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Further Development of the Internet Based, Business Process Utility (

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Title: Further Development of the Internet Based, Business Process Utility for Insurance Claims Author: Ellen Wilcox Last modified by: William F. Swiggart – PowerPoint PPT presentation

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Title: Further Development of the Internet Based, Business Process Utility (


1
Further Development of the Internet
Based, Business Process Utility (BPU) for
Insurance Claims
  • Moderator
  • William F. Swiggart, Esq.
  • Panelists
  • Ellen Wilcox ES Wilcox Assoc., LLC William
    F. Swiggart, Esq.
  • Josh Lee - Microsoft
  • David Ferrara - ProcessClaims

2
Agenda
  • Claims Utility
  • Market Overview
  • Business Implications
  • BPU Legal Considerations
  • Technology Implications
  • Real World Example
  • Panel Discussion / QA

3
Claims Utility Market Overview
  • What is a Claims Utility?
  • Initial Offerings
  • Current Trends
  • Potential Future Markets

ES Wilcox Associates, LLC
4
Claims Utility Business Implications
  • Competitive Positioning
  • Operating Models
  • In-house
  • Package
  • ASP
  • Outsourcing

ES Wilcox Associates, LLC
5
Legal Considerations Q What is Legal Basis for
BPU?
  • State Street Bank Case (1998)
  • Pure Software Patentable
  • ATT v. Excel Case (1999)
  • Business Methods Patentable

Swiggart Agin, LLC
6
Legal Considerations Q What is best Business
Structure?
  • Ownership
  • Spin-Off vs. Joint Venture
  • Vehicle
  • Corporation vs. LLC
  • Venue
  • Delaware vs. Bermuda, etc.

Swiggart Agin, LLC
7
Legal Considerations Q Are there Anti-Trust
Concerns?
  • Spin-Offs
  • Rules and Procedures to prevent customers from
    using BPU to violate anti-trust laws
  • Joint Ventures
  • Must prevent any appearance of Price-Fixing

Swiggart Agin, LLC
8
Legal Considerations Other Issues
  • Privacy of Customer Data
  • Gramm-Leach-Bliley
  • EU Privacy Directive, etc.
  • Laws re computer transactions
  • UCITA,
  • Electronic Signatures, etc.

Swiggart Agin, LLC
9
Technology Implications
  • Loosely coupled integration
  • Seamless desktop to back office communication
  • Use of data analysis for cost optimization

Microsoft Corporation
10
Technology Implications
  • Technology facilitated exchange
  • How much data is good for your company
  • Usage of standards, who is leading and who is
    lagging

Microsoft Corporation
11
Real World Physical Damage Web Based Hub
INSURANCE COMPANY
Management
Management Report, Analyze Optimize
Total Loss
Dispatch
Audit
Pay Clerk
Adjuster
Claims Creator
Claims Review
TL Processor
Claims Handle
Claims Payer
MD Claims Enabler
Assignment
Estimate Photos Rules Scorecard
Workflow Engine
Parts Black Box Info. Etc.
Estimate Aggregator
Partner Aggregator
Download Upload
Injury Sciences Hyperquest Etc.
Salvage, Visibillity, Rental
ProcessClaims
DRP Body Shops
Indep. Appraisers
12
Panel Discussion
  • Moderator
  • William F. Swiggart Swiggart Agin, LLC,
    Boston, MA
  • Panelists
  • Ellen Wilcox ES Wilcox and Associates, LLC
  • William F. Swiggart
  • Josh Lee - Microsoft
  • David Ferrara - ProcessClaims

13
Questions and Answers
  • What is an insurance claims utility ("ICU")?
  • Is there a perceived need for ICUs?
  • Is there a demonstrated need?
  • What is the current state of the market for an
    ICU?
  • What is the most likely future market for an ICU?
  • Describe recent past ICUs ?
  • Are there any current successful examples?

14
Questions and Answers
  • What are current successful examples of ICUs?
  • What has made current ICUs successful?
  • Are there any serious technical obstacles to the
    development of an ICU today?
  • If so, what are they?
  • What institutional obstacles are there, if any to
    the development of ICUs?
  • What ICUs are most likely to be available five
    years from now?
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