The Biggest Risk in Your Homegrown SIU Case Management System

By James Horner  |  August 30, 2012

Your homegrown SIU case management system has served you well over the past decade.

You can track cases referred for investigation, keep an eye on individual progress, and run some aggregate reports to give you a view across the entire SIU department. The solution may not be perfect, but it’s gotten the job done for you, supporting your investigations where nothing existed previously.

Yet all good things must come to an end. When that happens, it pays to have something new ready to go.

A recent article in Insurance Networking News asked an important question about legacy systems in general, and it applies to case management systems, too: “Will legacy systems outlive our ability to run them?”

The problem is based on a broader demographic issue: An aging workforce, particularly the Baby Boomers, is getting ready to retire. When that happens, an enormous amount of institutional knowledge and experience will disappear. Meanwhile, a new generation of technology professionals will have to figure out how to manage legacy systems built by someone else and with varying degrees of documentation available. Bug fixes, new releases, and performance optimization — among other issues — will take longer to complete.

The risk is already accumulating.

With a major talent shift on the horizon, insurers have an opportunity to move to new systems and take the lead in an increasingly competitive market. For the SIU department, implementing an off-the-shelf, customizable SIU case management product can remove legacy systems risk from the data center while improving:

  • suspicious claims referral rates
  • investigator efficiency and productivity
  • management oversight
  • SIU operations as a whole

SIU Case Manager, from ISO Claims Solutions, can help you prevent future staff shifts from disrupting your business, while delivering near-term results in the SIU department. The system is easy to implement and integrates with ISO ClaimSearch®. And SIU Case Manager provides end-to-end case management, from the time an adjuster uses ISO ClaimSearch to refer a claim through quarterly and annual reporting.

Investigators can use SIU Case Manager to manage the details of an investigation — including documents and photos — and to prevent cases from falling through the cracks. At the same time, SIU managers and directors can review both detailed and aggregate reports with only a few mouse clicks, reducing the time it takes to run reports from days to seconds, according to feedback we’ve received from our users. And the ROI case is straightforward: One fruitful investigation per user pays for SIU Case Manager for the entire year.

Fill out the form below to learn more about SIU Case Manager.

One marker of a successful insurance company claims operation is the effectiveness of its subrogation process. Over the years, a variety of benchmarking studies have shown that the best-performing insurers recover about twice as much through subrogation as the average insurer. And by one estimate, companies miss $15 billion a year in opportunities to recover from the responsible parties — often including their competitors. (For a summary of some of the studies, see this 2011 blog by Christopher Tidball.)

Why haven’t property/casualty carriers invested more in subrogation?
The primary challenge has been technology — or the lack of it. Without automated resources to help claims adjusters identify claims with subrogation potential and refer them to the subrogation unit for assignment, opportunities fall through the cracks. Many good referrals for subrogation come from adjusters with the experience to recognize conditional liability, but those adjusters suffer under increasing workloads and the continued pressure to attain closure rates of 100 percent. For junior adjusters, their lack of experience makes them likely to miss some opportunities.

Current volume-oriented goals to improve the number of referrals compound the problem. If adjusters must increase the number of claims they refer to the subrogation unit — they will. However, some of those claims may have no subrogation opportunity. More referrals may merely overload the subrogation department and be counterproductive: Missed opportunities become inevitable if the applicable statute of limitations passes on claims with legitimate subrogation potential.

ISO Claims Outcome Advisor® (COATM) has the answer to the property/casualty industry’s $15 billion question: How can we get more out of subrogation? Our new tool, ISO Subrogation AdvisorTM, offers an integrated approach to recapturing claims paid through subrogation. With a few mouse clicks, adjusters can identify and refer cases for subrogation. And because ISO Subrogation Advisor is easy to use, the increase in referrals comes without a significant increase in adjusters’ workloads.

Simply put: The right people see the right claims sooner, leading to increased recoveries and lower loss ratios.