Claims

PARSIPPANY, NJ--MFXchange Holdings, Inc. (MFX) announced the launch of its end-to-end application service provider (ASP) commercial lines solution. The comprehensive processing system is Web-based and features the many benefits of ASP-based products. MFX's Ray Roy, Chairman, explains, "MFX's founding mission is to build technology solutions specifically to meet insurance carriers' needs for increased productivity, shorter processing timeframes and lower costs. We provide this, in part, through ASP processing that does not require large capital outlays for hardware and software and is highly cost effective."

(St. Louis, MO-December 11, 2003) Genelco Software Solutions, a division of Liberty Insurance Services Corporation and a developer of software applications for the life and health insurance industry, has joined IBM's ISV Advantage Initiative, a program designed to provide independent software vendors (ISVs) with technical and marketing support to help meet the specific needs of small and medium business (SMB) customers.

POOLESVILLE, Md., Dec. 12-- The insurance Fraud DetectionSystem (FDS), developed using Visual Analytics, Inc.'s award winning product, VisuaLinks, was successfully launched this past week by the Korean Financial Supervisory Services, FSS. The FSS announced that they have implemented and will be using this system to detect fraud through the integrated analysis of insurance-related data including accidents, contracts and claims.

HARTFORD, Conn., Dec. 11-- Aetna InteliHealth, Aetna's online consumer health information resource, and Aetna Navigator, the company's self-service website for members, have received 2003 eHealthcare Leadership Awards for Health/Healthcare Content and Interactive Site, respectively.

Most consumers admit that purchasing life insurance is not something they relish-mainly because of the issue of their mortality. For life insurers, selling their various products has been difficult as well, but this shortcoming has little to do with consumer resistance.

The insurance industry appears poised to remove the "technology laggard" label. Despite a back-to-basics management philosophy brought on by the two-year economic slump, insurance companies continue to move forward with their Internet strategies.For the third consecutive year, Internet-related categories ranked at the top of Insurance Networking News' "Best of the Newest" survey, a poll of 17 technologies rated by insurance company executives and industry experts. The panel rated each technology based on its impact on carriers' operations and its level of innovation.

Ask not for whom the bell tolls; it tolls for carriers' legacy systems. At least that's the conclusion of a survey conducted by Guidewire Software Inc., a San Mateo, Calif.-based Web-based claims system provider.Three-quarters of property/casualty and workers' compensation carriers are engaged in significant claims system projects, according to Guidewire (see chart). "Mid-sized carriers are really biting the bullet-looking at what's in front of them and starting to take steps," says James Kwak, vice president of marketing at Guidewire. "So we're seeing many of them looking at replacing their claims systems."

In the past, insurers could write off fraud expenses with investment income and capital reserves. But those days are over. Reduced investment income and reserves have forced insurers to face such operational bugaboos as fraud and subrogation head on. Fortunately, insurers ahead of the curve have identified technology-based strategies to get to the heart of the matter.

Unlike many insurance companies that reach a point of pain with old technology, Berkley Risk Administrators Co. LLC (BRAC) was not under duress when it decided to migrate to a new platform.

Great-West Healthcare began using computer-based training to teach new sales reps about its products and services. The company is now using online training for its claims examiners, call center reps and HIPAA compliance across the organization.Spending on employee training has not been felled by budget axe wielders. That's according to the American Society of Training & Development (ASTD), Alexandria, Va., which also found the percentage of total training dollars spent on e-learning jumped from 8.8% in 2000 to 10.5% in 2001-the largest increase in four years.

When executive recruiters at Los Angeles-based Farmers Insurance Group need to fill a vacant position, posting a print version of a job opening to attract prime candidates is regarded as an option-albeit an increasingly obsolete one.Call it an evolution from a "dinosaur" methodology to a "monster" opportunity. That's because at Farmers, a host of job-recruitment Web sites-from Monster.com to Insurance-pros.net-are bringing the lion's share of new claims executives. With such a success rate, it's no surprise that the Web has stepped forward to become the predominant tool of choice to fill staffing.

When the call arrived at PMA Insurance Group's customer contact center in Allentown, Pa., it was unlike most of the in-bound inquiries normally fielded at the sprawling facility."The agents at our contact center assist injured workers seeking claims-related indemnity or medical payment status," explains Meg Schumer, assistant vice president of call centers for the Blue Bell, Pa.-based mid-size property/casualty insurer. "But in the midst of a call, an individual informed one of our agents that he was contemplating ending his life. Our agent began to talk the individual through the crisis-basically got him to calm down-and then sought intervention from crisis counselors, who took it from there."

A recent report by the Data Warehousing Institute claims that the annual cost of poor data quality for U.S. industries is $611 billion. This includes direct costs of analyzing and correcting data errors and indirect costs as well.For instance, when errors become exposed to customers and regulators, fines can follow and the backlash can force an avalanche of expensive changes to how an insurance company conducts its business.

With almost 60% of its homeowners insurance business consisting of coverage for homes valued at $1 million and up, Novato, Calif.-based Fireman's Fund Insurance Co. understands that appraising affluent homes is an extremely tall order.Expensive dwellings don't come equipped with run-of-the-mill furnishings. Often, such homes feature rare and exotic items ranging from Pella French doors, Italian granite countertops, premium carpeting and elaborate building materials.

Ten years ago, telecommunications costs were typically the 14th or 15th line item for insurance companies, says Johnny Podrovitz, CEO of MSS Group Inc., Castle Rock, Colo. "Now, they're the third or fourth."

Harvard Pilgrim Health Care serves more than 765,000 members, 22,000 medical providers, 2,000 employees and a community of independent brokers. With so many disparate constituents to accommodate, the Wellesley, Mass.-based provider decided in 2002 that it was time to deploy Internet applications that could offer a higher level of Web customization-not standardization.Developing Web portals proved to be the answer.

In today's tough economic climate, insurers are striving to increase productivity and efficiency while keeping expenses in check. And, due to escalating competition, they are also doing more to retain existing customers.As a result, many employees are overwhelmed by the challenges of finding and delivering the right information to customers when, where and how it is needed.

When Farmers Insurance Group conducted testing on a Web-based customer self-service program, the Los Angeles- based property/casualty insurer considered implementing a capability that would enable customers to make changes to their policies.Farmers executives recognized the value of self-service capabilities. After all, enabling a customer to instantaneously make a change to their auto or homeowners policy represents the spirit of customer self-service. But earlier this year, as Farmers executives examined the concept further, they uncovered a flaw with the concept: Giving customer unfettered access to make changes was considered an affront to Farmers' agents.

The nation's largest insurers together received a mediocre score for online customer respect. But the good news is: The banking and securities sector, as well as Fortune 100 firms overall, didn't ace the test either.This assessment comes from The Customer Respect Group Inc., a Bellevue, Wash.-based research company that studies the Web sites of Fortune 100 and Fortune 1000 companies. The group gave insurers among the Fortune 1000 a 6.8 overall customer respect index (CRI) for their Web sites, while financial services firms scored 6.7 and Fortune 100 firms scored 7.0.

Blue Cross Blue Shield of South Carolina (BCBSSC) in January introduced a new program that many believe could revolutionize the Web-based self-service model.The program, known as Blue-By-Design, is a consumer- driven health plan (CDHP) that gives members the power to make their own healthcare decisions, says Terry Povey, director of Web business development, market research and statistics, for the Columbia, S.C.-based health insurer.