Claims

Chicago - Danish insurance company ALKA is fighting customer fraud and enhancing customer services with PredictiveClaims, an application developed by SPSS Inc. ALKA recently purchased and implemented the software in an effort to improve claims handling efficiency while reducing the cost of fraudulent claims.ALKA is one of the five leading insurance companies in Denmark. To differentiate itself in a highly competitive market, the company aimed to optimize its expensive claims handling processes and offer better service to customers. ALKA sought to enable "fast-track claim handling" while still sifting out the fraudulent cases from its high claim volumes. Industry experts estimate that on average 10% of all claims are fraudulent, whereas usually only 0.5% to 1% of fraud is actually being detected.

Seattle - Many companies advertise great service, but how many have been recognized for this by a non-partial third party such as J.D. Power and Associates? To receive recognition, companies must score higher than 730 out of a possible 1000 points. PEMCO received 911 points, a score that was noted as unusually high by J.D. Power and Associates."We come to work every day committed to giving our customers the absolute highest level of service and value," says Jon Osterberg, spokesperson for PEMCO, a provider of auto, home, boat, life, and umbrella insurance to Washington state residents. "This certification demonstrates that. Service is the bedrock of PEMCO's culture, and it's extremely gratifying to see our customers recognize that."

Hartford, Conn. - The Industrial Hygiene Laboratory of St. Paul Travelers has added a state-of-the-art instrument that helps customers address OSHA's proposed lowering of the Permissible Exposure Limit (PEL) for hexavalent chromium (CrVI). St. Paul Travelers purchased this instrument to help its customers better protect their employees and reduce workers compensation losses.Hexavalent chromium (CrVI) is a human carcinogen for which OSHA has proposed a 50x reduction in the PEL from the current standard. The new Inductively Coupled Plasma Mass Spectrometer (ICP-MS) has enabled the Industrial Hygiene Laboratory to develop a method for the analysis of CrVI below OSHA's proposed PEL.

San Diego - CareGroup Healthcare System has gone live at Beth Israel Deaconess Medical Center (BIDMC) with an application that delivers automatic healthcare information updates every 15 minutes to the Centers for Disease Control (CDC) in Atlanta. The bio-surveillance system, which feeds the CDC with information key to early identification of disease trends, is built on the CACHE post-relational database. InterSystems Corp., a health care database provider, spotlighted the bio-surveillance implementation at the HIMSS 2006 conference in San Diego, Calif.BIDMC is one of 10 U.S. hospitals that were approached by the CDC to provide medical data on an ongoing, around-the-clock basis. The initiative is part of a mandate by Health and Human Services (HHS) Secretary Michael Leavitt, who chairs the American Health Information Community (AHIC), a group charged with advising the federal government on standards for electronic health records (EHRs). Bio-surveillance and public health monitoring are among the first focus areas for AHIC and Leavitt has stated that he wants a system for streaming emergency department (ED) data to public health authorities in place by the end of 2006.

Washington, D.C. - Health insurance plans' cutting-edge information technology (IT) strategies are adding value to health care for employers, health care practitioners and most importantly, consumers, industry leaders said today on Capitol Hill.Participants in the briefing stressed that health insurance plans are using IT not only to process claims more efficiently, but also to promote evidence-based care, add value to health care services and empower consumers through access to better information and decision tools.

Chicago - The company stockholoders of CCC Information Services Group Inc., a supplier of software, communications systems, Internet and wireless-enabled technology solutions to the automotive claims and collision repair industries, voted to adopt a merger agreement with entities affiliated with Investcorp, a global investment group.

San Jose, Calif. - Business Objects S.A., a provider of business intelligence (BI) solutions, has entered into a definitive agreement to acquire privately held Firstlogic Inc., a La Crosse, Wis.-based global provider of enterprise data quality solutions and services.

Kansas City, Mo. - Vision may be the most important element required to underwrite liability risk, says Ajay Gupta, marketing leader of GE Insurance Solutions, a provider of reinsurance and commercial insurance and risk management services. Gupta says insurers tend to look backward at historical loss experience but not forward to factors that may impact future losses.Gupta's article, "Crisis or Opportunity: The Liability Dilemma", appears on GE Insurance Solutions' Web site at: www.geinsurancesolutions.com/erccorporate/theinstitute/pc/0601_cris.htm.

Yonkers N.Y., - An investigation in the March 2006 issue of Consumer Reports magazine contends that a national system of Electronic Health Records (EHRs) being developed by the federal government, states, HMOs, and PPOs to link the medical records of every American has potential for abuse. Consumer Reports claims that while such electronic medical records systems could save lives and billions of dollars in health-care spending, it may also jeopardize the security of personal health care information.The advantages of EHRs are many, according to Consumer Reports, include: more precise patient care from doctors, greater participation by patients, and an early-warning system for medical disasters such as the appearance of avian flu are among the hoped-for achievements for an electronic medical records network.

