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Talking Claims Innovation: John Gilmartin, Mitchell International

Gilmartin recommends that carriers implement modern document management systems, predictive models, and data warehouses.

As part of our research for I&T's June 2011 digital issue, I reached out to thought leaders on the topic of claims innovation. My question was what are best practices for insurers seeking to create competitive distinction through claims. Here, John Gilmartin, VP, product delivery, Mitchell International (San Diego) recommends three things carriers can implement to stand out from the crowd:

Document Management System Implement a document management system to improve customer satisfaction through shorter claim cycle times and improved internal-external communications and, by doing so, eliminate costs/waste in the system. Improvements such as modern document management systems are also vital for attracting new talent. I'm still amazed how many carriers are still shuffling paper around their offices. While many have made strides in this area, there are many areas that are still in need of an overhaul, for example, medical bill/record ingestion, letters, forms, and other correspondence, etc.

Predictive Models While they're trendy at the moment predictive models still have not been adopted widely by claims organizations. Some are still confused as to their use, and others are concerned about IT integration issues. But the technology is not that mysterious, and most carriers can develop/build with partners and implement predictive models into their claim workflows with little to no IT involvement -- especially if facilitated through technology vendors. Underwriting is still leading the way and claims continues to lag, but we've seen a great deal of interest in this area. The opportunities are still rich, particularly in the areas of medical severity, claim segmentation, subrogation and fraud.

Data Warehouse Implement a data mart/data warehouse with reporting. While this is somewhat obvious, many still don't have these created within their claims departments. Carriers frequently ask their various vendors to help with data mining, research, analysis, and reviews in order to find the trends and nuggets of insight that could drive improved business results. However, their lack of appropriate tools, expertise, and experience is delaying the action that they could take, depriving them of game-changing insight.

Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio

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