A special Claims feature that enables you to evaluate offeringsof software providers servicing claim management initiatives.

Editor's Note:

This is a special feature that will enable you to evaluate someofferings of software providers servicing claim managementinitiatives. Another Technology Showcase is scheduled for ourNovember 2004 issue as well.

In an effort to give you expanded, in-depth updates ontechnology offerings for claim professionals, we invited providersto supply detailed descriptives of their software offerings.

The inclusion of these presentations in no way constitutes anendorsement of the featured programs. They are offered in an effortto help our readers make intelligent, responsible decisions on thebasis of their individual needs and budget allowances.

Locate-and-Search Information Tool

Launched in May 2001 as a product division of Seisint, of BocaRaton, Fla., Accurint is a comprehensive locate-and-research toolused by many of today's insurance professionals. It is powered byan in-house computer. The system is available through the web andthrough batch processing. Highly customizable tasks can beperformed at cost, once a client is approved to use the system.

Accurint provides access to public record information fromhundreds of sources. There is no activation fee or monthly minimum.In most cases, there is no charge for a search that does notproduce a result. The basic person search costs 25 cents, and adirectory assistance tool is available for 10 cents. To gain use ofthe system, clients must have legitimate business reasons to usethe data before being awarded exclusive passwords. Accurint's mainmenu lets users choose among searches ranging from people andbusinesses to licenses, court documents, and criminal records.

For investigative purposes, an initial search can be performedby entering information, such as name, address, or social securitynumber, into one of the screen's designated fields. The basicsearch results will include a subject's name and any aliases,Social Security number, and historical address data dating back 20to 30 years. A feature of Accurint's search window is the bold bluecheck marks that identify a subject's probable current address. Thehyperlinks offer reports on leads, such as neighbors, relatives,and associates, all of which is helpful when simply having asubject's phone number yields no return.

Accurint users can retrieve information by navigating the website through a series of drop boxes leading to data source links,such as people, businesses, assets, licenses, court documents, anddirectory assistance. The option to run detailed reports also isavailable. The report options include a summary report, skip-tracereport, asset report, and a comprehensive report. The comprehensivereport comes in both flat-rate and customizable versions. Theflat-rate version is $4.50 and provides a current address,historical addresses, telephone numbers, property ownershipinformation, vehicle registrations, driver's license, associates,relatives, neighbors, criminal convictions, etc.

An online help guide is available in each individual search areaand there is an index to the help documentation on the main menu.Accurint offers free online training on all of its searchfeatures.

For more information, visit www.seisint.com.

Web-Based Estimating

ADP Claims Services Group, a provider of integrated businesssoftware for the property and casualty, collision repair, andautomotive recycling industries, has announced the availability ofADP Estimating, a web-based estimating program.

ADP Estimating offers all the same features and functionality ofexisting estimating products in the market, but adds the advantagesof access to parts and labor data as it becomes available andeliminates the need for loading CDS. Industry participants now canshare the same estimate during the review process, which reducescycle time and improves communication among parties. Shops andinsurance companies no longer have to interpret and reconciledifferent calculations made by different systems.

Clients can easily dispatch appraisals, write estimates, performtotal loss valuations, audit estimates, and write reports, all fromone system and all on the web. Total loss valuation requests areperformed through a new, web-based version of Autosource, alsorecently launched by ADP. The integration between ADP Estimatingand Autosource eliminates the need for double entry of claiminformation.

ADP also has announced the integration of new Real Steelrecycled part data from vendors that includes availability andpricing, all within a user interface in ADP Estimating.

The web-based ADP Estimating lets clients take immediateadvantage of the latest features as they become available. Clientshave no dedicated hardware or software to install, increasingconvenience and reducing costs. In addition, on-the-road appraisersstill have the flexibility of using the CD-based version of ADPEstimating when they do not have access to the Internet.

ADP Estimating provides tutorials that make it easier for newshop employees and appraisers to get up and running quickly.Clients also can write estimates faster and more accurately withSmart Estimating's new advanced decision support and new logicalnavigation.

