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How many times have you heard an enthusiastic claims manager agonize over the decision of replacing an existing system only to find the new one was worse than the old? No one wants to own up to the responsibility of a bad decision. Many times this leads to procrastination or no decision. Stick with what you have…….or??

What is the solution? Throw price aside as it is the last decision, but instead put all emphasis on analysis, as system selection is critical. First determine what you need, what you want, and your intended objective, otherwise, you get exactly what you wish for, a system that probably does not accomplish your goal.

Planning a new system needs several considerations. In the old days, systems were generated using the same business practices of the manual systems. Nothing has changed, new systems are being developed with the same criteria in mind. I don’t want to be too far away from the mainstream, yet I want to give myself the latest technology is the standard mantra. One of the major parameters is to emerge with new capabilities. Be sure that there are no limitations on growth. When purchasing claims management software, price may not be the only question. Expensive doesn’t mean good! Instead of considering an expensive price tag, find the one that is easy to use yet still does the job.

Defining exactly what your needs are, how the system will be used, what major accomplishments are intended, what kind of reporting, who will we be interfacing with or transferring data all are major when considering a purchase. Depending on the size of the organization, a RMIS system can be thousands, or hundreds of thousands of dollars, with the size of the organization being the determining factor. This may be one of the most expensive budget items for the entire department. The benefits of the expenditure must be substantial to offset the costs. This decision will be the turning point in the consideration of replacing an existing system that may work OK. It must have value! The corporate decision to replace a system, deploy it, fine tune it normally takes 1 to 2 years and it’s no wonder considering the factors that make up the decision.

It may be in your best interest to look at all the systems out there currently and then create your requirement document. Instead of trying to define what you think you need, take a look at what’s out there and try to assemble from all of those brilliant ideas a comprehensive systemthat makes sense to you. There’s no substitute for knowledge and the more aware you are of what’s taking place in the marketplace the better your analytical decision will be.

So many times people take the position of being too consumed with their day to day tasks to intelligently analyze, so the easy road becomes the simplest method, go with the vendors recommendation. Unfortunately, the result is never the desired intent. If the client does not have an exact idea of what they would like to accomplish, the vendor has considerable latitude, many times not in the client’s best interest.

Once you have thoroughly evaluated all the systems out there and your exact needs, it is now time to consider the price. What provides you with what you need in terms of software, support services, customization, and other peripheral items related to the deployment of the product at a reasonable price? Too cheap is probably just that and too expensive may not get you the quality you were expecting. If you do a good job researching you will ultimately end up with a good product, longevity and less of a reason to go shopping because your existing system does not do what you need in the foreseeable future.

The post How To Decide If You Are Ready For A RMIS Upgrade? appeared first on JDi Data Corporation.

A graduate of the University of Cincinnati, Rick comes with over 15 years of leadership in the insurance technology marketplace. Rick has been able to significantly increase market share and revenue as Senior Vice President of Sherwood International, Sr. Vice President at E.W. Blanch and most recently Senior Sales Executive for ISO, a Verisk Analytics company . We look forward to Rick expanding JDi Data’s footprint in the in the insurance claims and policy administration solutions provider arena.

Rick gears up to dive into learning more about our suite of insurance software products, and explains that “it’s very exciting to join a company which has such a strong commitment to continually make sure they are providing best of breed solutions to their clients”

Rick keeps a balance between work and home life by taking time out regularly to spend time with his wife and 12 year old daughter. Rick is also the past President of Big Brothers/Big Sisters of Greater Cincinnati, and presently a member of their foundation board.

Connect with Rick on LinkedIn - www.linkedin.com/pub/rick-aronoff/0/67/700

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According to the World Insurance Report 2012, insurers are concentrating on improving underwriting performance by optimizing claims, customer acquisition and other operational costs. Surveying insurance executives across the United States, Europe and Asia-Pacific the study found that for 93% carriers in Europe and 67% carriers in US that increasing the efficiency of policy administration technology is one of the major priorities for improving margins.

The importance of adapting a good policy administration system to stay ahead in the current competitive market speaks for itself. Let’s touch on the basics:

Scalability –  With new business growth as a priority, your policy admin system should be flexible to grow as your company grows without major programing changes. With the likelihood of new features getting added and with more and more customers accessing, your system should be scalable.

