.

Chicago - Insurance Networking News magazine, a SourceMedia publication, released the results of its 2007 INNovators Award, a special designation intended to advance the spread of business technology acumen in the insurance industry.Nominees for the 2007 INNovators program included insurance carriers, agencies and brokerages. Their "innovation" was required to have been in production long enough to have returned demonstrable, tangible results.

U.S. CONSUMERS WANT CONTROL OF E-HEALTH RECORDSAmericans show a strong interest in controlling their own electronic medical records, according to a national survey released at a health IT conference.

ARCOT SYSTEMS AND ADOBE WORK ON DIGITAL SIGNINGSunnyvale, Calif.-based Arcot Systems Inc. has collaborated with San Jose, Calif.-based Adobe Systems Inc. to create a new option for digital signing in Adobe Acrobat software and Adobe Reader software using "Roaming Digital IDs."

Why do companies go out of business even though they rate decent customer satisfaction scores on surveys? Maybe somebody's not asking the right survey questions.Instead of a barrage of queries, researchers need to pose the "ultimate question" in a regular, systematic and timely fashion to get a true measure of success and growth-the Net Promoter Score (NPS).

PURE CHOOSES ONESHIELD FOR POLICY ADMIN SYSTEMPrivilege Underwriters Reciprocal Exchange (PURE), a startup with headquarters in Plantation, Fla., has selected software from Westborough, Mass.-based OneShield Inc. to support administration of new insurance products. PURE deployed OneShield's Dragon platform to manage the end-to-end policy administration of PURE High Net Worth Insurance personal lines product offerings.

Picture yourself in the early 1900s. You own a horse-drawn carriage but you're frustrated with the slow, bumpy ride. So you invest in the latest wheels and bearings for less rolling resistance. You buy modern suspension to cushion the potholes, and you say goodbye to old Nellie and get a friskier steed. Now you're going a little faster, with fewer bumps. You're feeling good until a "horseless carriage" whizzes by, leaving you in the dust. You realize your expensive improvements haven't helped you much.The insurance industry finds itself in a similar situation with claims. Insurance companies have re-engineered claims processes, replaced legacy systems, installed imaging systems, and implemented business process management tools and workflow systems. Despite the millions spent, those efforts have rarely delivered significant improvements in productivity or slashed claims costs.

Stamford, Conn. - Agents claim time savings of more than 50% when carriers provide industry-standard, real-time solutions for processing transactions, such as quoting, billing and claim inquiries, loss runs, and policy views, according to a survey by a software vendor.