Needham, Mass. - In the next five years, analysts predict more than 77 million individuals in the U.S. will be of traditional retirement age, and this segment of the population is predicted to be the dominant demographic for a period of 20 years or more. TowerGroup, a Needham, Mass., research firm, expects that this explosion in the retired market will ultimately redefine the U.S. financial services industry, accelerating industry consolidation across banking, securities and investments, and insurance.

Chicago - It was a year with more storms in the Atlantic than any other on record, and it was also the costliest hurricane season ever. Impact Forecasting, a wholly owned subsidiary of Aon Corp., studies some of the possible reasons for the activity, including shifts in the frequency of storms and the impact of El Nino, behind a year that produced more Category 5 hurricanes in the Atlantic Basin than any other.The report, "Atlantic Ocean Basin Hurricane Frequency Shift," is available at http://www.aon.com/.

Orlando, Fla. - Greenguard Environmental Institute (GEI) has released a mold risk reduction program that certifies the design, construction and ongoing operations of newly constructed multifamily and commercial properties. Greenguard Mold Protection Program is designed to ensure that buildings use industries' best practices for safeguarding against the damage and resulting losses caused by mold.The program fills a void for lenders, insurers and building owners that has grown increasingly serious over the last several years. As large court judgments for mold continue to cloud the construction and financing of new buildings, more are turning to mold prevention measures as a way to manage their financial risk.

New York - While to date there exists no standard economic capital methodology in the U.S., it is becoming increasingly clear that the insurance industry needs to move in this direction. This is the conclusion of the 2006 Industry Outlook report issued by the Insurance and Actuarial Advisory Services (IAAS) practice of Ernst & Young LLP, New York. The report, released this week, addresses key life and property/casualty sector issues, including economic capital, catastrophe modeling and risk recalibration, and mergers and acquisition (M&A) activity.

Waterloo, Ont. - Intelligent Mechatronic Systems Inc. (IMS), a of provider of usage-based insurance (UBI) technologies, is launching a year-long iPAID pilot program in North America and the United Kingdom.The pilot will allow the media, advocacy groups and government policy makers to evaluate the effectiveness of UBI programs in improving driver safety, potential insurance savings, and its ability to alleviate traffic congestion and decrease the levels of vehicle-emitted pollutants.

Dublin, Ireland - Insurers will benefit from a trend in wide-spread adoption of electronic capture of patient data, according to Research and Markets, Dublin, Ireland. In a newly released report, Research and Markets says many businesses already routinely capture documents and data for both regulatory and business intelligence purposes. But health care in the clinical setting has resisted this industry-transforming technology for nearly 20 years, citing the lack of user-friendly interfaces for busy health care providers, lack of workflow understanding on the part of vendors, the expense and complexity of implementation and maintenance solutions, and, simply, the lack of a transparent return on investment for providers. Research and Markets addresses this in "How Electronic Data Capture Will Change Healthcare and Pharmaceutical Marketing," an addition to its offerings of market research reports and industry newsletters.

Atlanta - Consumers can now apply online for health insurance through Kaiser Permanente of Georgia's Personal Advantage online consumer portal, which is powered by the Southborough, Mass. -based ikaSystems' enterprise-wide technology platform. Kaiser Permanente's Personal Advantage product has several plan offerings targeting the individual market."Since implementing the portal just over a month ago, we've received 1,116 Personal Advantage applications," says Nancy Melton, Kaiser Permanente's Personal Advantage product manager. "This represents a significant increase over any previous month in the past year."

Much is written about the wonders of technology. Often overlooked, is how companies become the best at attracting and keeping the people who make technology work for them-their IT employees. Many companies readily spout the corporate dictum about how people are their most important asset; far fewer actually "walk the talk."Now, with IT hiring on the rise again-especially in the financial services sector where it's projected to increase 28% in the first quarter of this year-industry observers are warning: It may be time to pay closer attention to the human factor in IT.

Depending on whom you listen to, offshore outsourcing is the best - or the worst option available to insurance companies.The downbeat discussion typically follows the "hidden costs have pushed the business cycle full circle" path, while proponents focus on the logistical effort and patience required for an improved-if not elusive-bottom line.

One of the most frustrating aspects of life for American consumers in the 21st Century is trying to complete a transaction or obtain information from a company over the telephone.Whether it's ordering a new pair of shoes, checking the status of a utility bill, or seeking help with a computer problem, the experience can be both exasperating and mind numbing.

TRANSAMERICA RECEIVES SIX 'BEST IN CLASS' RANKINGSAs a testament to its relationship with its clients, Los Angeles-based Transamerica Retirement Services received six "Best in Class" ratings from the Chatham Partners' 2005 Client Satisfaction Analysis. Transamerica received "Best in Class" ratings: timeliness of contributions, distributions and loans, accuracy of contributions, overall satisfaction with processing of employee transactions, accuracy of participant statements, clarity of participant statements, and courtesy and professionalism of personnel.