Claims Management

Payers Benefit From Newer Claims Technology

The shift from legacy to cloud-based systems is unlocking new benefits and new possibilities for employers and other claims payers.
By: | March 7, 2017 • 5 min read

The retirement of baby-boomer age computer professionals is helping drive more workers’ comp claims payers to abandon older, legacy-type claims management systems for nimbler software as a service (SaaS) technology.

The shift is occurring as the aging computer professionals, along with claims adjusters who spent their careers working with the assistance of the older legacy claims systems, are replaced by millennials accustomed to newer, smarter technology.

Tim Davidson, director of return to work solutions, Riskonnect

“The people who have been maintaining these legacy systems, as well as your adjusters who are used to using those systems, are getting older and exiting the business,” observed Shahin Hatamian of Mitchell International Inc. “You are bringing in younger people who don’t know how to use that legacy system and they want something that is easier to use, more configurable, and a little more automated. That is where newer systems come into play.”

The newer technology also accommodates a younger, less-experienced adjuster workforce with automation that eliminates more of their decision making.

Several other equally pressing reasons are pushing claims payers to continue a migration away from legacy systems to SaaS platforms. For one, more services now developed to improve workers’ compensation claims outcomes are created on these platforms, allowing for easier data interchange between claims payers’ systems and other services the claims payer uses.

“You would be hard pressed to not want to take advantage of the benefits of SaaS,” Hatamian said.

Legacy systems typically rely on in-house server technology for information storage and often were developed to meet a specific company’s needs. Their ongoing use, modification and maintenance usually requires the expertise of people familiar with that system.

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“There are a group of legacy systems that have more attractive, contemporary user interfaces, but they are still built on architectures that are fairly rigid and require a lot of custom coding,” said Aaron Shapiro, executive director of sales, marketing and legal at Origami Risk.

By contrast, SaaS systems are cloud based and accessed via a web browser. While much of their updating can be done simultaneously for many customers, they also allow ease in customization, according to proponents.

“From a claims management standpoint there are so many moving variables at any point in time. … There are a plethora of people involved in the whole claims process.” — Tim Davidson, director of return to work solutions, Riskonnect

The newer technology’s flexibility allows easier configuration to meet a purchaser’s unique workflows, rather than requiring the purchaser to flex their operations around the technology, Shapiro added. It can ease risk managers’ connection with other company departments, such as safety, and with their company’s operations managers for quicker action on data revealing workers’ comp claim drivers.

“That leads to much higher engagement in the operational field,” Shapiro elaborated.  “Where you have a risk manager that has a collaborative relation with field operations and safety there is an opportunity to automatically trigger workflows the second there is a report of injury.”

Shahin Hatamian, Vice President, Product Management and Strategy, Mitchell International Inc.

Similarly, information can be more easily shared with outside parties such as third party administrators, nurse case managers and other workers’ comp service vendors relaying information that may prevent a claim from growing more expensive.

“That is what SaaS products do,” said Nicholas Toal, vice president of business development and sales at JW Software. “It’s a solution that tries to make the workflow seamless,” eliminating challenges claims payers frequently encounter when attempting to connect older systems with third party claims services.

Factors driving the shift away from legacy systems to SaaS also include ease in updating the newer systems with state regulatory changes and less disruption when employees leave a company employing the technology, said Tim Davidson, director of return to work solutions at Riskonnect.

The most pressing reason for moving to SaaS, though, is the ability to connect with many sources of information — including industry trends and service provider data — impacting a claim, Davidson said.

“From a claims management standpoint there are so many moving variables at any point in time,” he elaborated. “It is not just the injured employee or employer. You are dealing with medical providers, you are dealing with bill review, you are dealing with nurse case managers, independent medical examiners. There are a plethora of people involved in the whole claims process.”

Multiple Benefits

Improved integration of information from all those sources can help adjusters and other end users make better decisions, Davidson said.

Tom Ryan, market research leader, Marsh’s Workers Compensation Center of Excellence

Meanwhile, newer technology companies have emerged offering risk management information systems with “a broader platform of service capabilities,” said Tom Ryan, market research leader at Marsh’s Workers Compensation Center of Excellence. Those capabilities include data analytics and the conversion of data into highly customized reports and dashboards for workers’ comp claims management.

Simultaneously, employers are increasingly knowledgeable about the data management capabilities of risk management information systems, Ryan added.

