Claims Magazine September 2010
Cover Story
Staying Ahead of Medical Claim Fraud
Much has been discussed about the rising costs of health care in this country. What hasn't been discussed, however -- and what ends up costing millions of dollars on its own -- is medical claim fraud.
Features
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Advanced Claim Analytics and Data Mining
Advanced analytic technology and data-collection techniques can help an insurer settle similar claims in similar ways, leading to more adequate claim reserves, improved loss cost management, and more equitable settlements.
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The Face of Vehicle Theft Today
Vehicle theft rates have been steadily dropping in the last few years. While this is encouraging news, it does not tell the whole story of vehicle theft.
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Determining Total Textile Costs
With increasing pressure on insurance carriers to reduce severity, the contents restoration segment has gained in importance, and the garment and textile niche offers a substantial opportunity for carriers to achieve their objectives.
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The Claim Transformation Journey Continues
As an update to Ernst & Young's 2008 publication, "Building the Case for Claims Transformation," this article will provide a review of the key drivers behind the continued investment in claim transformation.
Columns
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Musings on Successful Leadership
If you have decided that management is your calling, then some practical considerations are in order.
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Back to School
As older students return to school, they are taking possessions and vehicles to colleges and universities some distance from home. This raises questions about insurance coverage and claims.
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The Move to Paperless Payments
When compared to traditional check processing, electronic payments increase control over finances, reduce fraud, free up adjuster time, and can increase claimant satisfaction.
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Touching the Third Rail
A "third rail" is the power source for a train that is so charged that one touch is fatal. So get ready as the Iconoclast stretches out his Fibber's 10-foot pole toward a few forbidden "third-rail" insurance topics.
Departments
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Check Yourself
Claim professionals must remember that their tone ultimately conveys their feelings toward an insured and the legitimacy of a situation and claim.
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Speaking Of: Environmental Forensics
We discuss how forensic experts are assisting with the oil spill, what certifications experts should hold, and misconceptions about their role.
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Crawford Confirms Role in Oil Spill Claims
Crawford & Company has confirmed that GCG has been retained to assist Feinberg Rozen, LLP with Mr. Ken Feinberg's role as the administrator of the Gulf Coast Claims Facility.
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Splitting Costs on Concurrent Wind/Water Claims
Legislation introduced in the Senate on July 29, which would split the difference on "wind vs. water" claims after a hurricane, appears to be generating little support within the P&C insurance industry.
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Motorists Admit to Driving While Hungover
Aside from a nasty headache or fatigue, overindulgence can pose a dangerous liability when the intoxicated decide to drive to work the following morning.
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Fraudster Gets Just Desserts
Yet another cold, hardened criminal was convicted of profiting from staging auto accidents and will now pay a hefty price for the hundreds of counts of insurance fraud filed against him.
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Subrogation Tool Coming to Eight New States
Subrogation and claim specialists in New York, Texas, and six other states will soon join nine others who have access to a tool that helps streamline the subrogation process -- at no charge.