“We are very excited about taking estimating solutions to a newlevel,” said Jose Rivero, senior vice president, ADP ClaimsServices Group. “ADP Estimating offers the advantage of real-timeaccess to data, the convenience of the web, full integration acrossall ADP claim management products, and file-sharing capabilitiesthrough a single system to let clients write estimates more quicklyand accurately and reduce cycle times. Our goal is to make it aseasy as possible for our clients to take advantage of the moststreamlined, efficient estimating process.”

For more information about ADP Estimating, contact the companyat 800-546-5237.

Enhanced Work Flow, Customization

APU Solutions, a provider of alternative part procurementsoftware and support to the automotive claim and collision repairindustries, has upgraded the work flow and customization featuresof its PartsNetwork.

Version 4.5 offers repair facilities and insurance carriersintuitive intelligence features that simplify how they search forand procure alternative parts, casting a wide net for every part onevery claim. After repair facilities enter data into PartsNetworkusing an EMS extract, the software generates part requests tomultiple suppliers in seconds. Version 4.5 also includes anauto-quote feature for searches of aftermarket inventories forinstant pricing and availability information.

Repair facilities can use PartsNetwork alongside any estimatingsoftware, eliminating the need to use multiple processes withdifferent estimating companies and carriers. Insurance carriersbenefit from PartsNetwork's extensive reporting and claim-auditingtools. The software allows carriers to observe repair facilitybuying decisions as the purchases occur, adding another dimensionto carriers' buying consultations with their shops. Carriers alsohave access to claim data for re-inspections and desk reviews toclosely manage all areas of claim activity.

“Our ongoing investment in research and development keeps APUSolutions at the forefront of the industry and, as a result,attracts many of the top insurance carriers,” said Charles Lukens,president and chief operations officer of APU Solutions. “Since ourinception, we've provided alternative part procurement softwarethat works for the industry. We tap into evolving customer needs,fine-tune our offerings, and deliver industry-leading solutionssuch as Version 4.5.”

For more information, contact Scott Westbrook at 913-599-1600,[email protected].

Cash in Hand: A Lingering Problem

By listening to its providers, Preferred Medical Claim Solutions(PMCS) recognizes that positive cash flow is one of the essentialingredients in operating a successful business. In today's economy,health-care payables are the last obligation to be paid, therebycontributing to dramatically increasing health-care costs. Thediscounts that providers must take in order to be part of a PPO'snetwork force them to drive up their prices in order to stay inbusiness. With enrollment in the PMCS Advance Funded Provider (AFP)program, however, health-care payables become PMCS' number onepriority.

The creation of the AFP program has resulted in more than400,000 providers, in all 50 states, being registered to receivepayments on their outstanding receivables within five daysfollowing benefit verification. PMCS processes out-of-networkclaims associated with third party administrators and self-fundedemployers, which, combined, total more than 3.8 million coveredlives, further reducing providers' costs and time delays associatedwith collecting medical receivables.

While the standard PPO merely reprices medical claims andreturns them to plan administrators for payment, AFP members havefull access to the Preferred Data Interchange (PDI), eliminatingadministrators' need to mail or fax paperwork. Administrativeerrors are eliminated, allowing PMCS to remit payments directly toproviders.

PDI is the customized software that provides an electronicinterface from the client's claim operating system directly to PMCSduring the normal process of claim submission, repricing,adjudication, and payment remittance. It allows administrators toincrease client retention by reducing loss ratios for theirclients, as well as lifting the administrative burden associatedwith typical cost-containment tools, while simultaneouslyincreasing the profits for the administrator.

Through PDI, insurance carriers, TPAs, and any payors canbenefit from the savings generated from the PMCS program. Whenvendors request an organization to mail, fax, or enter claim datainto their systems, it takes time and adds administrative burdens.PMCS' technology, however, saves its clients time and money byautomatically selecting and exporting claim data at the close ofeach business day, and providing the results the following morning.By reducing the provider's allowable charges owed, patients alsoreceive the benefit of lower payables. PMCS, therefore, provides atriple solution to lowering health-care costs.