“So a lot of employers are looking for more customized dashboards and tools to manage workers’ compensation,” Ryan said.

RMIS systems, and their dashboard technology for managing claims, have improved significantly over the past two to three years, added Duane Pifer, senior consultant and data analytics lead in the integrated casualty consulting group at Willis Towers Watson.

But the systems typically provide relatively stagnant information, Pifer added. Employers and other claims payers could benefit, he said, should the next generation of technology products allow claims payers to receive more interactive claims information delivered in smaller, more frequent, notifications, like those that social media sites push out concerning a user’s network contacts.

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In that way alerts pushed-out to cell phones or tablets, for example, could inform employers of organizational changes — such as increased employee turnover in a specific production unit — that would likely impact claim filings, Pifer said.

Similarly, information could alert claims payers when claims are nearing a certain status point, such as a specific expense level.

“It is that kind of information, in small chunks, that Is intuitive that the user wants to see,” Pifer said. “I think the technology is beginning to get there and I know some RMIS have apps that provide that. But it is not widespread yet.”

When it comes to both RMIS and claims management systems, however, there is widespread agreement that the newer platforms are much simpler to use.

Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected]com. Read more of his columns and features.

More from Risk & Insurance

More from Risk & Insurance

Exclusive | Hank Greenberg on China Trade, Starr’s Rapid Growth and 100th, Spitzer, Schneiderman and More

In a robust and frank conversation, the insurance legend provides unique insights into global trade, his past battles and what the future holds for the industry and his company.
By: | October 12, 2018 • 12 min read

In 1960, Maurice “Hank” Greenberg was hired as a vice president of C.V. Starr & Co. At age 35, he had already accomplished a great deal.

He served his country as part of the Allied Forces that stormed the beaches at Normandy and liberated the Nazi death camps. He fought again during the Korean War, earning a Bronze Star. He held a law degree from New York Law School.

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Now he was ready to make his mark on the business world.

Even C.V. Starr himself — who hired Mr. Greenberg and later hand-picked him as the successor to the company he founded in Shanghai in 1919 — could not have imagined what a mark it would be.

Mr. Greenberg began to build AIG as a Starr subsidiary, then in 1969, he took it public. The company would, at its peak, achieve a market cap of some $180 billion and cement its place as the largest insurance and financial services company in history.

This month, Mr. Greenberg travels to China to celebrate the 100th anniversary of C.V. Starr & Co. That visit occurs at a prickly time in U.S.-Sino relations, as the Trump administration levies tariffs on hundreds of billions of dollars in Chinese goods and China retaliates.

In September, Risk & Insurance® sat down with Mr. Greenberg in his Park Avenue office to hear his thoughts on the centennial of C.V. Starr, the dynamics of U.S. trade relationships with China and the future of the U.S. insurance industry as it faces the challenges of technology development and talent recruitment and retention, among many others. What follows is an edited transcript of that discussion.


R&I: One hundred years is quite an impressive milestone for any company. Celebrating the anniversary in China signifies the importance and longevity of that relationship. Can you tell us more about C.V. Starr’s history with China?

Hank Greenberg: We have a long history in China. I first went there in 1975. There was little there, but I had business throughout Asia, and I stopped there all the time. I’d stop there a couple of times a year and build relationships.

When I first started visiting China, there was only one state-owned insurance company there, PICC (the People’s Insurance Company of China); it was tiny at the time. We helped them to grow.

I also received the first foreign life insurance license in China, for AIA (The American International Assurance Co.). To date, there has been no other foreign life insurance company in China. It took me 20 years of hard work to get that license.

We also introduced an agency system in China. They had none. Their life company employees would get a salary whether they sold something or not. With the agency system of course you get paid a commission if you sell something. Once that agency system was installed, it went on to create more than a million jobs.

R&I: So Starr’s success has meant success for the Chinese insurance industry as well.

Hank Greenberg: That’s partly why we’re going to be celebrating that anniversary there next month. That celebration will occur alongside that of IBLAC (International Business Leaders’ Advisory Council), an international business advisory group that was put together when Zhu Rongji was the mayor of Shanghai [Zhu is since retired from public life]. He asked me to start that to attract foreign companies to invest in Shanghai.

