From the May 2006 issue of Claims Magazine •Subscribe!

Rising to the Challenge: The Future of Claim Management

The National Underwriter Company along with Claims Magazine is committed to doing our part to aid in the recovery process of New Orleans. It was with careful consideration that we decided to hold the 10th Annual ACE America's Claims Event in New Orleans on June 12-14, 2006.

The city might be different than the way you remember it, but the urban core is still vibrant and the French Quarter has rebounded and is ready to welcome us. Preview some of the sessions below and join us as we learn and participate, and most importantly, become part of this great city's renaissance.

Hurricanes of 2005: What Did We Learn?

We know the numbers. We saw the images. Some of us were at the scene getting first-hand accounts of the horror that was the hurricanes of 2005. But what did we learn? Dakin Kinser, claim manager of catastrophe services for State Farm Insurance, will address this important topic at the 10th annual ACE America's Claims Event.

"We need to talk about access to catastrophe sites, public information, and how we partner with civil authorities and state folks," Kinser said. "In Louisiana, while the Department of Insurance was very cooperative, we ran into perished governments that created some issues for us."

Reaching policyholders is another area Kinser believes needs significant improvement. When response is set up for a catastrophe, it is sometimes centered on the catastrophe's location. In the case of Katrina, he said, policyholders went away, all over the U.S., some still in need of response from their carriers.

"When our policyholders from any company are so dispersed from the area like they were, [we should see to it that there are] better mechanisms in place to make sure that they can be taken care of just like they would've been had they stayed," he said.

The human factor is closer to what Kinser said is the most important lesson to be learned from last year's catastrophes.

"A mega catastrophe like [Katrina] had such a human impact," he said. "I learned that we also have to be ready to respond to the needs of our own people, our responders, in a way to make sure that they are psychologically prepared for what they will experience and go through."

To hear Kinser's general session, "Lessons Learned from the Hurricanes of 2005," make plans to attend this year's ACE America's Claims Event in New Orleans.

Fraud Fighting: Come Together Now

There's vehicle cloning, identity theft, even self-destructive -- and often fatal -- staged auto accidents. What will fraud schemers think of next?

As the insurance industry becomes more familiar with fast-paced, high-tech services, so does the work of the fraud perpetrator. Mark Russell, National Insurance Crime Bureau vice chair and Grange Mutual Casualty Company vice president/chief administrative officer, believes the industry's fraud-fighting efforts can be updated accordingly. Russell will share insights on how to do so at this year's ACE America's Claims Event.

"The industry as a whole has a lot of room to improve in how we collaborate to fight fraud -- data collection, data analytics, data sharing between companies -- all within the scope of the fraud immunity statutes," he said. "There's also a lot of room for us to place more focus on medical fraud and using technology to fight fraud. There is an emerging use of predictive modeling, rules-based applications, and link analysis. We've come a long way on that, but there's still a lot of room to grow."

Russell said fraud perpetrators are getting much more sophisticated in terms of ring activity, medical fraud, and vehicle cloning. When asked if the industry has had a sufficient handle on fraud in the past, he said it is getting better."The industry has put a lot more resource into fighting fraud, [and] that seems to have leveled off somewhat. There is a need to heighten the investment in the fight against fraud from an industry perspective," he said. This investment need -- which includes training, technology, and bringing talent into the industry -- is what Russell anticipates might stick with the audience of his breakout session the most.

Do not miss Russell's vital session, "The Industry Challenge for Responding to Insurance Fraud."

Worst Time to Plan? Post-Catastrophe

When a catastrophe strikes, claim adjusters are expected to be among the first people to arrive at the scene. They are a direct reflection of the policyholder's company. Making a good first impression and getting the claim off on the right foot is essential.

"The predictions for 2006 are pretty bad in terms of what [weather specialists] are expecting the hurricane season to be," said John Ketch, vice president, national sales manager for Crawford and Company. "The time to establish a relationship with an independent adjusting firm shouldn't be post-storm. There should be a relationship on the day-to-day business so that both the carrier and the independent can understand the needs, the policy, the handling, and any expectations prior to worse-case scenario following a disaster."

In his session at ACE America's Claim Event, entitled "Maximizing the Relationship Between Carrier and Independent Adjuster," Ketch will reinforce the fact that independent adjusters can do a lot for carriers -- if carriers allow them to.

"There's certainly a lot of pre-planning that can go into that to assist the carrier and to understand what resources the independent can bring and what they can anticipate," he said. "[Independent adjusters] have the ability to tap into resources [carriers] may not have, local expertise in an area where the carrier may not have field staff, knowledge of the local market, including attorneys, contractors, whatever the case may be depending on the service or product line."

Most importantly, Ketch predicts staffing issues will continue to crop up as hurricane seasons continue to maintain their levels of severity. He recommends arranging for services prior to actual need to maintain a positive rapport with policyholders. "There is a limited amount of resources out there. There are only so many catastrophe and independent adjusters and, unfortunately, I would say the industry was pretty tapped out [last year]."

How does Ketch feel about presenting in New Orleans? "I think it sends a positive message to the folks in Louisiana and New Orleans that the insurance industry is here to assist in getting their lives put back together. I think it is a great idea."

Register now for ACE America's Claims Event at www.aceclaimsevent.com.

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