Gore Mutual reveals new customer-friendly claims processing approach

Insurance Business America | April 16, 2019

Gore Mutual is introducing a new approach to its claims processing, improving the experience significantly for consumers. Called “ClaimCare,” the new approach ensures that “there are no surprises in the claims process,” Gore Mutual said in a release. As part of the approach, a ClaimCare Concierge has been established to answer customer inquiries and to resolve coverage issues whenever any of Gore Mutual’s ClaimCare Advisors are unavailable – this is to ensure that there are no gaps in service. In addition, a ClaimCare Mobile Response Team and Mobile Response Centre have been formed. Both the team and centre were designed in response to climate change, allowing Gore Mutual to quickly mobilize to the ground following catastrophes. On-site personnel will be providing care and assistance to customers, including emergency funds for food, shelter, and other emergency needs. “It’s not enough to say that we’re really good at claims,” said Gore Mutual vice-president of claims Neil Weir. “The mix of changing consumer demographics and service expectations being driven by technology and other innovations are forcing us to constantly adapt to meet rapidly increasing customer needs.

Spotlight

As the United States seeks ways to regain our economic footing and rebuild prosperity, all should be reminded of the simple but immensely important fact that the nation’s collective health bears both an economic and human cost. Poor health of a population can exert tremendous force on employment rates, interest costs and other tangible factors that ultimately affect the ability to maintain a strong global economic position.


Other News
RISK MANAGEMENT

Bubble Launches Online Embedded Insurance for Housing Industry in the Wake of $1.75M in Funding

Next by Pacific Life | January 14, 2022

Bubble, the company that has made getting tailored home and life insurance an instantaneous online process, today launched its turnkey Insurance-in-a-Box offering on the heels of $1.75M in pre-seed funding anchored by The House Fund with participation from Tuesday Capital, Correlation Ventures, and North Coast Ventures. With Bubble, real estate and mortgage companies are able to embed digital homeowner's and life insurance seamlessly into real estate transactions. This enables people buying a home or refinancing a mortgage to easily – often in just a few minutes online – protect their homes as well as their families' futures at the same time as making a home/loan purchase. Bubble's Embedded Insurance-in-a-Box offering includes widgets, APIs, white-labeled or co-branded consumer sites and referral URLs that real estate companies can use to embed accurate home and life insurance quotes into home and loan purchase flows. Combining data from home and mortgage transactions with its own extensive database and proprietary analytics, Bubble delivers custom-tailored quotes in real-time. Through Bubble's online portal, customers can further personalize their coverage, maximize discounts, complete their applications, and have their policies approved and issued in a matter of minutes. Bubble integrates directly with top-rated insurance companies to match customers with customized policies instantly online. Its AI-guided recommendation engine, Bubble LifePal, currently finds the products with optimal coverage from Stillwater for homeowner's insurance along with SBLI and Pacific Life for term life, and integrations with other insurers are forthcoming. Customers are presented with transparent, personalized insurance packages, and often are able to get underwriting decisions and have their policies issued, all online in minutes. "We are excited to offer our range of home insurance products on Bubble's all-digital platform, Bubble's intuitive online flows demystify the process while giving users the flexibility to customize coverages to their needs. Together with Bubble, we're making insurance buying as easy as pie." -Stillwater VP of Inside Sales and Sales Systems, Alisa Ruenprapan. Recognizing that home ownership is a key catalyst to life insurance purchase, Bubble pairs two unique term life products especially suited for younger home buyers: Next by Pacific Life & SBLI's Simplified Issue Term Life. "With Next Term Life, you don't have to anticipate the future and buy more life insurance than you need, You start with the coverage you need today and can increase or decrease at key life events, such as buying a house, without additional underwriting. It's an innovative product that lets you 'lock in' your health rating, typically when you're young and healthy. Bubble's online platform that integrates life insurance at this key milestone is the perfect entry point for Next Term Life." -Joe Kordovi, AVP of Innovations at Pacific Life. The other term life product by SBLI offers a completely fluid-less (i.e., no medical test) underwriting process and provides instant online decisions in minutes, a perfect complement for busy home buyers that already have their hands full. "SBLI is very happy to work with Bubble and offer a unique and simplified issue digital term insurance solution to Bubble customers through this valuable partnership. This strategic collaboration supports SBLI's continued commitment to build diversification in both our product and digital distribution areas," said Denis Clifford, SVP of Sales & Distribution at SBLI. "Bubble streamlines the natural flow of life events: starting a family, buying a home, insuring it, and insuring everyone living there, Millennials especially stand to reap the benefits of bundling life and home insurance while they're young and healthy. They can lock in a great rate for the next several decades. Our mission is to make it as simple and straightforward as possible for them to do that." -Bubble Co-founder & CEO Avi Gupta. Bubble's digital Insurance-in-a-Box helps real estate companies minimize friction and speed transactions by enabling customers to quickly get insurance when they're buying a home. Lenders and loan servicers also mitigate the risk of default with term life policies covering borrowers. These companies in the housing ecosystem can even monetize insurance by sharing commission splits or referral fees with Bubble under certain circumstances. Dan Zettler, partner at Barnstable Mortgage Group, noted: "As mortgage brokers for nearly 20 years, partnering with Bubble allows us to leapfrog our offerings into the digital world with a completely online experience for personalized home and life insurance. Taking the pain and hassle out of insurance purchases is a no-brainer!" About Bubble Bubble's mission is to help homeowners protect their homes, loved ones and everything under their roof with the right insurance coverages, at the right time for the right price. By embedding online insurance into the path of a home or mortgage purchase, Bubble's sophisticated AI algorithms combine data from the real estate transaction with its own extensive library, to streamline the process of buying insurance, from an online quote to application to instant approval. About Next by Pacific Life Next by Pacific Life was created to provide a better, seamless digital experience for the modern customer. Offering an innovative insurance product built for customer engagement, Next by Pacific Life easily integrates with key digital distribution partners like Bubble. About SBLI (The Savings Bank Mutual Life Insurance Company of Massachusetts) For over 115 years, SBLI (The Savings Bank Mutual Life Insurance Company of Massachusetts) has specialized in providing hassle-free, affordable life insurance. Whether it be term life, whole life or a plan that combines the two, they offer dependable protection, at a fair price.