For more information, contact PMCS at 888-460-0068, ext.233.

Work Order Tracking Unites Services

CornerPost Software has released TotalTrac, a web-based workorder tracking and asset management program designed to unite allof an insurance organization's in-house service, maintenance, andasset inventory needs. The system automates the handling of troubletickets, routine maintenance, and cataloging for computer andoffice equipment, furniture, vehicle fleets, and other assets ofany kind.

Available exclusively under an application service provider(ASP) model that eliminates the need to purchase, install, andmaintain servers and software, TotalTrac centralizes work ordertracking and asset management for disparate groups of items under asimple user interface suitable for anyone from custodial totechnical staff. This provides a single point of entry forreporting all types of problems, not just computer-related issues,and makes the efficiencies of paperless problem managementaccessible to all support personnel. In an insurance setting,TotalTrac can be used to track a claim's status, submit workorders, manage the maintenance of office items, monitor equipmentthat moves from room to room or person to person, and so on.

Default fields in the asset management component of theTotalTrac system are tailored to each asset category (computerhardware entries include an IP address field, for example, whilemotor vehicles do not). Custom fields can be added quickly andeasily.

TotalTrac uses a Microsoft SQL database and access is possiblefrom any web browser. Features include:

oBar code and Global Positioning System (GPS) support,permitting the use of bar codes to expedite asset lookup andinventory management, and the use of GPS data based on WGS84 Datumand NAD83 Datum standards to accommodate radio towers and otherout-of-building assets.

oThe ability to attach files to a given asset record, includingimages, system drivers, user manuals, and other files and documentsassociated with that item.

oDatabase import capabilities, allowing disparate databasesmaintained by customers to be incorporated into the TotalTracsystem.

oWireless access via PDA, enabling technicians to retrieve,modify, or close trouble tickets from their hand-held devices. Theuse of an optional bar code scanning attachment on the PDA alsoallows users to view asset records or trouble tickets stored onTotalTrac by scanning the bar codes.

“Most inventory, asset management, and work order systems todayare designed strictly for computer equipment, but organizationsneed a total solution that encompasses other aspects of theiroperations,” said Ryan Elswick, chief operations officer ofCornerPost Software. “TotalTrac answers that need for totaltracking with a flexible system that can be adapted easily to theneeds of any kind of enterprise, from schools and businesses tohospitals and banks.

“Unlike other client/server or stand-alone softwarealternatives, TotalTrac is the only ASP-based work order managementand tracking solution on the market today,” he continued. “Not onlydoes TotalTrac require no upfront capital investment or on-premisesinstallation, but the service automatically links any individual,department, or service organization with a web browser, keeping allcritical parties in the loop for each work order.”

More information is available at www.cornerpost.net.

Business Rule Engines Improve Claims

Increasingly complex customer requirements, constantly changingjurisdictional requirements, high claim handler turnover — it's nowonder that obtaining high productivity and improved claim outcomesis so difficult. What costs would be saved if new customerexpectations could be integrated into automated claim processes?Envision the value of automating such activities as claim triageand assignment, generation of claim documents, and alerts andnotifications based on your business rules. Imagine the benefits ifthe knowledge of your claim handlers were embedded in your claimsystem and all your claim handlers were using best practices tomanage claims. Think of the value of being able to implement newbusiness rules and make changes to existing rules rapidly andefficiently.

The answer is here and it does not require precious informationtechnology resources to bring it to life. The solution is abusiness rule engine (BRE). A BRE separates business rules fromapplication code and allows business users to control the rulesrunning claim management practices. With a BRE, modifications canbe made easily to business logic without changing actualapplication code.

Generally, the rules that affect the claim management processfall into one of the following categories:

oProcess-oriented rules Rules that support practices,procedures, and work flow.

oInference rules If/then rules that make logical conclusionsbased on multiple facts.

oComputation rules Rules that perform mathematical operations ondata values.

oData-oriented rules Edit rules applied to ensure correct datainput or change existing data.

