Tech Advancements Alter Re's Grand Canyon Techscape

With technology, the reinsurer now has the ability for an underwriter to develop an electronic module that can generate a proposal automatically from the terms and conditions used to underwrite the risk. If the proposal is accepted, then a contract may automatically be issued consistent with the underwriting and proposal. In some situations for more simplified coverage, this is done electronically with no manual intervention.

The electronic model has two main advantages. First, it ensures consistency between the underwritten terms and the actual terms issued in the contract. Second, it eliminates what once was a considerable delay between an issuance of final treaty and a bound proposal. The longer the duration between the times that these final wordings are issued, the more possibility there is for misunderstanding between the reinsured and reinsurer regarding terms and conditions. Anything that can deliver timely and accurate reinsurance treaties to the reinsured is to be highly valued.

Premium, claim and other administration

Premium payments are submitted electronically from the reinsured’s bank account to the reinsurer. Claim reimbursement requests are submitted electronically by the reinsured, and claim reimbursements are returned electronically to the reinsured along with explanations of benefits (EOBs). The status of all premium and claim activity is also available via customized client reports and online customer service systems.

All forms, procedures and service manuals are sent to the client via the Web. This isn’t to say there shouldn’t be a personal touch throughout the duration of the contract. It’s still important to install accounts on site, and relationships count for as much as ever.

A Web-enabled case management referral system between the reinsured and various managed care vendors offers reduced cycle time with use of managed care vendors to control claim frequency and severity. For example, organ transplant patients, where time is of the essence, can be matched rapidly with appropriate networks. Neonatal case management forms can be submitted online. This type of system provides a 24/7/365 platform for managed care case status and utilization savings reporting between reinsured, reinsurer and vendors.

Renewals

All information needed for the renewal (census changes, claims status coverage parameters) is sent to the reinsured electronically and returned electronically to the reinsurer.

In the future, the reinsurer may actually go online with a reinsured’s claim database and pull the information it needs to adjudicate a claim as opposed to having the client submit it to the reinsurer. The main benefits to the reinsured would be quicker recoveries with less work. In turn, the reinsurer will have more access to underlying claim information to better underwrite the case and service the claim.

Notwithstanding the expanded role of technology, insurance is still a relationship business. In a commoditized environment, low cost and customer service can be business drivers. Focus on the customer is facilitated by a focus on technology as a means to that end.