Policy adminstration

It seems as though the insurance industry just can't cut a break in the media. As I write this, the news of a MetLife agent convicted in a New York murder-for-life-insurance plot received coverage across all major business wires. Those of you who remember insurance executive Michael Segal's 2004 conviction on racketeering, fraud and embezzlement, or the trials and tribulations of Maurice R. "Hank" Greenberg, will agree that regardless of guilt or innocence, propaganda or truth, information is power. This is particularly true as health insurers put their talking points together to respond to the recent release of Michael Moore's movie, "Sicko." This type of news brings the entire industry down... and puts the industry under increased scrutiny.Information published by either the public or the trade press is held to stringent ethical standards, and although this may not always be the case, we'd like to think that professionals from both mediums report truthful information without bias. This is INN's editorial mission. Reporting negative information tends to stir the pot, however, from generating a quiet dialogue to generating results that force accountability. The facts are the facts.

SC BLUES WINS CALL CENTER TECH AWARDBlueCross BlueShield of South Carolina, Columbia, S.C., took top honors in the "Best Use of Technology" category during the 3rd Annual Call Center Excellence Awards held recently in Las Vegas.

FEE REDUCTION FOR INSURANCE SERVICESThe Depository Trust & Clearing Corporation's (DTCC) Insurance Services New York business reports its first fee reduction in history, reflecting growing usage of its services. Insurance Services has automated linkages and data exchange between carriers and their broker/dealer, bank and other distributor partners who market insurance products.

What do insurance, consumer goods, retail and manufacturing companies have in common? Each relies on a complex value chain of partners engaged in collaborative business processes in order to develop relationships and deliver goods or services to customers. This is true for B2B insurance companies such as Health Net Inc., Woodland Hills, Calif., and Delta Dental Plans Assoc., Oak Brook, Ill., consumer-focused organizations such as Galveston, Texas-based American National Insurance Co. (ANICO), which offers a broad line of insurance products and services, including life insurance, annuities, health, property/casualty and credit insurance and Service Masters' American Home Shield (AHS), or American Insurance Group Inc. (AIG), which serves commercial, institutional and individual customers.Whether providing individual policies direct to consumers or a range of portfolio products to commercial or business customers on behalf of employee members, insurance companies operate within complex, process-driven environments.

The relationship between IT and the business within insurance companies is a subject insurance professionals will talk about until the cows come home. How do the two work together? Who are the forward thinkers? How does IT know what the business needs and vice versa? These questions plague both sides. CUNA Mutual Group, Madison, Wis., may have figured it out. In fact, this epiphany helped win the company Insurance Networking News' 2007 INNovator of the Year award for its ability to successfully combine the efforts of IT and the business to create a specialized claims processing solution, Claims Express."We're (business and IT) part of the same team," says Tom Gosnell, CIO at CUNA Mutual. "I think it's that close working relationship that helps best position us to be able to share ideas with the business and vice versa and to be able to come up with the right solution across the board."

With the 2007 business environment for North American insurance carriers looking relatively good for the second year in a row, according to Forrester Research Inc., insurance carriers have become slightly more generous in their IT spending. The Cambridge, Mass.-based research firm anticipates that IT spending in 2007 in the insurance industry will increase by 7%, compared with 5% growth in 2006.Efficiency and innovation will be the highest priorities, and the initiatives to support these priorities are utility-oriented projects such as infrastructure consolidation and disaster recovery. However, competitive pressures and technology-enabled opportunities will drive the need for innovation in Internet and mobile applications as well as the replacement of legacy applications. Underpinning these changes will be a continued drive toward service-oriented architecture (SOA) for internal integration of systems, usage of services firms for transformation, and greater focus on process standardization.

