AssuredPartners London enters the world of M&A insurance

AssuredPartners | September 13, 2019

AssuredPartners London now has a mergers and acquisitions (M&A) insurance division. The unit comes to life with the appointment of Ben Crabtree and Felix Sloman, who are both making the switch from JLT Specialty. They are slated to join AssuredPartners London towards the end of the year. “We have been looking to offer M&A expertise as part of our expanding asset management division for some time now and both individuals had the experience and market presence that we were after,” explained UK chief executive David Heathfield. “It’s an exciting time to become part of the AssuredPartners’ family and we are looking forward to working with Ben and Felix going forward.”

Spotlight

A carrier’s quality assurance process is the backbone of its success. While not as well-known as underwriting or claims adjusting, QA is a vital part of insurance operations. QA auditors assess open, denied and paid claims to determine if avoidable errors occurred during processing, adjusting or settlement. Their reviews track performance against business standards and help improve internal operations and claim quality. QA gives employees vital information with teachable


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CLAIMS

Sapiens Recognized by Celent as Functionality Standouts for Property & Casualty and Workers' Compensation Claims

Sapiens | June 16, 2022

Sapiens International Corporation (NASDAQ: SPNS) (TASE: SPNS), a leading global provider of software solutions for the insurance industry, has announced that Sapiens' claims solutions for P&C and for Workers' Compensation have been recognized by Celent as a Functionality Standouts in the Celent 2022 Claims System Vendors report for North American Property & Casualty Insurance. The Celent report profiled 23 claims administration systems available in North America for property-casualty insurance carriers, including an overview of their functionality, customer base, technology, implementation, pricing and support. Celent credited Sapiens ClaimsPro for Property & Casualty as 'a full function core claims system that many midsize and small insurers may wish to consider, especially in light of Sapiens' growing add-on analytic and digital offerings,' according to the recent report. Key benefits highlighted include faster claims cycle times, lower expenses and settlement costs, intuitive and easy-to-use interface, 360-degree customer experience and vendor management. Customers rated the solution favorably, particularly the medical case management/disability management features and configurability. Clients felt the solution integrated most easily with their other internal applications, such as reporting, documents or financial systems. Regarding their implementation experience, responsiveness and issue resolution received the highest marks. Sapiens ClaimsPro for Workers' Compensation, a component of CoreSuite for Workers' Compensation, received outstanding recognition by Celent as 'a full-function core claims system tuned over the years for Workers' Compensation claims that both monoline workers' compensation insurers and other insurers with a substantial workers' compensation book of business may wish to consider.' Its key features highlighted in the report include statistical reporting, configurability, continuity with the implementation team and consistently meeting service level. We are delighted to receive this prestigious recognition by Celent, which illustrates our depth of impact, breadth of knowledge and keen understanding of the property-casualty industry, As Sapiens continues to power the insurance transformation, leading analysts are taking notice of our deep industry acumen." Jamie Yoder, Sapiens North America President and General Manager. Sapiens ClaimsPro for Property & Casualty is a critical component of Sapiens CoreSuite for Property and Casualty. ClaimsPro streamlines end-to-end claims processing for all personal, commercial and specialty lines, preparing carriers to adapt to new business requirements. The solution provides full lifecycle support for handling claims for all personal and commercial lines of business, including workers' compensation. Sapiens ClaimsPro for Workers' Compensation supports carriers to improve operational performance by reducing claim inventories and supporting medical costs using advanced outcome-based case management. Its real-time payment processing allows automatic and split payments, offsets and deductions, refunds, transfers and 1099 processing for financial efficiency. The platform's rules-driven auto-adjudication and decision support enables proactive case management that reduce claims time to settle and claims closure. About Sapiens Sapiens International Corporation (NASDAQ and TASE: SPNS) empowers the financial sector, with a focus on insurance, to transform and become digital, innovative, and agile. Backed by 40 years of industry expertise, Sapiens offers a complete insurance platform, with pre-integrated, low-code solutions and a cloud-first approach that accelerates customers' digital transformation. Serving over 600 customers in 30 countries, Sapiens offers insurers across property and casualty, workers' compensation and life markets the most comprehensive set of solutions, from core to complementary, including Reinsurance, Financial & Compliance, Data & Analytics, Digital, and Decision Management.