Adaptability – Legacy policy administration systems that lack the flexibility to adjust, add or remove products are no more useful in the today’s market where the needs of business insurance are often changing. Supporting your business and other technical requirements which may arise in the future should be on your requirements list.

Flexible architecture – Just like the software of the system, the hardware of the system should also have a flexible architecture to adapt change.

Configuration sharing – A typical insurer deals with many insurance products that often have overlapping features. To make the best of your new policy administration system, make sure that it provides effective configuration sharing so that you can configure different products with common characteristics with less effort.

Easy to use – Your new system becomes less effective if it takes more of your time and resources. So, make sure that its operation is not only effective but also easy. Every department involved in its operation should feel comfortable using it – then only it becomes viable. This also avoids you to hire new resources, which is an additional expense. 

What essential characteristics are insurers focusing on when modernizing their policy administration system?

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From fancy cars and expensive clothes to fine dining and exotic vacations, there are many ways you can spend your hard-earned dollars. And there is nothing wrong with rewarding yourself for a job well done — but what would happen if you rewarded someone else instead? JDi Data is continuing our commitment to  continuously thinking of others with our  12 months of Giving blog series.

This months featured charity is the  Alzheimer’s Association,  chosen by JDi Data’s President James DeRosa whose mother passed away from the terrible disease.

Started back in  n 1979, Jerome H. Stone and representatives from several family support groups met with the National Institute on Aging to explore the value of a national, independent, nonprofit organization to complement federal efforts surrounding Alzheimer’s disease. That meeting resulted in the April 10, 1980, formation of the Alzheimer’s Association with Mr. Stone as founding president.

Today, the Association reaches millions of people affected by Alzheimer’s across the globe through our national office and more than 75 local chapters. As the largest donor-supported, voluntary health organization for Alzheimer’s, the Association is a catalyst for advancements in Alzheimer’s research and care.

The Alzheimer’s Association works on a global, national and local level to enhance care and support for all those affected by Alzheimer’s and related dementias.

As the largest non-profit funder of Alzheimer’s research, the Association is committed to accelerating progress of new treatments, preventions and ultimately, a cure.  Through their partnerships and funded projects, they have been part of every major research advancement over the past 30 years.

Alzheimer’s Disease Facts and Figures 2013

JDi Data  donates yearly and urges you to also take a minute to donate today! Click here to join the cause - http://www.alz.org/join_the_cause_donate.asp

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HOW TO WORK EFFECTIVELY WITH AN ATTORNEY:

Making Skilled Legal Advice A Part Of Routine Construction and Design Practices

Every design and construction firm needs access to capable and competent legal services, not just to handle lawsuits or threats of lawsuits, but for the more mundane, but equally significant, advice on proposed contract language and practice liability issues. In truth, like almost every other area of personal and professional life these days, selecting and working with an attorney requires the client to be a wise consumer of legal services. There are no fixed rules as to how these services should be provided to a design or construction professional. It is incumbent upon the practitioners as prudent businessmen or women to identify available skilled legal counsel and to integrate the requisite legal services into their particular practice. This article is intended to assist the small firm or solo construction or design practitioner in obtaining such legal services and in crafting a workable, affordable attorney-client relationship- i.e., one that tailors legal services to the professionals’ particular skills, interests and needs.

UNDERSTANDING THE LEGAL IMPLICATIONS OF DESIGN and CONSTRUCTION PRACTICES

The first order of business for any practicing AEC professional, whether solo or in a firm, is education.  Legal issues and questions arise routinely in the practice of construction services.  All design professionals should know something about the legal consequences of standard design practices.  Why?  Such a basic understanding is crucial in order to:

1.   Craft routine business practices and policies which minimize liability;

2.   Select and prepare contracts (and other contract administration forms) that clearly and accurately define the role of the design/construction professional in each respective project, as well as the legal obligations of that role;

3.   Make the most effective use of the services of an attorney who is skilled in the practice of design/construction law.

In addition, knowledge of the legal aspects of design should assist the practitioner in recognizing problems on a project, hopefully in sufficient time to see to fair informal resolution, or to maximize the potential for success in the event of the more formalized dispute resolution processes–mediation, arbitration and civil litigation.

