Claims

Allstate Insurance Co., Northbrook, Ill., filed a half-million dollar lawsuit against a Philadelphia chiropractic clinic, All-Care Chiropractic, alleging fraudulent billing practices for insurance claims involving patients with personal injury lawsuits.The suit alleges that All-Care owners and operators Richard Walinsky, D.C. and Eileen Nelson Means, D.C. fraudulently billed Allstate for treatments that were never performed, over billed for services that were performed and used improperly licensed and unsupervised personnel for in-home patient visits.

Anthem Blue Cross and Blue Shield and Accenture are testing digital pen technology designed to help healthcare professionals capture and send medical claim information digitally. The solution, which is designed to complement physicians' hand-written claims process, was introduced in a two-phase pilot with Anthem plans in Indiana and Kentucky.In the first phase, health care professionals are using the pen to file claims electronically in conjunction with a desktop computer. Claims are written on specially designed digital paper forms that enable electronic data capture. The data is then uploaded electronically via a desktop computer to Anthem.

JUPITER, Fla.-- Property and casualty insurers more than doubled their profits during 2003, earning $32.3 billion compared to the $13.5 billion reported in 2002, according to Weiss Ratings, Inc., the nation's leading independent provider of ratings and analyses of financial services companies, mutual funds, and stocks.

WHITE PLAINS, N.Y.--Cybersettle, the world's number one online settlement company, has been selected by CNA, the fourth largest U.S. commercial insurer, as its online settlement partner to assist with the quick resolution of commercial insurance claims.

SAN FRANCISCO--California State Compensation Insurance Fund's anti-fraud program has enabled statewide district attorneys to win more than $5 million in restitution orders. The restitution judgments are a direct result of 155 premium fraud convictions during the last six years.

HARTFORD, Conn.-- The Hartford Financial Services Group along with Ibbotson Associates, recently surveyed investors and found that eight out of 10 investors indicated that they are practicing asset allocation. However, when asked to describe what they believe asset allocation is, the majority describe simple "diversification" of assets rather than true asset allocation.

UnumProvident is now providing toll-free access for brokers to connect directly with individual disability income protection underwriters."We’re encouraging this dialogue so brokers can better understand the ‘whys’ of underwriting, and so we can better understand the individual customer," says Steve Joseph, vice president of individual disability underwriting at the Chattanooga, Tenn.-based insurance company.

NEEDHAM, MA--Until recently, regulatory compliance has been a relatively straightforward issue for U.S. insurance companies. Long deemed a service for the "public good," the insurance industry has been regulated by various entities for over 100 years - making compliance as commonplace as breathing for most insurers.

OMAHA, Neb., and HARRISBURG, Pa.-- Two leaders in the employee benefits arena -- Mutual of Omaha and United Concordia Companies, Inc. -- today announced a new line of dental insurance plans for employers of all sizes.

SAN FRANCISCO--Esurance, a direct-to-consumer personal auto insurance company, has selected ProcessClaims to provide a customized software management platform to support Esurance's expanding claims organization. Esurance believes that ProcessClaims' ClaimsPort material damage management system will increase claims handling efficiency, decrease cycle time costs, and scale with Esurance's rapid growth.

Forty-six percent of U.S. insurance organizations identified the lack of historical databases as a major cause of poor claims management, according to a recent customer poll conducted by Insurance Services Office Inc. (ISO), Jersey City, N.J. This follows an earlier ISO poll in which 78% of insurance organizations said reducing the rising cost of claims handling is their single most important goal for 2004.The poll asked insurance organizations to identify the most likely reason for paying injury claims incorrectly. Of the five options, just under half (46%) identified lack of historical databases as a major cause, and 20% cited lack of medical knowledge as the second most probable reason. Sixteen percent said inadequate negotiation skills, while 13% cited claims adjusters' inexperience.

Group Health Incorporated (GHI), a statewide not-for-profit health insurer in New York, has launched several new initiatives that improve customer service for its members, from 100% online plan enrollment to disseminating important coverage updates through brief automated phone calls.GHI has partnered with Sunnyvale, Calif.-based eHealthInsurance Inc. to enable individuals and small businesses to purchase health insurance coverage with GHI online, in real time and without any printing, signing or mailing of forms. Applicants simply log on to www.eHealthInsurance.com, submit the required data, credit-card information for the first month's payment and authorize the transaction with an "e-signature." Approved applicants are covered beginning on the first day of the next calendar month.

New York--The Catastrophe Risk Exchange International, Inc. (CATEX) announced today that it has completed delivery of a Web based Property Aggregate Monitoring System to facilitate the underwriting of facultative property business by the reinsurer QBE Reinsurance Corporation (QBE).

SOMERS, NY --IBM today unveiled new PartnerWorld Industry Networks for independent software vendors (ISVs) focused on the government and insurance industries. IBM also introduced new technical offerings and expanded initiatives that can help ISVs participating in the PartnerWorld Industry Networks speed solution development and ensure interoperability with IBM's middleware portfolio.

CHATTANOOGA, Tenn.-- UnumProvident has received a top ranking for the success of its individual income protection insurance sales, according to JHA's 2003 U.S. Individual Disability Market Survey.

NEW YORK-- Swiss Re's chief economist said today that strong economic growth, coupled with a slight uptick in inflation, will force the Federal Reserve to raise the federal funds rate to close to 2 percent by the end of 2004.

SPOKANE, Wash.-- Itronix Corp., a developer of wireless, rugged mobile computing solutions, announced today that its GoBook II wireless, rugged laptop has been certified by the insurance industry's top three software providers, including ADP Claims Services Group, a wholly owned subsidiary of Automatic Data Processing, Inc., CCC Information Services Inc., and Mitchell International Inc.

FORT WASHINGTON, Pa.-- Coventry First, the creator and leader of the secondary market for life insurance, today applauded the National Association of Insurance Commissioners for overwhelmingly approving a new Model Regulation which governs life settlements.

WELLESLEY HILLS, Mass. -- Sun Life Financial announced today that Sun Life Assurance Company of Canada (U.S.) a member of the Sun Life Financial group of companies, has launched Sun Life Financial Masters, a re-branding of its variable annuity line.

The Hartford Financial Services Group Inc., Hartford, Conn., has enhanced its small commercial automation to make quoting and submitting new business applications faster and easier for independent agents--whether they connect to the Internet from their office, their customer's place of business or on the road.According to The Hartford, its ICON 2.0 electronic quoting and submission system offers agents Web-based access, efficient navigation, and a host of integrated features that streamline the submission process for the company's key small business coverages. Those include Spectrum business owners' policy, workers' compensation and commercial auto. Similar support for The Hartford's new "Xpand" products is currently being piloted.