Claims

Hartford, Conn. - Aetna has entered into an agreement to acquire ActiveHealth Management, a New York-based health management and health care data analytics company. Aetna will acquire privately held ActiveHealth for approximately $400 million and expects to finance the transaction from available cash. The transaction is subject to customary closing conditions and federal Hart-Scott-Rodino anti-trust regulatory approval. Aetna expects to close the transaction during the [second] quarter of 2005 and that it will become accretive to earnings within 12 months following the closing. Aetna places strong emphasis on medical management," says John W. Rowe, M.D., Aetna chairman and CEO, "and ActiveHealth's ability to provide practical, timely, clinical decision support to physicians and members can improve patient safety and medical quality and reduce medical costs." Aetna has been a customer of ActiveHealth since 2002, and has private-labeled the CareEngine-powered services it uses under the name MedQuery. Other health plans also have placed the services they purchase from ActiveHealth under private labels.Source: Aetna

Nashville, Tenn.- HealthLeaders-InterStudy, a provider of managed care industry intelligence, finds that CIGNA HealthCare has turned a corner in North Carolina. According to the latest issue of the North & South Carolina Health Plan Analysis, the national insurer's North Carolina HMO license tripled its net income in 2004 yet decreased premium revenues by 21%. It was the most dramatic turnaround among North Carolina's HMOs. CIGNA's HMO posted 2004 net income of $18.7 million on revenues of $277.5 million, says Jane DuBose, HealthLeaders-InterStudy analyst. "That's a 6.8% profit margin." All of the state's HMOs were in the black in 2004, although UnitedHealthcare and Aetna Inc., two other national insurers, had lower net income than in 2003, DuBose says.Source: Decision Resources Inc.

Quincy, Mass.--eStudentInsurance.com, a service of the Edvisors Network announced this month a new partnership with Worldwide Insurance Services. The Edvisors Network, a multi-national education services company, teamed up with Worldwide Insurance Services, a global leader in travel insurance, to create a new insurance policy for students traveling anywhere in the world. Global Student Health plans from eStudentInsurance.com are designed specifically to benefit international and domestic students by offering optimal affordable coverage, anywhere in the world.

As director of MetLife Auto & Home's special investigations unit, John Sargent knows that eliminating fraud is an unachievable goal. But that hasn't stopped his company or other industry leaders from trying."Our goal is to pay what we owe, and not a penny more or a penny less," Sargent says. "The more efficient we are at identifying and preventing fraud, the better we can be at writing business at a more competitive rate."

In some ways, insurers' fraud-fighting efforts are similar to this nation's so-called war on drugs: Both endeavors require the right mix of people, technology and information to identify the criminals. Also, public awareness campaigns are part of the effort to change consumer behavior, whether it's to prevent drug use or prevent policyholders from filing bogus claims. And both involve elements of organized crime that use sophisticated tactics and technology to perpetrate their crimes.However, despite all of the resources that have been dedicated over the past decade to fighting drugs and fraud, we're no closer today to eliminating either problem. There have been many high-profile successes for each campaign, whether it's the seizure of a ton of cocaine on a ship at sea, or the combined work of insurance fraud investigators and law enforcement officials to uncover a multi-state, staged-accident fraud ring. But the fact remains that insurance fraud continues to cost the insurance industry $30 billion a year-and that's just counting fraud perpetrated against property/casualty insurers.

Industry experts often criticize insurers as being "laggards" in adopting new technologies. But carriers are leading most other industries when it comes to adopting scanning and imaging technologies, a new study concludes.For example, 86% of insurers surveyed by AIIM, an enterprise content management association based in Silver Spring, Md., are using scanned documents and images to answer inquiries from customers, compared with 73% of companies across all industries. Furthermore, 60% of carriers use scanned documents to respond to litigation, compared with 45% of all survey respondents.

U.S. property/casualty insurers are expected to pay homeowners and businesses an estimated $2.1 billion for insured property-loss claims from eight catastrophes in the first quarter, according to preliminary estimates by ISO's Property Claim Services (PCS) unit.

