Claims

Portland, Maine – Results of a study measuring insurance industry challenges as well as how technology can assist disability carriers in successfully managing claims operations indicate that carriers are dissatisfied with their current claims management technology.

Hartford, Conn. - Property/casualty carriers in the U.S. can expect another year of overall industry underwriting profit in 2006, matching the results of 2004, according to the latest Conning Research and Consulting Inc. forecast report for the P&C industry, which provides a first look at results through 2008.

Chicago - With the goal of helping patients improve their surgical outcomes, Blue Cross and Blue Shield of Illinois says it has become the first health insurance company in the country to offer the EmmiHealth program, "Informed Decision Making for Bariatric Surgery," to its members considering bariatric surgery. Developed by Chicago-based Emmi Solutions, LLC, EmmiHealth is a multimedia, Web-based program that provides people with clear, concise information about their medical condition, the risks and benefits of treatment, alternatives to surgery and what to expect before and after their procedure - information that collectively leads to better expectations about their care and better outcomes.

Hartford, Conn. - Using a simple online search by zip code, Aetna members can find healthcare services at a variety of in-store clinics, the Hartford, Conn., company reports. Last week Aetna, announced its relationship with InterFit Health's RediClinic, Houston, which offers treatment for more than 25 common medical conditions, such as strep throat and ear infections, at health clinics located inside retail locations such as H-E-B in Texas, Wal-Mart in Arkansas and Oklahoma, and Duane Reade in New York. RediClinic also provides health screenings, medical tests, vaccinations, immunizations and physicals. RediClinic also offers a range of preventive health services, including health screenings, medical tests, vaccinations, and basic physical exams. Earlier this year Aetna announced a similar relationship with Minneapolis-based MinuteClinic's walk-in healthcare centers in Florida, Georgia, Indiana, Kansas, Maryland, Minnesota, North Carolina, Ohio, Tennessee, Washington, and the Washington, D.C./Maryland Capital area. Aetna, which serves just less than 30 million members, says those members who visit either clinic will pay the specialist office visit copay indicated by their plans. Aetna members can find the location of the nearest in-store clinic by visiting Aetna's "DocFind" directory and searching for a doctor in their zip code, selecting "specialist," identifying their plan, and then choosing "nurse practitioner" for specialty type. Members can also find locations by selecting "other facilities" as the type of provider, identifying their plan, and then choosing "view search results now." In announcing that InterFit Health's RediClinic has become a participating provider, William Hauser, M.D., Aetna's regional medical director for the Southeast and Southwest Regions, points out that as people's lives become busier, retail health clinics such as RediClinic can provide a convenient alternative for certain common health problems when a patient cannot see his or her primary care physician. "We urge members to continue to use their primary care physician as their first recourse for care of common health problems and to recognize that retail clinics are not meant to treat serious illness or emergency situations," he says. Source: Business Wire

IT INFRASTRUCTURE OUTSOURCING CONTRACTThe Netherlands subsidiary of Blue Bell, Pa.-based Unisys Corp. has expanded its relationship with long-time client REAAL Insurance through a new five-year outsourcing contract with a value estimated at $11.6 million (U.S). By managing the company's IT infrastructure, Unisys will provide support 24 hours a day, seven days a week, to REAAL and its agents. REAAL hopes to achieve significant cost reductions through consolidating infrastructure outsourcing services under one vendor. REAAL will consolidate its hundreds of existing support contracts and suppliers to one central contract with Unisys, and will reduce the number of services suppliers from 20 to one.

According to 2000 U.S. Census figures, 17.9% of the U.S. population (47 million people) speak a language other than English at home. In fact, from 1980 to 2000, the number of people in the United States who speak a language other than English at home doubled.U.S. Census projections issued in 2004 state these numbers will continue to trend upward. The current number of Asian people living in the United States is 3.6% of the population. In California, this jumps to 10.9%. And the 2004 U.S. Census projections predict the percentage of Asian people in the United States will grow over time.

Zurich, Switzerland - Zurich Financial Services Group, a property/casualty insurance company, promoted John LaGrassa to senior vice president and director of ceded reinsurance.In his new position, LaGrassa will be responsible for all of Zurich's ceded reinsurance functions in North America, including the placement and analysis of all treaties for Zurich North America Commercial business units and Zurich Global Corporate in North America. LaGrassa also will have governance responsibility for treaty, captive and facultative reinsurance.

If it can do all it's purported to do, business process management (BPM) has a tall order to fill. As a structured approach to employing methods, policies, metrics, management practices and software tools to manage and continuously optimize activities and processes, BPM holds great promise. But whether the insurance industry and vendor community fully grasps its capabilities remains to be seen.Like a supersonic jet liner, BPM, also known as business process optimization, is taking off, and a host of insurance carriers and vendors alike are riding the contrails hoping for a quick lift.

The insurance industry is awash these days in acronyms. Adding to the influx of acronyms is the confusion they tend to cause: Many don't describe what they truly represent. The number of definitions for what business process management (BPM), also known as business process optimization (BPO), is-and what it can do-are numerous. Yet, as stated in INN's cover story, its popularity is soaring."Insurance companies are relying on vendors to tell them two things: where to use it, and where not to use it," says Marc Cecere, vice president of the financial services team at Forrester Research Inc., a Cambridge, Mass., research firm.