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CORE INSURANCE

Improving the Canadian insurance industry through big data

Canadian Institute of Actuaries | July 07, 2022

A new statement from the Canadian Institute of Actuaries (CIA), Big data and risk classification: Understanding the actuarial and social issues, says that using big data derived from new technologies can contribute to the healthy functioning of insurance markets. Insurance companies establish different classes of risks to determine the availability and pricing of insurance coverage. This ensures that policy owners have coverage that appropriately matches their level of risk. “As big data becomes increasingly available through new technologies, insurers can use it to further refine their classes of risks and offer insurance that is more aligned with the different needs and situations of policy owners,” says Matthew Buchalter, FCIA, Co-Champion of the CIA’s task force on this issue. “As big data becomes increasingly available through new technologies, insurers can use it to further refine their classes of risks and offer insurance that is more aligned with the different needs and situations of policy owners,” says Matthew Buchalter, FCIA, Co-Champion of the CIA’s task force on this issue. The CIA believes that the use of big data is appropriate in insurance ratemaking, and that access to such data creates improved insight about risk and its contributing factors. Conversely, restricting access to this data could adversely impact the availability or price of insurance for individuals. “The foundation of actuarial work is to analyze risks based on complex datasets. Access to more data means insurance ratemaking can be based on more appropriate factors, ultimately reducing risk and setting more refined insurance costs,” says Emile Elefteriadis, FCIA, task force Co-Champion. Canada’s actuaries stress that big data – like all data used in ratemaking – is subject to the ethical data collection practices, privacy laws, and information security requirements necessary to protect consumers. “We believe in thoughtful innovation and evolution in the use of big data, while ensuring that the public interest is at the forefront of insurance and policymaking,” says Hélène Pouliot, FCIA, CIA President.

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HEALTH INSURANCE

HealthSmart® Launches DFW SmartCare™ Health Plan

HealthSmart | May 20, 2022

HealthSmart, one of the nation's largest third party administrators of health plans for employers and plan sponsors, announced the launch of DFW SmartCare™, a comprehensive level-funded health plan that offers market leading discounts to DFW-area small to mid-sized employers. The plan offers significant savings and protection for plan sponsors and features access to the Baylor Scott & White Quality Alliance (BSWQA), inclusive of Catalyst Health Network (CHN). BSWQA is a clinically integrated network of hospitals, facilities, and doctors that members can access through Employers Health Network (EHN). DFW SmartCare delivers a transparent, all-inclusive model that offers predictable costs through a level-funded plan with no additional risk for employers and significantly lower premiums than mainstream fully-insured programs. The program also offers financial security with stop loss coverage to protect plans from catastrophic claims. In addition to a comprehensive health benefits plan, DFW SmartCare boasts a superior member experience through its Concierge Advisor Team who works to guide members and help them navigate their healthcare journey every step of the way. This new health plan designed especially for the DFW Metroplex is a perfect example of how HealthSmart approaches our organizational mission of reducing costs for plan sponsors and delivering premium healthcare solutions to our members, This program demonstrates an innovative approach to help plan sponsors in North Texas control their health benefit costs by providing deeply discounted access to the BSWQA clinically integrated network through EHN.This is big news for DFW small and medium employer groups and DFW SmartCare is truly a game-changer for our broker community in terms of providing quality healthcare options with deep discounts." Craig Julien, CEO for HealthSmart. Plan sponsors typically must work with several players to build their health plans, By bringing together experts in the areas of most concern to small and mid-sized plan sponsors, we have created a one-stop solution that offers a top-quality, focused provider network, critical stop loss coverage, and comprehensive third-party administration services, relieving area health plan sponsors of the burden of shopping for these services individually." Omar Haedo, president of Elan Insurance Group About HealthSmart HealthSmart is one of the largest third party administrators in the country and the premier provider of innovative, customizable and scalable healthcare solutions for employers, brokers and payers. We partner with plan sponsors to provide key services needed to reduce healthcare costs and manage members with dignity and respect. HealthSmart is the one-stop source for health plan needs, including health plan benefit administration, pharmacy benefit management, care management and wellness programs and provider networks.