Rules vary in both complexity and their rates of change. Themost dynamic rules are complex constraint computations andinference rules. These types of rules manage business transactionsand workflow; therefore, they represent true candidates for abusiness rule engine. To achieve the optimal value of thistechnology, however, there are some important things toconsider:

Select the right business rule engine. A BRE should monitorclaim information continuously to determine when actions need to beperformed based on your business practices. Not all BREs arecreated equal, however. An inference BRE is an intelligent ruleengine, based on specific algorithms, and ideally supports bothforward and backward chaining.

Forward chaining inference rules evaluate data in an effort todetermine appropriate actions to execute. For example, if younotice a red light in front of you, you immediately put the brakeon without first considering whether to turn down the radio.

Backward chaining is a goal-driven process that is used when weare trying to explain the causes of results. For example, if it istoo hot, you consider why, ask yourself whether the heater is onand, if yes, turn it off. The ability to infer or deduce actions isa significant benefit of an inference BRE over traditional businessrule engines.

Insist on easy and comprehensive rule authoring. Because rulesneed to be created by business users, this process must be simpleand straightforward. To this end, two critical features areimportant. The first is the ability to author rules in naturallanguage, rather than writing rules in programming code. The BRE,therefore, should include the capability to be “taught” aboutconcepts, definitions, and relationships in your business terms todeduce the appropriate conclusion when executing rules.

The second feature is an authoring wizard that helps your ruleadministrator through a step-by-step process of writing rules. Thisprocess also must apply to complex, multi-variable rules. The BREwizard in Corporate Systems' ClaimsPro system uses common claimterms along with standard claim codes in an easily understandablesentence format. This approach simplifies the process of selectingthe right criteria, the right values and the right outputs oractions.

Require business rule library management tools. Within the claimprocess, there are thousands of rules, and more rules get added orchanged every day. To manage your rules, you need a rule managementtool and a rule library, a single repository for all of your rules.Your rule library should provide the following key authoring ormanagement tools: a set of tested, flexible templates that can betailored to your business requirements; the ability to edit andaudit rules in a production environment; the ability to report andperform data mining on rule execution; and flexible role-basedsecurity levels.

The Rules Center allows easy access to the management tools andestablishment of your rule library. The organization of the ruleswithin the library results in a knowledge repository that supportsa more thorough understanding of current business processes andclaim management policies while enabling business processimprovement.

For more information, contact Derek Coleman, director ofarchitecture, at [email protected].

Crash Modeling Evaluates Injury Claims

When you buy your next automobile, chances are that, during thedesign process, it was crashed into a mathematical barrier moretimes than it was crashed into a real barrier. Sound high tech?Next time you evaluate an injury claim you may be doing thesame.

Some claim adjusters and SIU personnel already are applying thistechnology to the evaluation of injury claims. Crashport hasintroduced a new crash analysis service to the property andcasualty industry that is based on mathematical modeling similar tothat used in the automotive industry to assess vehicle crashperformance and test vehicle safety features. Mathematical modelinguses the facts of an accident to reproduce the forces and motionsexerted on both the vehicle and the occupants riding inside,enabling various types of injuries to be evaluated.

“While new to the insurance industry, mathematical modeling ofoccupant dynamics is routine in the auto industry,” said JohnBurge, CEO of Crashport. “We looked at the methods being used bycarriers, attorneys, and expert witnesses and recognized that theywere in conflict with the much more sophisticated mathematicalmodeling methods being used in automotive design and injuryresearch. We have simply transferred this technology into theinsurance industry by largely automating the analysis process, madeit easy to use and cost-effective for evaluating injury claims,particularly those involving soft-tissue injuries.”

“Photos without scientific interpretation can be verymisleading,” said Robert Thibodeau, Crashport's chief technologyofficer. “Some vehicle damage photos look very dramatic, butmathematical modeling of the key variables associated with injurymay reveal that the potential for injury was very small. On theother hand, some accidents with minimal auto body damage maypresent a potential for injury. We will be helping claim personnel,attorneys, and courts make better decisions in this regard.”