Reinsurance firms are gripped by a series of major challenges, from increased consolidation in the industry to the rise in securitization and the greater risk primary insurers assume. Although the firms' brokers remain intent on winning clients by accentuating the personal touch, many reinsurers are aggressively adopting technology to confront the stiff obstacles they face.A principal new challenge for reinsurers is the rise in the use of securitization to support life insurance products. Both life and P&C insurance firms are turning to securitization to access capital markets, which has helped lead to a decline in recurring reinsurance since 2005, according to the recent study, "Emerging Trends in U.S. Life Reinsurance: Challenge or Opportunity," from the Hartford, Conn.-based firm Conning Research and Consulting Inc. While recurring reinsurance increased significantly from 1995 through 2000, it flattened out from 2001 until 2004, and then began declining in 2005. "To the extent that some primary insurers, initially several larger ones, use securitization as a substitute for reinsurance, it presents a threat to reinsurers," the study notes.

DIRECT-TO-CONSUMER INSURER CHOOSES RULES MANAGEMENT SYSTEMPrecedent Insurance Co., a subsidiary of American Community Mutual Insurance Co., headquartered in Livonia, Mich., chose Redwood Shores, Calif.-based Corticon Technologies' Business Rules Management System as a critical component in the development and management of Precedent's direct-to-consumer healthcare insurance solution. Precedent plans to deliver a suite of health insurance solutions called REMIX, which includes "Coverage on Demand" plans that charge the insured for only the health insurance coverage they need.

Remember the tale of the boiling frog? As the fable goes, a frog placed in a pot of boiling water will frantically clamber out. That same frog, however, will sit placidly in a pot of tepid water. It will remain there even as the water is slowly heated. Gradual changes go unnoticed, with the frog never recognizing the impending disaster as the water reaches the boiling point.Liken the pot of tepid water to legacy claims systems. P&C insurers are beginning to take a closer look at their systems, but will they act in time or wait on the sidelines and continue claims as usual?

RE: July, 2007 Insurance Networking News' Cover Story: Keeping Agents Honest Legally and Ethically: Dear Editor,I read your feature article on Keeping Agents Honest (Legally & Ethically) in the July issue and generally have to agree with your statements. There are some important areas that you have left out, or had not considered. The "other unethical - though maybe not illegal- sale practices" could just easily be directed at the companies that offer the products. The "Death Spiral" is intentional in the way the product is conceived by the company. The basic assumption for term life and its pricing is that the company will not have to pay claims, the policy will expire first. You talk about how companies have to keep a sharp eye on independent agents, and that it is hard to prove fraud, but companies do find fraud and cover it up all of the time. The first reaction is to protect the reputation of the company, not the customer or the general public. In my own town we had an agent that was "let go" by a direct writer, allegedly for fraud. That agent then opened an independent agency and got appointments from some companies. Within two years other agents were receiving complaints about not getting policies, about paying premiums at the agency, but not getting anything from the company until they had a claim, etc. These complaints were sent on to the companies involved. It took almost another year before the agent lost his appointments and was back on the street looking for another opportunity, and he found it in another nearby city, working for a direct writer (a different one). Why, one must ask, were the companies willing to allow this person to keep his license? If any one of them had reported their actions to the Department of Insurance action might have been taken to revoke that license. Companies are as responsible for the fraud committed by agents, captive or independent, if they refuse to report that fraud to the state DOI. Are they really interested in cleaning house, or just protecting their names? Sincerely, Jim Gislason, CPIA Account ExecutiveUnited Insurance Services, Inc.509 Main St.Vincennes, Ind. 47591 Dear Editor, I feel compelled to respond to your article that portrays "independent agents" as unethical thieves. While there may be a few agents that act unethically there are far more that are honest and truly work hard to do the best for their customers. My family and our agency have represented the independent agency system honestly and ethically for over 75 years and we greatly offended by your defamation of our character and ethics. Your article was poo rly written and the three examples you provide do nothing to prove that actual "independent agents" were involved in any of them. Could it be that the examples you gave were actually "captive agents" like State Farm, Farmers, Allstate, and Geico? I ask that you immediately take my agency Martin Insurance, Inc. 1122 Idaho Street Lewiston, ID 83501 off of your mailing lists and never send another copy of Insurance Networking News. I also want you to know that I will be emailing a copy of your article to the Independent Insurance Agents and Brokers of America to see what they have to say about your portray of their members. Mike Martin Jr.Martin Insurance, Inc.Via E-mail