SOURCES FOR LEGAL RELATED INFORMATION

While strides have been made in teaching the legal aspects of design as part of undergraduate and graduate professional design programs, for the most part the burden falls on the individual practitioner to see this aspect of his or her education.  Larger firms with “staff” attorneys have an excellent opportunity for regular “in-house” employee seminars, as well as the benefit of their employees’ continuous exposure to a legal practitioner working in their discipline.  However, all design professionals, whether in large firms, small firms or solo practitioners, have available a wealth of legal related information:

1.   Professional architecture and design associations are well known for their preprinted contract documents and practice advice books, booklets and bulletins, as well as their continuing education programs.  Among the national organizations are the American Institute of Architects (AIA), The American Consulting Engineers Council, The American Society of Civil Engineers and the National Society of Professional Engineers provide these services for both members and non-members alike (at an increased fee for non-members).  Particular attention should be paid to preprinted forms issued by the AIA and also the professional design groups under the auspices of the Engineers Joint Contract Documents Committee (EJCDC).  Not only are these documents worthy of careful study for their evaluation of significant risks and obligations of design practice, but all these groups publish annotations and other descriptive information to assist the uninformed practitioner.

2.   Professional liability carriers, most notably CNA, through Victor O. Shennerer & Co., Inc. and DPIC have long recognized that an educated insured is more likely to have fewer professional liability claims made against him or her.  Certainly, the cost of insurance premiums places professional liability coverage beyond the reach of many small design firms.  But the publications of these carriers are available to both insureds and non-insureds and should not be overlooked as a valuable source of information.

3.   There are numerous continuing education providers, professional associations, private companies and universities, all providing programs geared to the design and construction practitioner.  The AIA has over 1200 approved providers presenting programs coast to coast in support of their continuing education program.

REFLECTION – HOW YOU WISH TO PRACTICE DESIGN

Knowing that it is not realistic or economically practical for the small practitioner to refer every legal question to counsel, make a realistic assessment of your interest, skills and time available to research and craft solutions to particular legal problems.  Some design professionals may have a particular “knack” or interest in the business of design including the drafting and negotiating of contracts and the analysis and resolution of disputes.  Other design professionals will find these activities burdensome.  Look honestly at your daily practice.  Do you have the time, interest and skills to devote to legal issues such as the meaning and impact (for your design practice) of client-proposed contract language, or the risk and liability associated with a proposed scope of services or omission of those services from your scope of work?  If you do, your use of an attorney will differ substantially from those firms with no particular interest or aptitude in this regard.  There is no “right” or “wrong” here.  Only the necessity of understanding your professional strengths and weaknesses, and the decision making necessary to tailor a role for legal counsel which dovetails with your needs.

THE ROLE OF LEGAL COUNSEL:  COMMENTS FOR EACH

END OF THE SPECTRUM

You may wish to have legal counsel involved in your day to day business in an active way-reviewing and negotiating your contracts and advising on the legal/liability risks continuously before you.  Nevertheless, it is important for you to remember that it is YOUR business.  Most decisions relating to contract language and, indeed, most decisions relating to legal issues in design practice are not legal decisions.  Most are, and should remain, as business decisions to be made by the design practitioner with the benefit of legal counsel.  Too often, design professionals with little or no interest in the business aspects of design relegate all business decision making to the lawyers, often with disastrous results.  In the final analysis, there is no way for the design professional to escape the necessity to understand the legal aspects of his or her practice and to be the final decision maker as to which risks you are willing to assume and to what degree.

Conversely, some design practitioners enjoy handling these legal issues and seek less day-to-day expert legal advice.  In this regard, it is important to discuss the legal research potential available because of the use of computers and access to the vast data resources of the Internet.  Twenty years ago, few design professionals would have considered doing their own legal research.  Such research depends on enormous volumes of printed material – federal and state statutes, codes, rules and regulations of administrative agencies and printed court cases.  In the past this information was available in hard copy form only in law school libraries and larger metropolitan areas.  Even then, smaller county law libraries were likely to have only some of the widely published legal material available to practitioners.

Now, of course, access to some great search engines and other network services permits any individual to access this information.  But with opportunity comes responsibility.  Legal research is more than access to information.  In order to competently utilize the vast amount of material now available, it is necessary to understand the American litigation system.  This is clearly no small task – lawyers learn for three years in law school to understand legal principles, to research legal issues and to apply their research to specific fact situations.  Not all printed cases carry the same weight – some may be entirely inapplicable (different state, for example) some may have been overruled or clouded by subsequent cases – and some may be distinguished from the facts at hand.  For those design professionals interested in legal research on professional liability issues, the word is “CAUTION” – at a minimum you should undertake to be trained in research techniques and case factual analysis and you should double check your conclusions with counsel.

