Church Mutual Insurance Co. receives E-Fusion claims management award.

When Wisconsin-based Church Mutual Insurance Co. experienced substantial growth in recent years, it needed something to accommodate the growing claims activity around its expanded book of business. The solution was to develop a claims electronic file it calls eFile to eliminate the large amount of storage that was necessary to house the tremendous amount of paper claims it used to generate.

eFile is providing enormous benefits to the company and the novel approach has resulted in Church Mutual being named an E-Fusion Award recipient in the Claims Management category.

The system has a number of features useful to claims staff, including immediate simultaneous electronic access to file claim documents; the ability to find those claims over the LAN, WAN and the Web; and the automatic handling of incoming and outgoing e-mails, their attachments and faxes with agents, adjusters and customers.

"As a result of the efficiencies now facilitated by the system, we can accommodate higher claims frequency along with checks being issued faster every day," said Gerald Whitburn, chief executive officer, chairman and president of the company. In the new paradigm, 99.75% of claims are now being handled electronically. "Filing and piling of our claims is now over," Whitburn said.

Other finalists for the E-Fusion Award for Claims include:

Colorado-based CaseShare Systems Inc. has developed the Executive Claire Summary System, or ECS System, to facilitate the creation, distribution and review of executive claim summaries for American International Group. The system allows users to upload a Word document into a Web-based system where it can be viewed, edited and sent on to future users. The ECS System satisfies the need to make the creation and review of Executive Claims Summaries more efficient, with the ability to search reports and other documents for executives.

CCH Insurance Services implemented its Web-based program, Authentic-Web for Claims, to provide needed regulatory content. The Indiana-based company's program summarizes, researches, analyzes and drills down into the regulatory data so that companies are able to better leverage technology to increase productivity and minimize compliance risks. Authentic-Web allows users to search claims compliance by state, line of business, topic and subtopic to quickly produce regulatory rules.

The Guaranty Income Life Insurance Co. has created a new Claire Tracking system to aid in streamlining claims management, increasing claims data integrity and decreasing the amount of time it takes to process a claim. The Louisiana company has created a system to be primarily used by claim processors, consulting actuaries and management who use claim data and trends for making business decisions. Management can browse records and run a variety of reports, with variable parameters such as date ranges and various product and plan types that allow customization to meet specific needs.

Sedgwick Claims Management Services and MedRisk Inc. entered into a joint effort to create CLAIMExpert. The CLAIMExpert system helps to support Sedgwick's performance goals by intelligently and automatically processing claims accurately, according to customized client-specific processing needs, while at the same time maximizing efficiencies and reducing administrative costs by automating regulatory claims processing functions.

The companies worked together to create a system that could accommodate multiple client workflows and preferences, in addition to managing the already complex claims regulatory requirements in multiple jurisdictions and for multiple policies.

Valley Oak Systems Inc., based in California, has developed iVOS--a browser-based claims management and risk management system designed for multiple lines of insurance. Built on Java architecture, the program can be installed on the client's network or on Valley Oak's. The Web-based administration system features document imaging, integrated claim mail, report distribution and features-automated form and letter distribution for all jurisdictions.