Automating processes, detecting fraud and saving bottom-linecosts are just a few of the reasons insurers look to new claimstechnology, and vendors are eager to provide a wide array ofsolutions.

The following is a sampling of new claims tech productsintroduced or updated during the past year.

o Guidewire Software Inc., based in San Mateo, Calif., offersClaimCenter 3.1, the latest version of its claims system forproperty and casualty insurance carriers.

The Web-based claims system can be used for all lines ofbusiness to improve the claim process, reduce claims costs andenhance customer service, the company said. ClaimCenter 3.1 isdesigned to improve insurer control over core claim operations byincreasing visibility into key performance metrics, automation ofthe claim process and overall system flexibility.

The latest release features out-of-the-box integration with ISOClaimSearch to “dramatically enhance fraud detection whileeliminating re-keying for adjusters and integration work for[information technology] staff,” the company stated. Improveddocument management and robust capabilities for tracking claimslitigation are also offered.

According to Guidewire, the new version also featurescross-claim tracking (to detect possible fraud indicated by thesame contacts used across claims) and the flexibility of allowingusers to configure their own searches. Users can add new searchterms and specify search behavior.

Pricing is typically through an annual subscription fee based onpremium revenues, ranging from $200,000 to multiple millions, acompany representative said. Further details are available atwww.guidewire.com.

o SPSS unveiled PredictiveClaims, a software application basedon “real-time predictive analytic technology” that integrates withexisting claims management systems to determine which claimsqualify for approval and which are potentially fraudulent.

According to Chicago-based SPSS, the new product will “reduceinsurance fraud, significantly improve the claims process and cutcosts. 'Fast-track claims handling' considerably improves theefficiency of claim handling and customer service,” the companynoted.

PredictiveClaims automatically analyzes all claims entering asystem from any channel against risk profiles and external frauddatabases, said SPSS. The product either approves a claim forprocessing or flags it for further investigation. It can alsoprovide “smart” questions that prompt a claims handler to askcustomers for new information that could confirm the likelihood offraud.

The company added that PredictiveClaims helps p-c insurers tounderstand why certain claims are flagged as suspicious, so specialinvestigation units know where to focus their inquiries. Thesoftware combines and analyzes data from multiple sources,including federal and insurance industry databases.

The software integrates with existing claims management systems“without extensive customization or lengthy implementationperiods,” said SPSS.

Pricing is based on the number of claims processed, and “isgenerally in the range of several hundred thousand dollars,” acompany representative noted. Further details are available atwww.spss.com.

o Computer Science Corp. will announce the release of its newClaims Desktop for p-c insurers this month, according to theAustin, Texas-based company.

Claims Desktop is a browser-based system that integratesmultiple claim functions, applications and data, “enablingadjusters to introduce new capabilities such as claim profiling,claims routing and functional collaboration,” the companystated.

Adjusters can share data across multiple applications from asingle Claims Desktop screen, eliminating the need for redundantentry.

The new software will also include task management software toguide adjusters when they investigate and evaluate claims, saidCSC. Claims Desktop employs an external rules engine, “making iteasier and faster to define and modify business rules andcalculations,” said the firm. “The product integrates workmanagement and imaging/document management capabilities along withprocess orchestration.

Pricing will begin at $100,000 and is dependent on the direct,written premium of the company using it, the company noted. Furtherinformation is available at www.csc.com.

o The Insurance Services Office Inc. and the National InsuranceCrime Bureau last month announced they are collaborating on SIUCase Manager, an anti-fraud tool for insurer special investigationunits to be released later this year.

The new platform will integrate many functions associated withmanaging underwriting and claim investigations, said JerseyCity-based ISO. It provides workflow automation required by SIUprofessionals.

NICB, based in Palos Hills, Ill., is a nonprofit organizationdedicated to preventing, detecting and defeating insurance fraudand vehicle theft.

“SIU Case Manager will help investigators document, assign,report and archive claims being investigated,” said the ISOannouncement. “It will include a customer response diary, expensetracking, time-triggered mailings, and streamlined NICB and statefraud bureau reporting features for enhanced SIU productivity.”

SIU Case Manager will be integrated with ISO ClaimSearch, acomprehensive all-claims system, and ClaimDirector, a claim-scoringservice. SCM will also assist insurers with enterprise-levelreporting and compliance with regulatory requirements for antifraudprograms, said ISO.

The company declined to provide pricing information. Furtherdetails are available at www.iso.com.