“It turns out that it is harder [for China] to change, because they have one leader. My guess is that we’ll work it out sooner or later. Trump and Xi have to meet. That will result in some agreement that will get to them and they will have to finish the rest of the negotiations. I believe that will happen.” — Maurice “Hank” Greenberg, chairman and CEO, C.V. Starr & Co. Inc.

Shanghai and China in general were just coming out of the doldrums then; there was a lack of foreign investment. Zhu asked me to chair IBLAC and to help get it started, which I did. I served as chairman of that group for a couple of terms. I am still a part of that board, and it will be celebrating its 30th anniversary along with our 100th anniversary.

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We have a good relationship with China, and we’re candid as you can tell from the op-ed I published in the Wall Street Journal. I’m told that my op-ed was received quite well in China, by both Chinese companies and foreign companies doing business there.

On August 29, Mr. Greenberg published an opinion piece in the WSJ reminding Chinese leaders of the productive history of U.S.-Sino relations and suggesting that Chinese leaders take pragmatic steps to ease trade tensions with the U.S.

R&I: What’s your outlook on current trade relations between the U.S. and China?

Hank Greenberg: As to the current environment, when you are in negotiations, every leader negotiates differently.

President Trump is negotiating based on his well-known approach. What’s different now is that President Xi (Jinping, General Secretary of the Communist Party of China) made himself the emperor. All the past presidents in China before the revolution had two terms. He’s there for life, which makes things much more difficult.

R&I: Sure does. You’ve got a one- or two-term president talking to somebody who can wait it out. It’s definitely unique.

Hank Greenberg: So, clearly a lot of change is going on in China. Some of it is good. But as I said in the op-ed, China needs to be treated like the second largest economy in the world, which it is. And it will be the number one economy in the world in not too many years. That means that you can’t use the same terms of trade that you did 25 or 30 years ago.

They want to have access to our market and other markets. Fine, but you have to have reciprocity, and they have not been very good at that.

R&I: What stands in the way of that happening?

Hank Greenberg: I think there are several substantial challenges. One, their structure makes it very difficult. They have a senior official, a regulator, who runs a division within the government for insurance. He keeps that job as long as he does what leadership wants him to do. He may not be sure what they want him to do.

For example, the president made a speech many months ago saying they are going to open up banking, insurance and a couple of additional sectors to foreign investment; nothing happened.

The reason was that the head of that division got changed. A new administrator came in who was not sure what the president wanted so he did nothing. Time went on and the international community said, “Wait a minute, you promised that you were going to do that and you didn’t do that.”

So the structure is such that it is very difficult. China can’t react as fast as it should. That will change, but it is going to take time.

R&I: That’s interesting, because during the financial crisis in 2008 there was talk that China, given their more centralized authority, could react more quickly, not less quickly.

Hank Greenberg: It turns out that it is harder to change, because they have one leader. My guess is that we’ll work it out sooner or later. Trump and Xi have to meet. That will result in some agreement that will get to them and they will have to finish the rest of the negotiations. I believe that will happen.

R&I: Obviously, you have a very unique perspective and experience in China. For American companies coming to China, what are some of the current challenges?

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Hank Greenberg: Well, they very much want to do business in China. That’s due to the sheer size of the country, at 1.4 billion people. It’s a very big market and not just for insurance companies. It’s a whole range of companies that would like to have access to China as easily as Chinese companies have access to the United States. As I said previously, that has to be resolved.

It’s not going to be easy, because China has a history of not being treated well by other countries. The U.S. has been pretty good in that way. We haven’t taken advantage of China.

R&I: Your op-ed was very enlightening on that topic.

Hank Greenberg: President Xi wants to rebuild the “middle kingdom,” to what China was, a great country. Part of that was his takeover of the South China Sea rock islands during the Obama Administration; we did nothing. It’s a little late now to try and do something. They promised they would never militarize those islands. Then they did. That’s a real problem in Southern Asia. The other countries in that region are not happy about that.

R&I: One thing that has differentiated your company is that it is not a public company, and it is not a mutual company. We think you’re the only large insurance company with that structure at that scale. What advantages does that give you?

Hank Greenberg: Two things. First of all, we’re more than an insurance company. We have the traditional investment unit with the insurance company. Then we have a separate investment unit that we started, which is very successful. So we have a source of income that is diverse. We don’t have to underwrite business that is going to lose a lot of money. Not knowingly anyway.

