Open Your E-mail

See how the Internet alters the landscape irreversibly, shrinking space, making everything more visible. A friend tells me he has succumbed to the weird condition of Internet Insomnia, the state of expectation that any moment a life-changing e-mail will come. Well, it has arrived, and we now work in a smaller world. cost of purchase.

This year about 250 insurers, third-party administrators and corporations in the United States will invest in workers' compensation claims systems, which come more and more Internet-based.

Officer can't show taser training injury was intentional (05/13/13)
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Worker's contradictory statements block establishment of claim (05/21/13)
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Attorney's contingency fees limited by amount he substantially secured (05/28/13)

They might be big upgrades or another vendor's new product. A handful might create their own--lots of luck, for while functionality grows fast, complexity grows faster.

In the next five years, more than 1,000 systems will be upgraded, bought or created, tied to the Internet. They cost from a few thousands to tens of millions in total

Two people intimately acquainted with system buyers described to me twin explosions of expectations and performance.

One informant is buying a new system for a Fortune 100 company and has compared notes with peers. Another is a seasoned analyst who used to run a claims department and now helps to build systems.

What do Fortune 100 buyers want? Multilanguage, multicurrency, transborder capability. Medical-bill repricing, case management, utilization review, and cost or premium allocation to line departments. Ability to manage claims in groups such as by occurrence, defense or plaintiff counsel. Full compatibility with Microsoft Excel.

Buyers who use multiple TPAs and insurers want data downloads without delay into their central risk management information system. They want to enjoy easy connection with other systems such as human resources, payroll, liability, and short- and long-term disability.

My Fortune 100 buyer tells me that "connections with the buyer's general ledger and treasury systems" are on the shopping list. So is a means to import claims data from former systems without glitches such as conflicts over field definitions.

Underlying the theme of removing distance and banishing barriers to communication is the second theme of nonsoftware experts taking on the chores of tweaking software. I think the door now truly opens up workers' comp claims to the Internet Age.

Think of a complex network of adjusters, nurses, lawyers and line supervisors all sharing an online bank of data. New data source? Plug it in. Who reconfigures the work flow to cut the cost of risk? A former claims adjuster turned analyst.

Patty Morey Walker, after running the city of Boston's workers' comp department, won an award for creating the first online workers' comp claims submission service. She has since worked for a number of claims system vendors.

She says that the job of maintaining software used to be held hostage by small teams of expensive system engineers, a resource so scarce that half of them would be recent immigrants or temporary visa holders.

She tells me "software has advanced to the point where an individual with three years' experience in workers' comp claims and a confidence in using systems" is doing increasingly more upkeep tasks. Call them business analysts.

The business analyst can configure the system to alert the head of claims whenever someone sets a reserve over $100,000, or notify a line manager of a new claim under her watch. You can actually use these fancy tools!

So, just connect. With your business analyst.

PETER ROUSMANIERE, a Vermont-based consultant and writer, is the workers' comp columnist for Risk & Insurance®.

April 15, 2007

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