The clients who use Crashport do so because it helps themoperate more efficiently and effectively by better defining thelegitimacy of a claim. Is there a high correlation between theaccident forces and the injuries claimed? Or is this a claim forfurther investigation and validation?

“A claim that is wrongly paid can be very expensive for aninsurance company, and a claim that is wrongly denied can result inunnecessary litigation costs followed by eventual payment of theclaim, not to mention potential for bad faith liability if afirst-party case,” said Burge. The Crashport analysis allowscarriers to use the best science available, increasing theirability to identify which claims are more likely to be valid fromthose that represent potential abuse.

What if a case goes to court? The company now providescompetitively priced expert witnesses and strategy consultingservices to help attorneys and insurance companies address injurycausation issues in court, particularly those relating tosoft-tissue injuries. Crashport will provide testimony servicesonly in cases in which a Crashport analysis is consistent with aclient's position, however.

“Our modeling system is objective and will be the same for everycase,” said Burge. “The facts are the facts, however they fallout.” Objectivity is the most critical feature of any crashanalysis method, he added. “Mathematical modeling enables us toobjectively calculate everything that is necessary to understandthe forces and motions involved in the crash.”

It is easy to use the Crashport service through its webinterface. The adjuster spends five to 10 minutes entering basicinformation, such as type of vehicles, point of impact, andpassenger data. Photographs are loaded into the system forincorporation into the analysis. The data is then processed, withresults posted to a private web page. Pricing is on a per-claimantbasis, based on the number and types of vehicles involved and thecomplexity of the accident.

For more information, contact Burge at jburge@crash-port. com,www.crashport.com.

Innovation for Claims

The insurance industry was an early adopter of informationtechnology, and computer systems still are the backbone ofinsurance processes. In many organizations, however, technology nolonger supports business process improvement, but has become aconstraint that insurance professionals grapple with every day.

The limitations of existing technology are evident in today'sclaim organizations. In the last decade, visionary claim leadersconceived many new claim-handling processes that promised to lowercosts while improving outcomes and customer service. Just a few ofthese new ideas include beginning the adjusting process during thefirst contact, including referrals across a network of partners todeliver service faster; sophisticated segmentation and assignmentmodels that route work to the appropriate resources; andcollaboration among teams of professionals both inside and outsidethe claim organization, including adjusters, attorneys,investigators, case managers, and others.

Instead of making these ideas a reality, however, most claimsystems serve as an impediment to change. Too often, existingmainframe and client/server systems cannot be modified to supportnew processes at a reasonable cost. At the same time, adjustersstruggle with a plethora of everyday annoyances and obstacles, suchas the need to constantly switch among multiple screens or multiplesystems for even routine information; the inability for more thanone person at a time to work on (or even look at) the same claim;and failure to capture required data elements, generally thoseignored by the system's original developers.

Guidewire Software is dedicated to promoting innovation in theinsurance industry and unlocking the power of technology to improveinsurance processes. Guidewire's flagship software, GuidewireClaimCenter, applies this basic principle to claim organizations.ClaimCenter is built with state-of-the-art software technology,written in Java to the J2EE standard, with pure web client and webservice interfaces. More importantly, the system provides claimleaders the freedom to translate ideas into reality, allowing themto tune their claim processes to the specific and evolving needs oftheir businesses, rather than struggling with the artificiallimitations imposed by legacy systems.

At the core of the system, a data model allows each organizationto define the exact data elements it needs, both to adjust claimsand to analyze claim processes. Configurable screen layouts gatherthe critical information necessary to make accurate decisions atkey points in the claim lifecycle. Streamlined communicationmechanisms, from system-generated e-mail to automated flagging andhandling of exceptions, notify appropriate claim handlers at themoment that intervention is needed, not a week later, when theclaim already has escalated out of control.

Behind the scenes, a rule engine gives claim leaders the powerto mold the claim process or processes, as a different workflow canbe defined for each line of business, state, coverage, severity, orother factor. Based on any of these attributes, claim-handlingactivities can be specified, with varying priorities and due dates,and can be assigned to the most appropriate people inside oroutside the company. The extended organization can be subdivided asfinely as desired, creating specialist roles with specificpermissions, responsibilities, and geographic territories, forincreased efficiency and expertise.