Read More

RISK MANAGEMENT

Five Sigma Partners with Medlogix to Deliver Seamless Medical Claims Management

Medlogix | February 17, 2022

Five Sigma, an emerging leader in cloud-native Claims Management Solutions (CMS), today announced the launch of native integration with Medlogix, LLC, a national leader in U.S. medical claims management solutions. This innovation connecting the two platforms will help insurers to improve decision making, maximize efficiencies, increase ROI and enhance outcomes in medical claims management. Five Sigma's cloud-native claims management solutions enable property and casualty (P&C) carriers, MGAs, Insurtechs, and self-insurers, to simplify their claims process from first notice of loss to resolution. The partnership with Medlogix provides Five Sigma US-based customers with an out-of-the-box integration to itemize, assess, and aggregate special and general damages for bodily injury claims - to ensure proper, timely settlement and accurate reimbursement while complying with regulations that differ state-by-state. "Five Sigma is on a mission to simplify the claims journey. Our flexible SaaS solution and open APIs allow us to quickly add new partners and integrations to our claims management ecosystem," stated Oded Barak, Co-founder and CEO of Five Sigma. "We are proud to partner with Medlogix to provide our customers a more comprehensive, accurate and efficient claims process." According to Craig Goldstein, President of Medlogix, "Our partnership with Five Sigma represents a strategic combination of two technology-driven organizations that share a dedication to providing innovative, streamlined claims management solutions that exceed the expectations of our customers." About Medlogix Medlogix is a technology-driven, clinically-based medical claims management provider specializing in managed care solutions that deliver exceptional outcomes. Medlogix offers an end to end, integrated medical management solution powered by MyMedlogix™ proprietary technology. Through an exception-based workflow, recommendations from highly qualified medical professionals, and access to a directly contracted network of premier health care providers, Medlogix delivers an efficient, disciplined, and scalable medical claims process suite of solutions. Medlogix develops technology which achieves savings you can measure and see by eliminating redundancies and reducing manual processes. Learn more about the Medlogix story at: www.medlogix.com About Five Sigma Five Sigma is a cloud-native, data-driven Claims Management Solution (CMS) with embedded AI/ML capabilities to allow intelligent claims processing for the insurance industry. Five Sigma optimizes claims management by adding automated claims processing workflows, using data modeling and AI to provide smart recommendations, improving adjuster's decision-making, and reducing errors. Leading insurance carriers, Insurtech, TPAs and Self-Insured companies use Five Sigma's CMS to modernize their claims management operations, reduce claims leakage, enhance compliance and improve their customers' experience.