Newark, Calif.--As Florida's annual hurricane deductible law goes into effect on May 1 for the state's residential policyholders, Risk Management Solutions (RMS), the world's leading provider of products and services for the management of catastrophe risk, released the results of an analysis exploring the insurance industry impact of using the new deductible instead of a single event hurricane deductible.

COLUMBUS, Ohio--Nationwide Insurance and Washington D.C.-based ID Theft Assist are joining forces to offer ground-breaking identity theft protection and recovery service that surpasses IDtheft policies currently on the market.

MISSOULA, Mont.--RemoteScan Corporation, the makers of network connectivity software for document scanners and digital cameras, today announced the release of RemoteScan for Insurance Agents.

SIMSBURY, Conn. - The Hartford Financial Services Group, Inc. and Protective Life Corporation, through wholly owned subsidiaries, have formed Life Alliance, LLC, a new online joint venture to help broker-dealers, banks and other distributors meet their customers' term life insurance needs.

STAMFORD, Conn.--The Tillinghast business of Towers Perrin recently unveiled two new software applications to help insurers prepare for impending capital standards for variable annuity products.

SIMSBURY, Conn. - The Hartford Financial Services Group Inc., for the third consecutive year, is the No. 1 seller of variable life insurance, posting a year-over-year sales increase of more than 28 percent in 2004.

London--New research by independent market analysts Datamonitor, and leading outsourcing advisory firm Everest Group has found that the average deal size in the $600bn global IT and BPO services sector is shrinking. Based on figures from Datamonitor's "IT Services Contracts Tracker," the average size of contracts announced by IT and BPO services vendors in the first quarter of 2005 fell 18% to $68.9m compared to the year ago period. This means that average deal size has now declined for three consecutive quarters.

WINDSOR, Conn.--The head of LIMRA International, a financial services research and consulting association, is urging the life insurance industry to help American households bridge the wide gap between the amount of life insurance they own and the amount they believe they need for adequate family financial protection.

Fiserv Inc., a Brookfield, Wis.-based provider of software and outsourcing solutions to more than 2,000 insurance customers, has formed a strategic alliance with Lombardi Software, an Austin, Texas-based provider of the business process management (BPM) software called TeamWorks. The goal of the alliance is provide a BPM solution specifically designed for the insurance industry.

Novato, Calif.--Fireman's Fund Insurance Co. will provide identity theft restoration services nationally, offering customers access to a personal counselor who can help identify-theft victims with the legal and logistical burden of putting their lives back together.These services represent one of the first major programs by an insurer to deliver these services as part of an insurance policy. The enhancement comes at no additional cost, and with no deductible, to Fireman's Fund policyholders who have Prestige Home Premier with Added Measure coverage. This service became available effective March 30.

After flirting with test pilots, phased rollouts and other levels of adoption, the jury is still out on whether mobile computing will become as ubiquitous to insurers as pen and paper.With claims management activities providing the most compelling impetus for adoption, a select group of insurers have sworn by the capabilities of mobile computing technologies to improve workflow and customer service. But other insurers continue to wait for greater application functionality, dependability and scalability before they commit to adopting the technology.

Although computer technologies have been applied to improve productivity in vast arenas of the American economy, the insurance industry had-until now-limited access to technologies designed to improve the productivity of its highly mobile claims adjusters.Legacy systems in this market are costly and require intense IT support. Even then, they do not address the unique needs of this mobile workforce. Adjusters are rarely stationary: They are in the field moving from site to site and do not have the leisure to write their reports comfortably.

CHICAGO--Blue Cross and Blue Shield of Illinois (BCBSIL) Consumer Markets Division, as part of its ongoing effort to meet the growing demands of consumer-directed health care, announced today that it is offering two new Health Savings Account (HSA) compatible health plans: the BlueEdge Individual HSA and the BlueEdge Individual HSA 5000.