Policy adminstration

When online insurance marketplaces first appeared on the Internet horizon more than five years ago, they filled an important gap in carriers' online business strategies. At that time, most insurers had Web sites that industry experts mockingly referred to as "brochureware" to describe their informational, non-transactional qualities.Insurance marketplaces attracted the attention of consumers who were surfing the Web to comparison shop for auto, home and even life insurance. Typically frequented by young, Internet-savvy Generation Xers and baby boomers, these online insurance marketplaces provided participating carriers and independent agents with hundreds of leads from consumers who were patient enough to wade through screen after screen of questions before they received their prize: multiple quotes from brand-name insurers.

Avon, Conn. - The traditional business model used by carriers in the benefits arena is about to be challenged, according to Eastbridge Consulting Group Inc., a marketing advisory firm serving insurance and financial services organizations in the United States and Canada .

Brookfield, Wis. - Fiserv Customer Centered Solutions (CCS), the customer relationship management (CRM) arm of Fiserv, launched its Enterprise Relationship Management Suite (ERM Suite), an integrated product line designed to address service and sales issues facing CEOs.

El Segundo, Calif. - Computer Sciences Corporation (CSC) announced that five carriers in the life insurance industry have joined CSC's Next-Generation Automated Underwriting Platform Strategic Technology Program (STP). Through the program, CSC will develop a new automated underwriting software component based on Swiss Re's Life Underwriting System (LUS).

Boston - John Hancock announced a new turnkey marketing program called Key Employee Excess Enhancement Plan (KEEEP) to help producers sell deferred compensation cases and maximize sales in the business market. The program enables producers to present, sell, implement, service and administer a deferred compensation plan, including business owner and employee brochures on how the plans work and their benefits, as well as a sample client presentation. The package also contains executable documents needed to implement the plan that are ready for sign-off by the plan sponsor's legal counsel, and a producer guide offering a comprehensive program overview.

St. Paul, Minn. - Through aggressive health care fraud investigations and coordination among other states' Blue Cross plans, the Special Investigations Unit (SIU) of Blue Cross and Blue Shield of Minnesota stopped payment on more than $3 million of suspect claims last year, reducing the impact of fraud on premiums in that state. By comparison, Blue Cross stopped $8.7 million in claims in 2003, most of which was due to the rent-a-patient scams now being investigated and prosecuted in Southern California."We saved millions of dollars of our members' premium dollars, because we were able to identify the scam early and stop payment on fraudulent claims," says Dave Bohnenstingel, SIU manager. "In fact, Blue Cross and Blue Shield of Minnesota was integral in bringing the scam to light and the perpetrators to justice," he added.

San Francisco - InsureWorx Inc., a provider of modular software solutions to the insurance industry and the workers' compensation carrier market, has launched its new Web site, located at www.insureworx.com. The site introduces the look and feel of the newly formed InsureWorx organization which resulted from the January 2005 acquisition of Taliant Software by WorldGroup.The new InsureWorx Web site includes information about the company's PowerComp products, the company, and the insurance software market. Of particular interest to existing InsureWorx customers is the client services area. These pages are designed to become a primary source for customer information and communications/

Kirkland, Wash. - The National Association of Insurance Commissioners (NAIC) has selected Ubmatrix, a Kirkland, Wash., supplier of software and services, to provide technical support and training in the development of an XBRL demonstration project for use with NAIC's insurance statutory financial reporting data.

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

Peoria, Ill.- RLI, a property and casualty carrier and provider of surety bonds to niche or underserved markets, established a strategic information services department to manage and develop RLI's strategic and management information services. The newly formed department's goal will be to create accurate and consistent information that can be efficiently delivered to RLI managers and executives to enable them to react to potential problems and opportunities.The new business unit "will be essential in managing our growth and achieving greater profitability," says RLI President & COO Michael J. Stone.

Fireman's Fund Insurance Co. Novato, Calif., has taken a third major step in its total IT transformation by awarding IBM a ten-year $94 million contract to modernize a major portion of the property/casualty insurer's application, development and maintenance software into an On Demand infrastructure that could reduce the number of major applications by 70 percent while improving customer service. When completed, the work could save Fireman's Fund $200 million, more than double the project's actual cost.With IBM's assistance, Fireman's Fund will shift its IT operations to an Internet-based computing model known as a "service-oriented architecture" (SOA) that enables consolidation of costly, redundant applications. Under Fireman's Fund direction, IBM will sift through mission-critical applications using a unique IBM Business Consulting process called Component Business Modeling to determine which applications deliver the most value to the business and which processes can be refined, consolidated or eliminated.

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.

Moncton, N.B. Canada--Whitehill Technologies Inc., a provider of document composition and data transformation software, has acquired the technology assets of Metaserver Inc. With this deal, Whitehill now owns the patented technology platform behind Metaserver's suite of business process integration (BPI) software and solutions for the insurance industry.

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.

As Web services continue to move closer to mainstream acceptance for application development, new research indicates performance concerns now exceed network security issues as a factor that's limiting adoption.A recent study by RESolution Market Research found that service-oriented architectures and Web services, supported by XML, are regarded as a key choice for application development because of ease of programming and data interchange.

For insurance carriers, brokers and agencies, the ability to recover quickly from a systems outage or disaster is critical to their business-and, increasingly, may be mandated by law or industry oversight groups. As a result, business continuity has become a core management issue, whereas in the past it was an issue that was addressed by IT executives."The insurance industry is moving from recoverability toward resilience," says Ted DeZabala, national leader of Deloitte & Touche LLP's security services team. "This is a huge change of mentality, of management, and of technology for the insurance industry."

As an undergraduate at MIT and New York University, Dennis Callahan majored in mathematics. So, it's not so surprising that the CIO of Guardian Life Insurance Company of America has been so successful at focusing on the numbers at the New York-based insurance company.Since he took the CIO position in late 2000, Callahan has reduced the IT budget at Guardian by one-third-all while modernizing the entire corporate infrastructure.