Product: Insure3 Claims
Company: Castek
Web site: www.castek.com

The first release of Casteks Insure3 Claims solution has been delivered, but at least for one early customer, its a long road between release and implementation. National Grange Mutual (NGM), a New Hampshire-based P&C insurer, is one of two carriers implementing the product (the other chooses to remain unidentified), and Steve Canty, senior vice president of claims, says the implementation process will take approximately 15 months. With a year of development already behind them, wouldnt a packaged solution have been better? There are definitely some good products out there, but we had decided to reorganize the processes in our claims organization, Canty says. We worked closely with Castek to develop this. It was a much better opportunity for us to get what we wanted. [Castek] had the software knowledge, and we had the claims knowledge.

Insure3 Claims is a claims management system that supports the entire claims lifecycle, from first notice of loss to assignment, adjudication, settlement, and recovery. Insure3 Claims uses a Java 2 Enterprise Edition platform. A JSP-based, thin-client user interface makes it accessible through a Web browser. The component-based architecture and design provides flexibility and scalability by using Enterprise JavaBeans. The system is also portable across multiple platforms.

One of NGMs goals with this project was to reduce cycle time for claims. The carrier increased efficiency by getting away from regional offices receiving first notices and having all losses reported to a centralized adjuster center. Canty says this removed a tremendous amount of duplication and created a more consistent approach to the claims. The Insure3 Claims solution will route the less severe cases to one group of adjusters, while the customer-sensitive and high-severity claims will go to another set of adjusters. We are working on an automatic assignment process that allows us to build a profile on our own adjusters, says Canty.

Toronto-based Castek is looking to integrate Insure3 Claims into its Insure3 Policy system later this year as part of its Insure3 suite of products.

Product: SceneAccess.Net
Company: Scene Genesis
Web site: www.scenegenesis.com

Scene Genesis has come a long way in a short time. The companys first product back in 1998 was a digital photo repository for P&C insurers to use in the claims process. Now, with SceneAccess.Net, the company has created an end-to-end claims system that handles workflow and assignments. Theyve increased their functionality exponentially, says David Lawton, project manager for Atlantic Mutual, a New York-based P&C carrier. They have really created a bridge between the appraiser and the carriers.

Steve Welk, marketing director for Scene Genesis, believes two things had to happen to make such a system successful. The Internet had to become more accepted for commerce, and companies had to show a willingness to utilize outsourcing, Welk says. In the last few years, carriers have not been pulling in the dollars from premiums, and they had to ask themselves, How do we cut costs?

As the name implies, SceneAccess.Net is an Internet product available around the clock to anyone with a Windows-compatible desktop or laptop and a standard Web browser. The system allows users to import data from the major estimating systems for run reports, comparison searches, and data mining. SceneAccess.Net converts the data into XML format. The system also offers viewing of claims and inspections information, business process workflow, and business analysis reports.

Lawton says the system works well for his company. On the auto side, we use all third-party appraisers. This creates a means to electronically assign the appraisal to a firm, he says. They can then do their thing, and the SceneAccess piece bundles everything back together and sends it back up to their site where our adjusters are able to view the information. The move has created plenty of benefits for Atlantic. Before, we created a paper file for everything, Lawton says. Now, everything is electronic.

Lawton was pleased with the training program set up by Scene Genesis. Theres actually a client piece of software that resides on the appraisers laptop, Lawton says. Scene Genesis takes care of all of that. Atlantic started small, with five appraisers being trained, and it has been adding them on a regular basis. Scene Genesis does not publish pricing information, according to Welk.

Product: ViewLink Manager
Company: Insurance Services Office
Web site: www.iso.com

With its ClaimSearch database, Insurance Services Office (ISO) is the company P&C insurers turn to for information about fighting fraud. Now, with the purchase earlier this year of Alta Analytics, a developer of analytics tools, ISO has increased the pressure on fraudulent claimants. ISO calls this new division NetMap Analytics and, through it, offers ViewLink Manager, a software tool that combines the huge ClaimSearch database with Altas signature product, NetMap for Claims, to identify suspicious claims and reduce delays in paying legitimate claims.

ISO began working with Alta three years ago, and the association led to ISO purchasing Alta in February of this year. The acquisition brings together the ISO ClaimSearch database with the link analysis and data visualization tools developed by Alta, giving insurers another tool in the battle against fraud.

ViewLink Manager runs on the desktop with an encrypted Internet access to the ever-growing ClaimSearch database. Vincent Cialdella, vice president ISO – ClaimSearch, says insurers can purchase ViewLink Manager on a per-seat basis. Fees are based on the insurers net written premium. It is installed on the PC through a CD-ROM using a Windows application. The product uses a set of data elements by which they look to perform the links, he says. Called nodes, they include claim number, VIN, name, address, Social Security number, drivers license number, tax ID, and policy number. Those are the areas that have been found most indicative of a link, Cialdella says.

Ron Peters, assistant director of Safecos special investigation unit, says users are frequently awed by the systems ability to link a new claim to fraudulent claims. You run data, look at it and go, Oh my, and there it is, he says.

For Safeco, the challenge was getting it set up, Peters says of the NetMap installation. Multiple legacy systems required Safeco and NetMap IT personnel to write an extract. Once that was done, Safeco was able to pull the information from different sources into the NetMap repositories. He says Safeco has found the system works particularly well on medical billing and in performing payment audits. The payment audits were traditionally done across the country in the field, according to Peters, and now it is all done by literally one person using this program.