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AUTOMOBILE INSURANCE

The Plymouth Rock Company Appoints New Chief Operating Officer

Plymouth Rock | July 27, 2022

The Plymouth Rock Company, parent company of a leading group of auto and home insurance providers in the Northeast, announced that Andrew McElwee has been named President and Chief Operating Officer, taking over responsibility for the firm’s day-to-day operations from Hal Belodoff, following Belodoff’s planned retirement. Based in Boston, McElwee will report directly to Jim Stone, Founder and Chief Executive Officer of The Plymouth Rock Company. “I have known Andy for some years now and watched him excel as President of Homesite Group,” said Stone. “I have known Andy for some years now and watched him excel as President of Homesite Group,” said Stone. “We are thrilled to have him join our Plymouth Rock Assurance leadership team. His unique background and proven technical strengths will be invaluable in driving operational excellence and continuous improvement across the company. As COO, Andy will oversee all of our group presidents in formulating and executing strategies for profitable growth. I feel very lucky he has joined us.” McElwee joins Plymouth Rock from American Family Insurance, where he was most recently the Enterprise Chief Underwriting Officer. Prior to that, he was President and Chief Operating Officer of Homesite Group, an affiliate of American Family. McElwee has more than 30 years of insurance industry experience, 25 of which were spent within the Chubb Corporation in various roles of increasing responsibility, including Executive Vice President of Chubb & Son and COO of Chubb Personal Insurance and Chubb Accident and Health. “I have long admired Jim Stone as an entrepreneur, innovator and industry leader,” said McElwee. “I’m delighted to join him by taking on the role of President and COO for The Plymouth Rock Company. In Hal, I succeed a beloved leader, and my immediate focus will be to carry on his great work for our customers, agents, and employees.” Belodoff is retiring as Plymouth Rock’s President and COO after serving the company in various roles for 31 years. He will continue to support the company as a member of Plymouth Rock’s Board of Directors and in an advisory role. “Hal has helped build and shape the culture of this company, as well as its results, for over 30 years,” added Stone. “The decision to hire Hal back then was one of the best I’ve made in my life. I am grateful for his partnership and friendship and glad he is remaining on our board and available for occasional assignments.” “I’m extremely thankful to have had such a fulfilling career working with great people at a place whose mission I believe so deeply in,” said Belodoff. “I’m looking forward to the next chapter of life, spending more time with family and enjoying a slightly slower pace. I have great confidence in Plymouth Rock’s future and believe Andy’s leadership will help the company continue to grow and advance.” About Plymouth Rock Plymouth Rock was established to offer its customers a higher level of service and a more innovative set of products and features than they would expect from an insurance company. Plymouth Rock’s innovative approach puts customers’ convenience and satisfaction first, giving them the choice to do business the way they want – online, with a mobile app, by phone, or by contacting their Plymouth Rock agent. Customers can chat, text, or email to get answers quickly and easily. Plymouth Rock Assurance® and Plymouth Rock® are brand names and service marks used by separate underwriting, managed insurance, and management companies that offer property and casualty insurance in multiple states. Taken together, the companies write and manage more than $1.7 billion in auto and home insurance premiums across Connecticut, Massachusetts, New Hampshire, New Jersey, New York and Pennsylvania.

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Spotlight

A carrier’s quality assurance process is the backbone of its success. While not as well-known as underwriting or claims adjusting, QA is a vital part of insurance operations. QA auditors assess open, denied and paid claims to determine if avoidable errors occurred during processing, adjusting or settlement. Their reviews track performance against business standards and help improve internal operations and claim quality. QA gives employees vital information with teachable

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