Claims

Still in its infancy, knowledge management technology has the potential to help carriers deliver a consistent brand image and high-impact advertising to target audiences.Advocates of knowledge management systems have long pointed to the many benefits insurance carriers could derive from the technology, but one area frequently overlooked is brand image.

As a result of switching to document scanning, and eventually upgrading its equipment, Blue Cross Blue Shield of Georgia has seen what its describes as a significant increase in efficiency and cost savings.The paperless office could be compared to the Loch Ness monster: People swear it exists, but no one has ever seen it. Blue Cross Blue Shield of Georgia, however, is one of the few companies that can say it has achieved this elusive goal, with the results to prove it.

Throughout much of the 1990s, the road to auto insurance accountability and compliance in the state of New York was in disarray. That's because throughout the decade, New York state officials and auto insurers watched with helpless dismay as a growing number of New York motorists circumvented a mandatory auto insurance law. They did this by carrying fraudulent insurance identification cards.In many instances, using a fake ID will only take the illegal user so far. But in New York, the inability of state databases to crack down on the activity enabled card carriers to run amok. With detection difficult, motorists saw an opportunity to create their own proof-of-insurance cards.

Unlike many other insurance contracts, annuities are marked by significant fluidity where accounts change daily, weekly and monthly. When an accountholder makes a change, the service provider must be prepared to hold up their end of the bargain.This isn't always easy. A report commissioned by Edison, N.J.-based NaviSys Inc. states that "many potential customers fear the loss of control of their money as an immediate annuity essentially locks up those assets for the rest of their lives."

In law enforcement, the most egregious acts of theft are often solved more quickly than cases of simple theft. That's because law enforcement officials often devote vast resources to bringing high-profile crimes to justice.High-profile insurance fraud also is often solved expeditiously for the same reason-the resources committed to the big-dollar cases are significant. But when it comes to common fraud, insurers have found that the jury's out on their overall ability to identify and curb it.

For Royal & SunAlliance, processing auto claims went from being a royal pain to a royal gain-thanks to an outsourced solution that's firing on all cylinders.Insurers that strive hard to improve their claims processing abilities within auto insurance lines sometimes watch the entire effort come crashing down due to one crucial deficiency: poor auto repair experiences.

Before the days of integrated marketing programs, independent agents or their customer service representatives picked up the phone and called customers in the hopes of retaining the business of the agency's most profitable clients.Times have changed. Today, it's too expensive and time-consuming for an agency to hunt and peck its way through a large client list looking for its most profitable customers-then conceive ways to keep them on board. And it's too expensive for agencies to have a marketing arm or customer service representatives who do anything more than sell, sell, sell.

The numbers are too compelling to ignore. The average salary for a call center agent in India is one-tenth that of a U.S. agent's-or roughly $300 a month. In a 500-seat operation, that amounts to $16.2 million a year in payroll savings alone.In addition, India's young, educated and highly motivated workforce, views working in a call center as a prestigious job, unlike their American counterparts who typically view it as a temporary step toward a "real" career.

When insurance companies explore implementation of top-of-the-line mobile computing solutions, many concede that laptop is technology no longer on their short list for consideration.Once regarded as a viable option for conducting business remotely, laptops lost ground to other hand-held options, such as Web-enabled wireless phones, two-way pagers and Personal Digital Assistants (PDA).

Despite the growth of online self-service, call centers remain the most common way for customers to interact with companies. New technologies promise ROI by focusing on the performance of the people who deliver service to the customer-call center agents.Driving customers to the Internet for self-service is an effective way for insurers to reduce the high costs of providing information and processing transactions off-line. The fact is, most customers still prefer to call and talk to a human being-the most expensive customer-service channel.

Most insurers and reinsurers espouse a belief that new business doesn't always equal good business. To most insurance providers, the honeymoon period with a new customer ends as soon as claims activity intensifies.

Individuals who have experienced an auto accident or incurred damage to their vehicle often discover that the road to swift claims settlement is a bumpy, winding and volatile one.

Claims processing capabilities within the automobile insurance segment is not unlike a car itself-hitting on all cylinders is essential to ensure high performance.In 1999, Mayfield Village, Ohio-based Progressive Insurance Co. debuted TotalPro, a Web-based claims processing application that can be activated by both internal affiliates and Progressive policyholders.

As insurers' expectations for e-commerce revenue tumbled over the past couple years, e-business spending has focused on self-service initiatives such as enterprise portals and agent extranets. But most insurers lack the infrastructure and customer understanding to maximize the return on these and other technology investments, such as customer relationship management.Therefore, insurers need to create financial services hubs: technology platforms for delivering services that span multiple systems.

With the insurance industry, one moment of impact-whether it's two vans, two workers or two ships-can initiate a lengthy reporting trail weighed down by paper handling and delays. The first notice of loss, which carriers receive from agents by phone, fax, or Internet, starts the trail.

Some senior insurance executives have a hard time understanding how a seemingly esoteric technology such as artificial intelligence (A.I.) could possibly be used by the insurance industry.This mental juxtaposition is ironic because the potential applications are manifold. And more importantly, the insurance industry was one of the first to widely adopt artificial intelligence technology in the form of expert underwriting systems.

When Blue Cross Blue Shield of Massachusetts embarked on its customer relationship management (CRM) initiative four years ago, the Boston-based health insurer could find no other healthcare organization to use as a benchmark.Today, insurers thinking about implementing CRM would do well to examine Blue Cross Blue Shield of Massachusetts as a model for what can be accomplished with a customer-focused business strategy supported by sophisticated CRM technology.

With 2.4 million members, Blue Cross Blue Shield of Massachusetts has avoided the common errors of implementing customer relationship management (CRM).First and foremost, senior management decided in 1998 that the Boston-based company would adopt an enterprisewide, client-centric business strategy, which it calls Concierge Service Delivery.

Even though claims service provided by property/casualty insurance carriers represents a major factor in their ability to retain customers and attract new ones, insurers are not providing the level of service that is considered acceptable to corporate customers and consumers, two new studies conclude.Moreover, even well-capitalized carriers that possess the financial stability to support quality claims service appear to be dropping the ball.

HNC is widely recognized as a leading developer of analytic and decision-management tools. But are carriers ready to turn their important underwriting and claims decisions over to machines?The similarities between fighting terrorism and combating insurance or credit card fraud are not very obvious. However, the Bush Administration's Homeland Security initiative is considering using some of the same technology that's now being applied to identify fraudulent transactions for more than 300 million credit cards worldwide, and by nine of the 10 largest insurance companies.