New Product Allows Insurers to Share Claims Records, Cut Costs

Property & casualty and health insurers overpay injured people an estimated $15 billion a year because each sector of the industry lacks information about claimants that only the other side has, according to Stephen Ambrose, CEO of ICEX, an insurance information-services company.

To plug that gap, ICEX has developed ClaimCatcher, a cross-claims data exchange designed to reduce overpayments for medical and injury claims.

“For the first time, P/C insurers will be able to tap into an injured claimant’s medical claims history from health insurers to verify preexisting injuries related to the current claim,” says Ambrose.

Separately, health insurers will be able to find out when their members have filed injury claims with p&c insurers. The health insurer can then subrogate against the member.

ClaimCatcher complies with HIPAA and NAIC model regulations and the most stringent state insurance laws on privacy, claims and data, according to Ambrose. The technology will be used by p&c carriers, health insurers, Medicaid, self-insured employers, and workers’ compensation carriers.

Between 0.5 percent and 1.0 percent of all paid medical claims result in subrogation recoveries, according to CIGNA. Relying on predictive analytics and form letters, Medicaid and commercial health plans recover less than $2 billion annually, perhaps only 25 percent of what’s available, Ambrose explains.

Because ClaimCatcher doesn’t rely on claimants to personally validate their involvement in a claim, widespread adoption of the technology could eventually boost recoveries to nearly $9 billion, Ambrose reports.

Almost 39 million injury claims are filed annually and payouts from all p&c insurers total nearly $180 billion a year, according to A.M. Best. Using ClaimCatcher’s process, p&c insurers can request and match up prior medical claims related to the claimant’s current injuries. Ambrose believes better identification of preexisting conditions can save P/C insurers $7 billion and slash overall claims costs by nearly 4.0 percent.

“Overpaying claims is unfair. It costs insurers, employers, taxpayers and insureds a fortune. Providing a new level of transparency will make claims management far more accurate and fair,” says Ambrose.

ClaimCatcher is expected to become available during the second quarter of 2013. ICEX is currently looking for a strategic partner to help deliver its proprietary technology to the insurance industry.

Comments

Resource Center

View All »

Contractors General Liability Coverage 102

What is a prior work exclusion? Which option is right for my client? Why do...

Sign up today to get a 50% matching credit -...

Insurance marketing sometimes seems like it's a game of swings and misses, but we're here...

Guide: 5 Steps to Selling Cyber

Cyber risk and data security is on the agenda of every business owner and executive....

Citation Correlation

Do rigger and signalperson qualifications correlate with the cause of crane and rigging accidents? ...

Complete Guide to Electronic Signatures in Property & Casualty Insurance...

In property and casualty insurance, closing new business quickly is key. Learn how to leverage...

INSTANT ACCESS: Complimentary Sales Closer Questionnaires

Help property owners or managers compare your commercial residential property insurance coverage vs. the competition....

Determining Vacant Property Perils and Valuations

Are your clients fully covered for Vacant Properties? In this economic climate, your insureds may...

Risk Management for Law Firms

This package of 3 concise risk management articles offers straightforward content and practical suggestions law...

Guide: Top 15 E&O Risks-And How To Avoid Them

Accidents happen. But when it's an errors and omissions oversight, that accident can open your...

We'll Show You How to Reach Your Sales Goals

Whether you work alone or have a team of agents working for you, we can...

Claims Connection eNewsletter

Breaking news on disasters, fraud, legal trends, technology, and CE initiatives for the P&C claim professional – FREE. Sign Up Now!

Claims-Handling Guidelines

Claims Magazine is providing the following free guidelines and regulations in order to help adjusting professionals stay abreast of each state’s unique property and casualty claim-handling requirements.

View our State Guidelines »

Advertisement. Closing in 15 seconds.