ClaimCenter provides continuous management of the claim process.Supervisors can see caseloads across their teams and viewindividual claims, while overdue activities or potentially riskyclaims are escalated automatically. As a result, managers not onlycan define their ideal claim processes, but also can monitor themin operation and intervene as required. By analyzing ClaimCenter'sdatabase of claim information (coverages, claimants, vehicles,etc.) and process information (activities, completion times,service levels, etc.), they can better identify the key drivers ofclaim outcomes and refine their processes accordingly.

ClaimCenter's flexibility is underscored by the diversity of itscustomer base, ranging from a regional all-line carrier to aspecialist in long-haul trucking to one of the largest commercialinsurers in the world. What these companies have in common is avision of how technology can support innovation and make theircompanies more successful. ClaimCenter is their tool for makingthat vision a reality.

More information is available at www.guidewire.com.

Browser Revolution in Claim Management

It is estimated that claim settlement costs could be reduced byas much as 15 percent through the use of sophisticated technology.Every few years, a new technology is touted as the next big thing.In order to really take hold, however, innovations must adhere tothe core objectives of claim management: cost control, efficiency,and timely, appropriate responses for optimum outcomes.

The claim department must be able to access critical informationto make effective decisions and run reports in order to improveperformance. In addition, claim professionals must be able to focuson the activities that directly affect outcomes. To avoid laggingbehind the best-practice curve, organizations should align theseobjectives with appropriate claim tools.

Responding to these requirements, browser-based technology hasbegun to revolutionize claim practices, allowing participants inthe claim process to communicate and collaborate effectively. Thisnext-generation claim management technology is both flexible enoughto adapt to an organization's unique needs and is accessible viathe Internet.

The impact of browser-based technology has increasedsignificantly as the concept, “The network is the computer,” hasbecome more widely accepted. Browser-based technology can run overthe Internet or be configured on a company's own network orintranet. The only thing a user needs to run the application is abrowser; no middleware is necessary.

As a result, the application model has had a profound impact onhow claim departments acquire, use, and maintain informationsystems. Claim organizations save valuable IT resources, asbrowser-based technology does not require installation or updatesat individual workstations. Instead, maintenance and updates occurat the server level.

For claim professionals, the main benefits of browser-basedtechnology include accessibility and connectivity. Remoteemployees, attorneys, nurse case managers, and other third-partyorganizations can gain access to claim information at any time,from anywhere. Linking multiple parties allows the variousspecialists to focus their expertise in specific areas, allowingthe sharing of information and improved collaboration amongdifferent parties.

With today's high volume of claim activity, streamlined workflowis critical to operational efficiency. As a result, workflowmanagement has come into the spotlight as a way to enable the exactand timely use of automated processes and expert resources.Business rules are the means by which many organizations defineworkflow but, traditionally, this has taken place through a diarysystem.

While diary-centric workflow is great for claim adjusters, itdoes not work well for others who are becoming increasinglyintegral to the claim process. Today's browser-based technology nowincludes document imaging and provides work-flow management beyonddiary-based task lists. For instance, an organization can establishbusiness rules to alert nurse case managers via e-mail of claimsthat require their attention and medical management expertise.

Browser-based rules automatically involve more specialists inthe workflow process. These rules are easy to configure withdrop-down menus and check boxes, and can be modified quickly inresponse to legislative changes and new policies. Rules enablenotification via e-mail, pager, or mobile phone, which plays acritical role in alerting decision-makers of large loss claims(death, multiple employees).

Browser-based applications further expand on the Internet model.One good example is sending a claim link, an Internet hyperlink toa specific case, via e-mail within the claim system. This can besent to an authorized specialist, such as a defense attorney, toeither view or update specific aspects of the claim, such as thelitigation component. The link is secure, with access restricted bythe sender, typically the claim adjuster. The link allows theattorney to view the latest claim notes and activities, withouthaving to contact the adjuster.