Read More

INSURANCE TECHNOLOGY

ZENTIST IMPROVES THE VERIFICATION OF INSURANCE ELIGIBILITY AND PATIENT BENEFITS

Zentist | June 08, 2022

The denials management feature in Zentist's Remit AI software revolutionizes the way dental support organizations (DSOs) and dental practices utilize Electronic Remittance Advice (ERA) while meeting the crucial challenge of dealing with denials. Claims are commonly returned to dental practices unpaid and under a 'pending' status because they were submitted with insufficient information.While eligibility and coverage issues render some claims unpayable, many more are closed prematurely, leaving hundreds of millions of dollars on the table. This money goes unpaid, to the benefit of the insurance company instead of the patient. According to the National Association of Dental Plans, just 4% of insurance company revenue is used to pay patient benefits. Our goal is to help dental practices minimize denials to almost 0 by providing actionable data that improves eligibility and benefit verification and eliminate blind spots in revenue cycle management." Ato Kasymov, CEO and Co-founder of Zentist. Remit AI decreases the level of accounts receivable (AR) by cleaning the claims coming from payment information. The software automatically filters all ERAs and Explanations of Benefits (EOBs), gathering and categorizing denials. Remit AI identifies any further actions to be taken before a denial can be resubmitted. We have an enormous ability to control our revenue cycle management process with Remit AI and are excited with the results we achieved with Denials Management. Our team's efficiency to manage claims has at least quadrupled and we have clear data as to how we can improve and drastically reduce claim denials pretty fast." Semira Avanessian, Director of Revenue Cycle Management for Cambridge, Massachusetts-based Boston Pediatric Dental Group. When Remit AI is able to identify the cause of an unpaid claim and solve that problem, preventing other claims from being returned for the same reason, the software pays for itself – eventually tenfold." Mr. Kasymov. About Zentist Zentist is a platform that uses advanced technology to simplify and automate insurance revenue cycle management (RCM) for dental practices. At a time when dental businesses lose an estimated $2.1 billion due to legacy billing systems, Zentist leverages robotic process automation (RPA) and machine learning to place otherwise tedious billing tasks on autopilot. Zentist's platform is fully and easily scalable to meet the more complex billing needs of the modern dental industry—which has been marked by aggressive consolidation and unprecedented pressures for scaling RCM. Its software minimizes human error, maximizes insurance payout, provides advanced analytics on revenue, and improves the patient-provider relationship.

Read More

LIFE INSURANCE

Mutual of America Financial Group Announces Agreement to Acquire Landmark Life Insurance Company

Mutual of America | April 27, 2022

Mutual of America Financial Group announced today that it has entered into a Stock Purchase Agreement to acquire Landmark Life Insurance Company, a widely licensed Texas life and annuity insurance company ("Landmark Life"). The transaction is expected to close during the third quarter of 2022, subject to customary closing conditions, including regulatory approval. The acquisition of Landmark Life represents another positive step toward achieving Mutual of America's strategic growth plans in the guaranteed retirement income space." John R. Greed, Chairman, President and CEO of Mutual of America Financial Group. This transaction will enhance our financial and distribution capacities to provide guaranteed income solutions and other products to individuals outside the state of New York. Simpa Baiye, Executive Vice President and Chief Actuary of Mutual of America Financial Group. The sale of Landmark Life represents a meaningful step toward our plans to focus on providing high-value, third-party administrative services to life insurers nationwide." Tom Munson, CEO of Landmark Life and Jarvis Family general partner. Merger & Acquisition Services, Inc., served as the financial advisor, and Eversheds Sutherland (US) LLP served as the legal advisor to Mutual of America for the acquisition. Propel Advisory Group, Inc., served as the financial advisor, and Winstead PC served as the legal advisor to The Jarvis Family Limited Partnership. About Mutual of America Financial Group Mutual of America Financial Group is a leading provider of retirement services and investments to employers, employees and individuals. We provide high-quality, innovative products and services, together with outstanding personalized service, at a competitive price to help our customers build and preserve assets to meet their retirement and investment related needs for a financially secure future. Our mission is built upon our values—integrity, prudence, reliability, excellence and social responsibility—which have guided us since 1945 and continue to serve us and our customers well. About Landmark Life Landmark Life, based in Brownwood, Texas, is a wholly owned subsidiary of The Jarvis Family Limited Partnership. Founded in 1964, Landmark Life underwrites life insurance and annuities in 36 states. Landmark Life solicits annuity and life business via an independent agency force.

Read More

Spotlight

As the United States seeks ways to regain our economic footing and rebuild prosperity, all should be reminded of the simple but immensely important fact that the nation’s collective health bears both an economic and human cost. Poor health of a population can exert tremendous force on employment rates, interest costs and other tangible factors that ultimately affect the ability to maintain a strong global economic position.

Resources