In describing the system, Scheib says it feeds enrollment and diagnostic information into the models for a given year or population. The software will put the diagnoses into clinically or financially homogenous buckets that are used in regression equation to explain current costs or predict future costs, he says.

Benchmarking numbers can be taken from an outside database or, as Highmark does, be developed internally. The models are a lot more accurate than the traditional age, gender actuarial techniques, Scheib says.

He believes making the product Web based will improve its flexibility and interactivity with the insurers data. It will store everything in an interactive database so you can design queries to track down your point of sale products, Scheib says. This should automate those processes.

DxCG RiskSmart is priced according to the size and scope of each clients implementation.

Product: SunGard Insurance Workstation
Company: Sungard Insurance Systems
Web site: www.insurance.sungard.com

SunGard Insurance WorkStation is a new Web-based platform that provides a front-office sales solution for both insurance carriers and financial advisers. The product is a joint effort from SunGard Insurance Systems and SunGard Online Investment Systems.

Insurance WorkStation guides a sales presentation by providing theory, analysis, and recommendations used to identify a clients needs. It presents carriers with a consistent strategic approach to insurance sales, according to Patti Frese, SunGards director of marketing. SunGard, based in Miami, Fla., is targeting the growing number of financial services professionals entering the insurance market. Its interactive approach allows users to identify pertinent needs, recommend appropriate insurance solutions, illustrate products, and perform compliance reviews, according to Frese.

Product: JConfigurator 2.0
Company: ILOG
Web site: www.ilog.com

The newest release of ILOGs JConfigurator (version 2.0) gives insurance carriers control of the product and service configuration process. Carriers have the ability to plan and customize coverage for business, health, auto, and homeowners policies. The product is also used by other financial services organizations.

JConfigurator has support for Web services through Simple Object Access Protocol (SOAP), which allows configurations created as Web services to communicate remotely with other applications. Customized insurance benefits packages can be configured, according to the Mountain View, Calif.-based software developer.

Product: Team-Up
Company: Connective Technologies, Inc.
Web site: www.connective-edi.com

Independent agents are wary of carriers offering to install software on their agency management systems for policy uploads, so carriers are turning to Web-based alternatives, such as the new Team-Up solution offered by Connective Technologies, Inc., of Houston, Texas.

Mutual Benefit Insurance Group CIO Steve Gildea says his company was looking for a very intuitive and easy-to-use way for our independent agents to upload personal lines new business to us. He says using the Internet was a priority, and the browser-based solution offered by Connective solved the ease-of-use question.

It wont require any training, and there is no installation of software on the agents systems, he says. They are able to start uploading with us in minutes. Gildea says Mutual Benefits, based in Huntingdon, Pa., spoke with its independent agents about failed attempts from other carriers and solution providers to determine what the agents wanted from the carrier. We were looking for a solution that allowed us to roll out our existing upload solution to additional agency systems, but we didnt want to build and maintain multiple processes and sets of edits for each system, Gildea says.

Team-Up can be integrated with a carriers existing Internet offering. It offers support for both AL3 and ACORD XML standards. It also offers immediate access to uploaded files through the carriers secure Web site and secure delivery of unique underwriting requirements.

For carriers, Team-Up provides automated processing of new business, renewals, quotes, and change requests without requirement for re-keying data, checking for data completeness, or applying preliminary data edits. With the addition of Connectives new modules for workflow and underwriting, qualified risks can pass through unique underwriting requirements straight through to the policy processing system. Team-Up allows the carrier to select as little or as much automation as it likes. Its flexible architecture allows carriers to expand its offerings as business needs change. The system can also be integrated with existing modules and legacy systems.

For agents, Team-Up requires only a browser, eliminating any implementations or maintenance work. Agency focus groups provided input to the technology developers. The flexible solution allows for both real-time and batch processing with multiple user access. Easy reporting helps in the development and expansion of trading partners.

Team-Up integrates with existing expert underwriting, workflow, and policy management systems at Mutual Benefit.

No pricing information was available.

Product: Decision Point 6.0
Company: Mitchell Medical
Web site: www.mitchell.com

New enhancements, including a user-configurable action and workflow rules engine, are available on Decision Point 6.0, the newest release of the medical bill review, utilization review, and management reporting software from Mitchell Medical, the San Diego, Calif.-based provider of casualty claims solutions for the auto insurance industry.

Insurance carriers use Decision Point to control first- and third-party medical claims costs, giving greater flexibility to the claims management staff in designing and managing internal workflows. Decision Point can be run as an Internet-based application hosted by Mitchell or through a carriers intranet.

The new version also includes Sentry, Mitchells rules engine that puts the power of writing rules in the hands of the carrier. The Sentry rules engine allows for consistent and accurate reviews based on the policies and procedures of the organization, says Tom McCarthy, senior vice president of Mitchell Medical. The rules allow for automatic payments for selected procedures under a specified fee. When the rules are exceeded, cases are routed to the proper adjuster for review.

Product: eAudit
Company: eAutoclaims, Inc.
Web site: www.eautoclaims.com

eAutoclaims, Inc., a provider of online claims management solutions through both an Application Service Provider (ASP) and outsourcing solutions services, has launched a new claims auditing application, eAudit, which enables insurance carriers to electronically audit an auto insurance claim to red flag exceptions, allowing an unlimited number of guidelines to be entered in the process.

eAudits operating system features built-in logic that mathematically identifies claims for probable leakage based on historic data from previous claims exceptions. When dealing with auto claims, insurance companies need to track the cost of labor versus the cost of parts and estimate a number or percentage that is acceptable. The companies set their own internal guidelines for repairs and evaluate them on a claim-by-claim basis.

This technology enables users to identify those claims that fall outside of their auto estimating guidelines and also scrubs the claim and compares it against a mathematical model for probability of leakage, says Eric Seidel, CEO and president of eAutoclaims.

Insurance adjusters and claims managers can pinpoint inflated body shop labor rates. eAudit automatically identifies instances when a shops labor rate exceeds the acceptable estimated amount set by the insurer, and the inflated rate is immediately flagged. The new application also verifies the accuracy of the repair and parts costs.

eAudit is being released as a follow-up to eAutoclaims eJusterSuite, an ASP for streamlining repair claims for the automobile insurance industry. eJusterSuite integrates claims processing into one Web-based system that brings together multiple service partners.

The original product was developedby Decision Support Services, Inc., of Escondido, Calif., and enhanced by eAutoclaims. The two companies have a 10-year, exclusive partnership agreement.