Connecting with Technology

This issue of Claims spotlights some of the new and evolving technologies that company claim departments are using to increase cost-cutting capabilities, streamline processes, and detect fraud. But to find out what insurers could do better, and to gauge developing technology trends, Associate Editor Eric Gilkey spoke with John Postava, president of Simsol Software, to get the lay of the land.

Talk a bit about a modern day insurance companies' claim technology needs. What do you see them doing right? Wrong?

Today's insurance carrier claim departments require higher level of connectivity than ever before. With increased customer expectations, state department of insurance requirements and forecasts of an increasing number of more devastating storm and catastrophic events, today's insurance carrier must process claims more efficiently and accurately than in years past in order to retain their customers' business and maintain a healthy bottom line. Electronic connectivity among all the various parties involved in an insurance claim enables insurance carriers to reach that higher level.

Property claim units also must deal with a formidable challenge when it comes to connectivity and the adjustment of property claims — the catastrophe itself. In as much as adjusters can depend upon wireless connections when they are in their own backyards handling every day type losses, connectivity after a major cat usually goes out the window in the period following the event, rendering computer systems that are completely based on web connectivity useless. Because of this scenario, workflow systems must be flexible enough to allow the electronic gathering of data in the field so adjusters can do their work on PCs, generate and print estimates for their policyholders, and issue payments on the spot.

Better connectivity starts with the electronic processing of the first notice of loss, confirmation of coverage and assignment to the individual or preferred network tasked to adjust the loss. Claim milestones such as dates of first contact with the policyholder, time of inspection, the date the estimate was completed and payment of the claim should be electronically monitored for quality assurance.

If a carrier's claims workflow is to improve, seamless connectivity must exist between the policy and claim management software, the electronic assignment software, the estimating and claim documentation software, the claim payment software and lastly, the estimate and claim data analysis software. This connectivity must be invisible to the end users. In other words, it must look like one integrated piece of claims technology.

There are software tools available in the marketplace today and more in development that address and solve these claim department connectivity issues. These tools, however, have only been available for a few years. And, as every vendor who deals with insurance carriers knows, new and better technologies are slow to be adopted by our industry.

What's the biggest trend in claim technology right now?

One of the biggest trends we see right now in claim technology is the sharing of information among all parties involved in the settlement of a property claim. Carriers want to know what their adjusters are doing, what their independent adjusting vendors are doing, and what their preferred contractor networks are doing with the assignments they are given. When mistakes are made today, managers can respond quickly and make the necessary decisions so they don't happen again.

The phone is no longer a viable option. Now that the Internet has matured, wireless connectivity is everywhere (most of the time). The average young adjuster is more knowledgeable in computers and technology. Surfing the web gives them the ability to find answers to claims questions. If knowledge is power, the carriers who allow their adjusters and mangers to utilize the web will become the most powerful companies in our industry.

Thanks to web technology the more sophisticated XML and WSDL data transfers and data analytical services once reserved for the top 10 property writers in the U.S. are now within the budgetary reach of small and middle market carriers. Qualified alternatives to the big gorilla software vendors are available at a significantly lower cost.

Insurance carrier management teams are now assembling claim assignment, estimating, and data analytic workflows and, in essence, constructing the property claim departments of tomorrow. They will be faster, more efficient, and more accurate than the claim departments of the 1980s and 1990s.

You started Simsol after working as a property adjuster for Fireman's Fund Insurance Company. How did this background aid you over the years?

My background in property claims allowed me to talk in a language property claim managers and adjusters understood. Having been in the trenches gave me the ability to demonstrate to users how to best use the software for all types of property claims they would be running into in the field. We still do that in our software training classes held around the country.

Being a former adjuster gave me the knowledge to better understand the types of services and data analytics that managers require to help them better monitor their adjusting staff and their claims units. Claim and estimate analytics go far beyond just number crunching. You must also take into account the human element and understand what make an average adjuster tick. I think we do a pretty good job of that at Simsol.