R&I: And that’s because you are a private company?

Hank Greenberg: Yes. We attract a different type of person in a private company.

R&I: Do you think that enables you to react more quickly?

Hank Greenberg: Absolutely. When we left AIG there were three of us. Myself, Howie Smith and Ed Matthews. Howie used to run the internal financials and Ed Matthews was the investment guy coming out of Morgan Stanley when I was putting AIG together. We started with three people and now we have 3,500 and growing.

“I think technology can play a role in reducing operating expenses. In the last 70 years, you have seen the expense ratio of the industry rise, and I’m not sure the industry can afford a 35 percent expense ratio. But while technology can help, some additional fundamental changes will also be required.” — Maurice “Hank” Greenberg, chairman and CEO, C.V. Starr & Co. Inc.

R&I:  You being forced to leave AIG in 2005 really was an injustice, by the way. AIG wouldn’t have been in the position it was in 2008 if you had still been there.

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Hank Greenberg: Absolutely not. We had all the right things in place. We met with the financial services division once a day every day to make sure they stuck to what they were supposed to do. Even Hank Paulson, the Secretary of Treasury, sat on the stand during my trial and said that if I’d been at the company, it would not have imploded the way it did.

R&I: And that fateful decision the AIG board made really affected the course of the country.

Hank Greenberg: So many people lost all of their net worth. The new management was taking on billions of dollars’ worth of risk with no collateral. They had decimated the internal risk management controls. And the government takeover of the company when the financial crisis blew up was grossly unfair.

From the time it went public, AIG’s value had increased from $300 million to $180 billion. Thanks to Eliot Spitzer, it’s now worth a fraction of that. His was a gross misuse of the Martin Act. It gives the Attorney General the power to investigate without probable cause and bring fraud charges without having to prove intent. Only in New York does the law grant the AG that much power.

R&I: It’s especially frustrating when you consider the quality of his own character, and the scandal he was involved in.

In early 2008, Spitzer was caught on a federal wiretap arranging a meeting with a prostitute at a Washington Hotel and resigned shortly thereafter.

Hank Greenberg: Yes. And it’s been successive. Look at Eric Schneiderman. He resigned earlier this year when it came out that he had abused several women. And this was after he came out so strongly against other men accused of the same thing. To me it demonstrates hypocrisy and abuse of power.

Schneiderman followed in Spitzer’s footsteps in leveraging the Martin Act against numerous corporations to generate multi-billion dollar settlements.

R&I: Starr, however, continues to thrive. You said you’re at 3,500 people and still growing. As you continue to expand, how do you deal with the challenge of attracting talent?

Hank Greenberg: We did something last week.

On September 16th, St. John’s University announced the largest gift in its 148-year history. The Starr Foundation donated $15 million to the school, establishing the Maurice R. Greenberg Leadership Initiative at St. John’s School of Risk Management, Insurance and Actuarial Science.

Hank Greenberg: We have recruited from St. John’s for many, many years. These are young people who want to be in the insurance industry. They don’t get into it by accident. They study to become proficient in this and we have recruited some very qualified individuals from that school. But we also recruit from many other universities. On the investment side, outside of the insurance industry, we also recruit from Wall Street.

R&I: We’re very interested in how you and other leaders in this industry view technology and how they’re going to use it.

Hank Greenberg: I think technology can play a role in reducing operating expenses. In the last 70 years, you have seen the expense ratio of the industry rise, and I’m not sure the industry can afford a 35 percent expense ratio. But while technology can help, some additional fundamental changes will also be required.

R&I: So as the pre-eminent leader of the insurance industry, what do you see in terms of where insurance is now and where it’s going?

Hank Greenberg: The country and the world will always need insurance. That doesn’t mean that what we have today is what we’re going to have 25 years from now.

How quickly the change comes and how far it will go will depend on individual companies and individual countries. Some will be more brave than others. But change will take place, there is no doubt about it.

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More will go on in space, there is no question about that. We’re involved in it right now as an insurance company, and it will get broader.

One of the things you have to worry about is it’s now a nuclear world. It’s a more dangerous world. And again, we have to find some way to deal with that.

So, change is inevitable. You need people who can deal with change.

R&I:  Is there anything else, Mr. Greenberg, you want to comment on?

Hank Greenberg: I think I’ve covered it. &

The R&I Editorial Team can be reached at [email protected]