Thoughts about the use of legal services at each end of the spectrum suggest a team-based approach.  The design professional, educated on legal and business issues becomes the team manager of a specialized business support team – legal, insurance, accounting and any number of technical design specialties necessary to complete today’s complex projects.  The practicing design and construction professionals need enough knowledge of these disciplines to ask thoughtful questions of those people who provide advice to fully understand the advice and to make certain that it is consistent with the firm’s overall business philosophy.

CRAFTING THE WORKING TEAM

Having delineated a role for an attorney as a team member (a consultant, not an employee), how do you go about finding the right player?  Some suggestions:

1.   Find an attorney who has a specialty practice in design and construction law.

2.   Ask what percent of their time is spent on design, construction and related matters.

3.   Find out what construction law associations they belong to and whether or not they are active participants in those groups. Most bar associations in large urban areas have construction law groups.  Also the American Bar Association’s Forum on the Construction Industry has approximately 5,500 members nationwide and provides its members with a quarterly construction law journal as well as three or more multi-day seminars on construction related legal topics each year.

4.   Ask whether they write for juried law publications or teach – either in law or architecture, design or construction programs, or continuing legal or practice education.

5.   Inquire as to what the attorney does to stay current in the field by way of seminars, journals or newsletters.

6.   Ask whether the attorney has a transaction-based or a litigation-based practice.  Unfortunately, many litigation-focused attorneys are too strident to provide helpful contract drafting and negotiation services or to help design professionals resolve legal issues short of litigation.

7.   Effective lawyering involves much more than a knowledge of a particular area of the law.  An understanding of the design and construction industry permits a lawyer to provide practical advice to his clients, with an understanding of the possible consequences.  Good lawyering is about mature judgment based on cumulative experience.  It is also about listening to you, the client, and communicating with and explaining options to you.  Insist on this level of service.

In the final analysis, you want to select an attorney who is not only knowledgeable and active within the specialized design/construction law practice area.  You want an attorney who is pleasant and helpful to work with.  Remember that you are looking for a lawyer to function as a part of the team necessary for successful design practice.

CONCLUSION

A successful small design or construction practice demands much of its practitioners  apart from the technical aspects of design and construction.  Working with an attorney can and should be more than making a telephone call if you are sued.  But getting the best legal advice on contract and other risk / liability issues requires an active involvement by the AEC professional.  The design practitioner must undertake to be an educated team leader if he or she hopes to successfully integrate the success of an attorney into the practice team.  And the firm’s principals must be decisive business managers:  decide the level of legal services you wish to utilize on a routine basis, select the best practitioner that you can find and learn to evaluate your attorney’s advice before making the final decision on any legal issue. IT IS YOUR TEAM, AND YOU’RE THE CAPTAIN!

About the Authors

Mary McElroy is an attorney whose California based practice is devoted to construction law issues.  A former chair of the American Bar Association’s Forum on the Construction Industry, she has taught and written extensively on construction law matters, including the publication Construction Industry Forms, John Wiley & Sons, Inc.  In thirty years of practice she has literally drafted hundreds of architectural and design service agreements as well as construction agreements for all forms of project delivery.

William F. Dexter is a nationally recognized risk management expert and the former Director of the California Center for Construction Education for the College of Architecture and Environmental Design at California Polytechnic State University, San Luis Obispo. His professional training and consulting company serves numerous industry associations in the areas of problem solving and liability mitigation. His overall experience in construction activities spans 40 years as a craftsman, contractor, consultant, educator and trainer.  He serves the Superior Court of California as a Special Master.

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Proper documentation is vital not only to record the facts and activity on a file, but it’s also the adjusters’ opportunity to back up their decision and the facts on damages, liability, coverage etc.

Claim documentation should be approached with care; here are a few tips to keep in mind.

A documentation audit ensures proper practices are being followed.
Making corrections, running audits, and proper training keeps employees following proper documentation procedures for each claim. Claim supervisors who perform regular quality assurance inspections help to not only track adjusters’ performance, but also create opportunities to improve and enhance their workflow process.

