Claims

Seattle - Safeco has named William Jenks chief information officer, effective April 17, 2006.Jenks most recently served as executive vice president and chief information officer of worldwide operations at Publicis Groupe, one of the world's largest advertising and media companies. At Publicis, Jenks led the consolidation of separate technology platforms following a major corporate acquisition. He also realigned the company's technical resources to support top-line business objectives and improve the efficiency of its global workforce.

New York - Lexington Insurance Co., a member company of American International Group, Inc. (AIG), has launced a new online site, www.lexaehelp.com, to provide relevant information to professionals carrying architects and engineers (A&E) liability insurance. The new Web site was created to provide insureds with access to ongoing education modules, contractual information and legal information resources."Because of the specialized liability concerns of architects and engineers, we created www.lexaehelp.com to give our A&E insureds resources specific to their field--including online classes that satisfy state requirements--to assist in mitigating risks and liabilities," says Kevin Kelley, CEO, Lexington Insurance Co.

Gilsbar Inc. has had a detailed disaster recovery and business continuity plan in place since 1996. The New Orleans-based third-party administrator, which handles claims for about 150,000 members, employs a certified disaster recovery specialist. And, the company's executives and technical staff go through tabletop disaster recovery scenarios at least twice a year.Like many other insurance companies, Gilsbar is prepared for catastrophes. However, when Hurricane Katrina hit last year, insurance executives were caught by surprise and had to act on their feet and respond to a bevy of unexpected circumstances.

I'm sure you've heard the one about the life insurance salesman who asked his client, "Do you know the present value of your husband's life insurance policy?""What do you mean?" countered the woman.

In a sign of the major benefits to be won by insurance firms that accentuate Web-based and electronic solutions, the Blue Bell, Pa.-based insurer PMA Insurance Group received superlative ratings in customer service in a recent survey conducted by an independent researcher.In the survey, J.P. Murphy and Co., a Malvern, Pa.-based marketing and opinion research firm, asked approximately 500 of PMA's active clients about the quality of customer service that the insurer offered in areas including claims processing, risk assessment, risk management and cost control.

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.

Washington - The American Academy of Actuaries disclosed that a future large terrorist attack in New York City could result in $778 billion in insured losses.Speaking at the National Association of Insurance Commissioners (NAIC) public hearing on "Terrorism Insurance Matters," Michael McCarter, chairperson of the Academy Terrorism Risk Insurance Subgroup, provided potential property/casualty, and group life insurance losses as a result of various types of terrorist attacks. His group estimated potential insured losses from a conventional truck bomb terrorist attack, as well as medium and large chemical, nuclear, biological or radiological (CNBR) events caused by terrorism.

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.

Chicago - The U.S. property/casualty insurance industry will report deterioration in profitability in 2005 because insured catastrophe losses reached record levels in 2005, according to Fitch Ratings.The decrease in profitability is largely due to the destruction from Hurricane Katrina, the most devastating insured loss event in history, and Hurricanes Rita and Wilma, each of which will rank among the top 10 historical insured loss events.

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.

Newark, Calif. - Increases to hurricane landfall frequencies in the U.S. hurricane model from Risk Management Solutions (RMS) will increase modeled annualized insurance losses by 40% on average across the Gulf Coast, Florida and the Southeast, according to RMS. And modeled annualized insurance losses in the Mid-Atlantic and Northeast coastal regions will increase by 25% to 30%, relative to those derived using long-term 1900-2005 historical average hurricane frequencies.This new view of risk is driven by an increase of more than 30% in the modeled frequency of major (Saffir-Simpson Category 3-5) hurricanes making landfall in the U.S. to account for current elevated levels of hurricane activity in the Atlantic basin, which are expected to persist for at least the next five years. When compared with a pre-2004 historical baseline, as has been previously employed for quantifying insurance risk, the increases in modeled annualized losses are closer to 50% in the Gulf, Florida, and the Southeast.

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.

Chicago - Aon Re Inc. has studied the results of companies that have implemented more sophisticated customer segmentation strategies over the past few years. The results of the study show that while the overall returns for the personal lines property industry still lag the cost of capital, "we are starting to see differentiating results between insurers," says Randall Brubaker, Aon Re Services senior vice president. "This differentiation has been somewhat masked by the increased frequency of hurricanes during the past two years but the underlying progress is evident."According to Brubaker, "It is clear that the core disciplines and customer segmentation tactics that are commonly utilized with personal lines automobile have improved the financial results of the non-catastrophe personal lines property business. The next phase of improvements in personal lines property will include substantial improvements to the disciplines and tactics associated with customer level segmentation on catastrophe risk. The current more active hurricane period has only accelerated the need to implement more sophisticated catastrophe-based customer level segmentation strategies."

Boston - Results from a study conducted by HighRoads, a provider of benefits lifecycle management (BLM) solutions, show that employers can use competitive auctions to provide health benefits more affordably. Its first annual price elasticity survey shows that using a transparent bidding environment reduces contract costs by more than 15%, on average.The survey is based on the outcomes of nearly 50 request-for-proposal (RFP) processes by companies with 5,000 employees or more. On average, vendors revised bids two to three times to win a company's business, reducing fees by 7% to 21% for fully insured and self-insured medical, dental, life, disability and other benefits plans.

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.

Bejing, China - IBM and Taikang Life Insurance Co. Ltd., China's fifth largest life insurance company, are launching a collaborative research project to help solve some of the information management challenges facing the worldwide insurance industry today.Taikang Life will use the worldwide resources from IBM's China, Almaden and Tokyo labs to improve the performance and usability of business intelligence applications embedded in the insurer's federated database systems.