A study of European insurance policy holders by Cambridge, Mass.-based Forrester Research Inc. revealed an overarching reluctance to manage their accounts online. Given many of the major carriers’ desire to drive more customers to the Internet for routine sales and service interactions, the data points to an uphill battle.

Hartford, Conn. - The economics of distribution channels in personal auto insurance can be difficult to understand, and this can present both opportunities and challenges in a softening rate market, according to a new study by Hartford, Conn.-based Conning Research & Consulting.

New Delhi and The Hague, the Netherlands - Insurers outside the U.S. are actively creating partnerships in a business affecting the banking and insurance industries.

Philadelphia – To support high-quality patient care, Philadelphia-based Independence Blue Cross (IBC) is providing physicians with enhanced data about members with chronic conditions.

Needham, Mass. – Leaders in claims operations are beginning to break away from traditional processes and seek technology to assist them in managing a complex business process that has, to date, been extremely people intensive, according to new research from TowerGroup, Needham, Mass. Claims departments have been historically reluctant to adopt technology solutions, perceiving technology as incapable of duplicating the decision-making process of an experienced claims adjuster.

Pearl River, N.Y. - Building upon the success of its initial rollout, the insurance standards body organization ACORD announced the expansion of its testing and certification facility to include test capabilities for ACORD Reinsurance & Large Commercial (RLC) Placing message implementations.

Seattle – Teenagers may liken Teensurance to George Orwell's all-knowing “big brother.” But Safeco is hedging its bets that parents will appreciate its new technology and services designed to help protect their teen drivers as they gain experience behind the wheel, and drive competitive advantage in the process. Safeco released its Teensurance product, which employs a set of online tools based on an on-board GPS and notification technology called the Safety Beacon. This new bundle of tools enables families to take proactive steps to monitor their teen’s behavior behind the wheel. Parents can set speed, distance and curfew limitations. A real-time notification service tells parents when their teen drivers are in danger. Teensurance is available to customers with Safeco auto insurance policies, and includes free installation of the Safety Beacon, which is guaranteed for two years. Safeco’s goal with Teensurance is to keep communications open about driving and the responsibilities that come with having a driver’s license. “Teensurance is a proactive solution to help our customers keep their families safe on the road, and the first in a series of Safeco innovations that push beyond traditional insurance to impact our customers on a broad scale,” said Jim Havens, vice president of consumer solutions at Safeco. The Teensurance program’s set of tools includes set “safe driving” zones to gradually ease new drivers into the driving experience; the ability to unlock a car door remotely using a simple code; access to 24/7 roadside assistance, a parent/teen contract and pertinent educational materials, including a “TeenDash” survey. Source: Safeco

New York – Aiming to capitalize on the record pace of mergers and acquisitions (M&A), Zurich has created a new business unit designed to cater to the companies involved. The unit, part of Zurich's global corporate business division, will offer customized products and services to help companies manage M&A transaction-related risks, the company says.

London - Though still nascent, enterprise risk management (ERM) programs are becoming more established amongst European insurers, a report from Standard and Poor's (S&P) has found. In its report, "Enterprise Risk Management Assessments on Europe's Insurers," S&P surveyed 70 European carriers about their adoption and use of ERM programs.

Boston - A new research report from financial research and consulting firm Celent predicts that online sales of insurance will double by 2011. Titled "Online Insurance Sales and Marketing: What's Happening and What's Next" the report projects that the Web will play a increasingly prominent role in personal insurance purchases.