Take advantage of technology advancements to assist with documentation.
With the vendor landscape for insurance software technology being much more mature, Insurers have the ability to integrate applications for live call monitoring and recording. Sophisticated claim systems can also give claim professionals the options to transcribe calls, notify adjusters of potential issues in their claim, and track patterns.

Keep documentation clear and concise.
All documentation should be straight to the point, leaving no room for interpretation. Keep logs of all phone calls and activities including negotiations and follow up attempts.  Review all claim documentation with a fine tooth comb. Diaries and notes should reflect the full story if any claim activity information is needed in a lawsuit.

Document how you came to your conclusion.
Investigating each claim is an intricate process. Insurers are relied upon to provide credible evidence for both denial of claims, and awarding of coverage. Bad faith dealings accusations can come up when proper notes are not involved and claim professionals are not able to explain clearly how coverage was decided. Approaching claim documentation in an appropriate manner alleviates such a finding.

Good documentation skills are essential for claim professionals to practice daily. The diary system in your claims management software is a powerful tool to record adjusters’ notes, create reminders, and ensure effective management of each claim file. Keeping an updated diary system of supporting documentation that can be easily accessed by all parties involved will keep a permanent storage of the data and eliminates the risk of loss.

What additional tips would you add to this checklist?

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David Bentley – Business Analyst

David comes to JDi Data with a wealth of knowledge stemming from past work experience at major companies Bank Atlantic, and American Express as their Manager of Business Analysis and Systems Development. David will be a great addition to the team, and will be responsible for working with JDi Data customers to determine their requirements, issues, and working with the IT development department to execute solutions.

David adds, “I get my personal job satisfaction from helping users in the business community solve problems by the appropriate application of technology solutions. This position has both aspects, of interfacing with the user community to identify problems that need to be addressed, and with the JDI Data development team to design appropriate solutions.”

David holds a degree from Hobart College where he majored in Liberal Arts. In his spare time you can find David on the tennis court, or woodworking.

Connect with David on LinkedIn - www.linkedin.com/pub/david-bentley/3/884/477

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Joe Faires – National Account Executive

JDi Data also extends a warm welcome to Joe Faires who is coming on board the team as our new National Account Executive, highly qualified with a Bachelor’s degree in Economics from DePauw University, and an MBA from the University of Indianapolis. With a work experience background that includes working with MarketStance, a company that provided information and analytics across the insurance industry as their Regional Relationship Director. Joe will for sure be able to dive right into his new position here at JDi Data successfully. Joe will be responsible for meeting all aspects of our sales objectives and executing the company’s sales initiatives for our insurance software product suite, Claims Manager and Policy Administrator.

 Joe will be working remotely from his home office in Indianapolis, Indiana. When not as his desk you can find him spending time with his family, and staying active through a variety of sports.

Connect with Joe on LinkedIn - www.linkedin.com/pub/joe-faires/7/5a/45b

Welcome to the team David & Joe!

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Is your current core claims system constraining your business? 

Your goal should be to deliver an agile yet simple technology solution for your adjusters, and customers. A system that brings efficiency and effectiveness not only helps with the bottom line but keeps adjusters providing optimal customer service.

1.       Prepare a detailed prioritized list of what are the most important items that need to be addressed. Your list should include enhancements such as:

Manage Claims Efficiently/Updated Workflows
Improve Customer Service
Business Intelligence
Reduce Claim Costs
Improve Fraud Detection
Compliance and Regulation Guidelines

2.       What is your success criterion? 

Knowing the ‘why’ is just as important as calculating the ‘how’. This knowledge will help you guide the search. A uniformed goal will assist in providing a practical approach. If your success criterion is to be able to better identify trends, then it’s clear that business intelligence, and capabilities to access detailed data to make informed decisions should be numbers one or two on your priority list.

 3.       What is your commitment level? 

Are you mapping out a full workflow starting with the frontline, all the components, and players that take part in each claim? Have you fully reviewed the IT resources needed to maximize your IT support without increasing requirements on your existing IT department? Modernizing an antiquated claims process is no easy fete and all areas should be fully assessed with a multi-functional perspective that takes a strong commitment to making a major system change.

The union of a very mature vendor landscape, and antiquated legacy has created an environment where insurers view claims management system transformations as an essential and accessible initiative. Most insurers have inflexible systems that constrain their ability to respond to market changes and new business needs. A practical approach with a detailed outline will help in creating the right business technology partnership, and maximized your ability to respond to business changes effectively.

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