STUDY SHOWS POOR USABILITY OF WEB HOME PAGESAccording to a recent study by Oak Park, Ill.-based Vox Inc., home page usability of many insurance companies isn't up to snuff. The study analyzed the positioning of key customer and user elements, such as insurance quote and "find an agent" functions. Each company was given a rating based on a set of usability and benchmark criteria. One exception to the overall findings is 21st Century Insurance Co., Woodland Hills, Calif., which recently redesigned its home page. The study, conducted in the first quarter, reviewed content and where it was positioned on the page, comparing 12 insurance providers: State Farm, Allstate, Progressive, Geico, American Family, Liberty, 21st Century, Country Financial, AIG, Nationwide, AAA Chicago and USAA.

Build it and they will come. Such was the faith in location intelligence technology from Church Mutual Insurance Co.'s leaders back in 1999 when the Merrill, Wis.-based provider of insurance for religious institutions began looking for a way to improve its claims operations.Seven years later, the insurance company is using mapping technology from Troy, N.Y.-based MapInfo Corp., in some surprising ways.

The Data Warehousing Institute based in Seattle came to the conclusion in its August 2005 report, "Strategies and Technologies for Deploying Business Intelligence," that 66% of organizations in different industries are trying to transform business intelligence (BI) from a departmental solution to an enterprise one. Only 17% of organizations have completed the task, while the remaining 17% will continue to deploy BI departmentally. This data shows that BI has a ways to go until it reaches maturity in most organizations.Newport Beach, Calif.-based Pacific Life Insurance Co. seems to have the maturity factor under control. It has implemented an enterprise server equipped with BI features.

Mayfield Village, Ohio - Young independent insurance agents identify technology to help them more easily write business and service customers as the second most important thing – after competitive rates – carriers can offer an independent insurance agency. Drive Insurance Group of Mayfield Village, Ohio-based Progressive Casualty Insurance Co. discovered this while conducting a survey of more than 750 young (40 years of age or younger or those who have been in the industry less than 10 years) independent agents to find out what they think about everything from business growth opportunities and technology to the skills necessary to succeed and the challenges faced by the industry.Drive insurance conducted the survey to coincide with the National Young Agents Leadership Institute, put on by the Independent Insurance Agents & Brokers of America, which gets underway in New Orleans next week.

Charlotte, N.C. - Montgomery Mutual Insurance Co., a Charlotte, N.C.-based member of Liberty Mutual Group, Boston, implemented the Commercial IQ SmartRisk underwriting and pricing system for business owners' policies developed by Liberty Mutual Agency Markets' strategic business unit.After a pilot launch in Maryland yielded a 100% increase in policy issuance, Liberty Mutual made Commercial IQ SmartRisk available to appointed agents for BOP coverage in Delaware, District of Columbia, Georgia, North Carolina and South Carolina, and will be available to Virginia appointed agents this fall.

Washington - Senior technical and management professionals from a number of insurance companies--Prudential, The Hartford, AIG and Blue Cross Blue Shield of Minnesota--are among the presenters at Rules Technology Summit, a new event at the 2006 International Business Rules Forum, November 5-9 in Washington.The Rules Technology Summit is aimed at technical audiences including IT architects and IS professionals whose goals are to take advantage of the business rules approach to build agile applications with the flexibility to accommodate frequently changing business conditions.

Boston - Dozens of new insurance activities, such as 'green' building credits and incentives for investing in renewable energy, are emerging to tackle the causes of climate change and rising weather-related losses in the U.S. and globally, according to a new report issued this week by the Boston-based Ceres investor coalition. But the report also states that more insurance companies need to be offering similar services to minimize losses and make the most of business opportunities related to climate change.

Washington, D.C. - As the country approaches the first anniversary of Hurricane Katrina next week, the American Insurance Association (AIA) and ProtectingAmerica.org were at odds as to how best to proceed with a national catastrophe agenda.

Health plan sponsors are ready to help workers make sound medical and financial choices, according to a recent employer survey. The problem is that many of these clients do not have the healthcare decision support tools to do so, notes Starmark, a Lake Forest, Ill., company that specializes in small group healthcare benefits and serves businesses with two to 50 employees.

Seattle - Safeco has launched online technology that enables independent agents to make instant changes to clients' commercial auto policies. The real-time capability cuts a one-week process into a two-minute drill--saving agencies time and enhancing their customer-service experience.Safeco agencies in 10 states have received access to Safeco's enhanced policy change tool. The rest of the company's more than 9,000 independent agent partners will receive access during rolling state launches that run through November 9. All agencies can use Safeco's single intake system for commercial endorsements, a simple policy change Web form introduced this spring that eliminates agents' need to call, mail or fax.

Mayfield Village, Ohio - Drive Insurance from Progressive, the carrier's program for distributing auto insurance through independent agents and brokers in the United States, has signed a joint marketing agreement with Homesite Insurance Group, a national provider of home insurance products.The agreement paves the way for a test that will allow selected Drive agents in three states--Ohio, Pennsylvania and Oregon--to provide their Drive auto insurance customers quotes for homeowners, renters and condo insurance policies underwritten and serviced by Homesite.