The Claim link provides transactional cost savings and cuts backon bottlenecks in receiving information, such as waiting forreturned calls or e-mail updates. Due to the flexibility ofbrowser-based technology, links and alerts established within thework-flow management process allow various participants in theprocess to be better informed of claim activity and betterpositioned for appropriate responses.

By adhering to established protocols and standards,browser-based technology is highly interoperable, meaning that itworks well with various platforms. As a result, browser-basedtechnology easily brings together medical bill review, riskmanagement information systems, incident reporting, accountspayable, and human resource databases, allowing for a one-systemprocess.

Revolutionize! It is a good time to get caught up in the browserrevolution. As claim managers continue to be challenged on severalfronts, such as tight budgets, rising costs, increased severity andfrequency of claims, and heightened pressure to improveperformance, they have turned to browser-based technology as aneffective answer to those challenges. In the final analysis, thesesystems allow collaboration with various specialists and provideexactly the type of access to information that claim managers needto reduce costs and improve performance.

For more information, contact Randy Wheeler, CEO of Valley OakSystems, at [email protected], www.valleyoak.com.

InsureWorx Claims: Out of the Ordinary

Acquiring new claim administration system capabilities presentsa difficult set of decisions and risks that will affect operations,expenses, and customer service for a decade or more. Until now,insurance companies seeking the strategic advantages of web-basedclaim applications have been faced with a plethora of undesirablerisks in dealing with their existing systems.

“Rather than trying to replace all core processing at once andtackle a high-risk approach to full legacy replacement, insurersnow can control their own destinies and effectively manage the riskand rewards involved in any legacy replacement effort bydetermining the starting points based on their own needs,priorities, and risks,” said Deborah Smallwood, insurance practiceleader with TowerGroup. “WorldGroup leverages new web servicetechnologies like J2EE and WebSphere that provide the framework forenterprise component-based architecture.”

In addition to providing time-to-market efficiencies forachieving web-based claim administration, the InsureWorxbuilding-block approach allows insurance companies to replacefunctional legacy areas, as needs dictate, yielding a manageablepiece-by-piece transformation to full replacement.

A popular starting point for web capabilities is claimreporting. The latest InsureWorx On Demand Solution, first reportof injury, offers efficiencies and customer service to thereporting process; allowing efficient and timely interventioncritically important to controlling overall costs of workplaceinjury claims.

In today's web-enabled world, an insurer's customers andproducers have all become system users. InsureWorx takes intoaccount the fact that system users can range from internal staffand external customers to producers and business partners, andprovides navigation that is flexible for the unique needs of allusers, whether expert, novice, or occasional. InsureWorx affordseasy access and processing efficiencies that accommodate fieldoffices, remote employees, remote work sites, and, mostimportantly, customers.

With InsureWorx, the insurer is able to support any and allweb-based services that customers may demand today, as well asservices the insurer may require in the future. Designedspecifically for mid- to large-sized group and commercial lineinsurance carriers, InsureWorx Claims offers complete lifecycleclaim processing. Multi-line, multi-state, multi-company, multipleclaim processing offices, and remote employees all are addresed ona on single InsureWorx Claims system.

Consider a multi-line carrier with dozens of regional claimoffices around the country. Compound the situation with remotehome-based examiners and field case managers. In this typicalenvironment, different systems and software packages historicallyare a given. With InsureWorx Claims, each of the company'srepresentatives, customers, agents, and brokers, regardless oflocation or line of business, can tap into a single system to takethe claim through its lifecycle.

InsureWorx also provides a broad technical stance for whateverthe future may hold. Created with the Java 2 Enterprise Edition(J2EE) standard, using IBM's WebSphere products, the systemprovides all the benefits that an open standard, platformindependent, web-based system has to offer. It can be the insurer'sfirst step for legacy transformation and a building block to thefuture. InsureWorx Claims gives an insurer's staff, customers,agents, and business partners the tools they need to do their work,and that translates into better claim processing and bettercustomer service.

For additional information, contact Ron Lang, director,insurance solutions, at 800-785-4526, www.worldgroup.com.