Product: Data Harvesting Service
Company: Injury Sciences
Web site: www.injurysciences.com

A good investigator can often tell you what happened in a car wreck just from a study of the accident scene. Youve got the drivers, passengers, and assorted witnesses to give accounts, but sometimes the number of interviews equals the number of different versions of the event. However, what if the silent participants in the accidentthe vehiclescould tell a story?

In a way, they can. Crash Data Retrieval is not just for air transportation. The ability to access data that can explain how fast a vehicle was traveling five seconds prior to the collision, at what point the brakes were applied, and other useful information is sitting in the wrecked vehicle waiting for someone to download the information.

This is pure data for the most part, says Bob Swift, assistant vice president in charge of litigation for Great American Personal Lines. Great American uses the Data Harvesting System offered by Injury Sciences. Used outside the IT department but interesting nonetheless, so-called black box information can be acquired from vehicles equipped with modules that detect collision events and assess their severity for the deployment of occupant protection systems, such as airbags, according to Scott Palmer, president and CEO of Injury Sciences. There are two ports on the vehicle that can be used to harvest the data.

While not all makes and models of cars have these analytics tools available, most car manufacturers are adopting them. Car manufacturers can use the data for testing and engineering purposes. Data can be harvested from all General Motors vehicles manufactured since 1996 as well as many late-model Fords, according to Palmer. He estimates 15 percent of vehicles on the road today are equipped with the modules, and that number should be going up each year.

Swift says there are concerns about issues of privacy in releasing data, but since the insurance company has an insurable interest in the vehicle, he feels courts will rule favorably for the insurers harvesting the data. He cautions insurers be careful to preserve the chain of custody of the data.

Palmer says the connection to harvest the data from the car into the adjusters laptop and the analytical tools needed to use the data are available for $1,500 a month to insurers, or $30 for each upload. Insurers also need technicians to visit the vehicle to upload the data. Training sessions for connecting the vehicle to a laptop via a modem can be done within an hour.

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Product: Ingenium 6.3.1
Company: SOLCORP
Web site: www.solcorp.com

SOLCORP has released a new version of its Ingenium software for the life insurance industry to improve time to market capabilities and address an insurers needs arising from globalization and convergence. The release brings the components PathFinder Enterprise Designer and ProductXpress Calculator to Ingenium. PathFinder shifts the burden of customization toward a model of configuration and away from traditional program language coding. It is deployed with IBMs WepSphere Application Server to provide a robust and scaleable environment for customers. ProductXpress makes customization easier and faster. It integrates with third-party or in-house software and allows for common calculations across illustrations, quoting, and administration.

Products: ClaimsPro and S3+ Claims
Company: Computer Sciences Corporation
Web site: www.csc.com

Computer Sciences Corporation (CSC) released two new claims products this summer. ClaimsPro was released in June. The product allows the claims department to perform each phase of the claims process electronically. The second product, S3+ Claims, was released in July and provides insurers an integrated approach for each step of the claims process.

ClaimsPro is designed for small to mid-sized P&C insurers. It uses the Windows/NT platform with a DNAF-based architecture and COM object programming. Key features include work management, ease of customization, and flexible reporting.

S3+ Claims uses the CSC Internet-based business service architecture that uses ACORD XML standards. The technical platform includes the browser or other Web-based input, middleware components, and a mainframe server for storage of data and processing. The platform is aimed at large companies with a high volume of claims. Among the features are automated coverage verification and work management. The business services architecture allows remote access to claims data for mobile and remote adjusters.

Product: OASIS for Claims Management
Company: Delphi Technology
Web site: www.delphi-tech.com

Delphi Technology has released version 3.1.0 of its Claims Management solution, part of its OASIS suite of products. The company made several enhancements to the product, including a claim number field in the claim header that will allow users to enter another claim number while working on an existing claim. A new window allows transactions to be searched primarily by check number. Also added was a Find Log window where records can be maintained and associated to a reference number.

Product: eJusterTransfer
Company: eAutoclaims, Inc.
Web site: www.eautoclaims.com

A new online claims management solution has been introduced by eAutoclaims, Inc., that can be run as an ASP or an outsourcing solutions service. Called eJusterTransfer, the product enables adjusters and insurers to modify and accept estimates produced in different formats, generating a full HTML report and posting it securely online.

The software eliminates the need to subscribe to multiple estimating services. A quick translation of the data from the estimating software into binary files results in a faster turnaround and more efficient processing of claims. The company says eJusterTransfer will be connecting to 3,400 body shops and its network of 1,800 appraisers through uploads.

Product: Visibillity Solution for Complex Litigation
Company: Visibillity
Web site: www.visibillity.com

Not all claims are settled quickly, and for carriers offering coverage in complex areas, Visibillity has released its latest offering, The Visibillity Solution for Complex Litigation. The solution manages the entire litigation process from set-up to resolution, allowing the carrier to manage the details of the claim.

Custom set-up features allow analysts to adapt to complex relationships, assign national counsel, enter customized data, and budget for a timeline and level of detail that is realistic for the claim. The system has been effective in dealing with the environmental line of the P&C industry for such areas as asbestos claims. Experts believe asbestos accounts for $200 billion in potential exposure to insurers with claims forecasted well into the year 2030.

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