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ICAE Roundtable Wrap-Up
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Randy Brown (WellPoint), encourages ICAE Roundtable attendees to choose daily behaviors wisely. |
A WellPoint Welcome...
Attendees at the April 2008 ICAE Roundtable were warmly welcomed by the sponsoring organization, WellPoint, at its corporate headquarters in downtown Indianapolis, Indiana.
Randy Brown, WellPoint executive vice president of human resources, welcomed attendees and shared his insights on the importance of the consumer affairs professional in shaping the culture of an organization. Mr. Brown was inspirational and practical in equal measures. Inspirational, in pointing out that it’s up to each individual, every day, to choose behaviors. Practical, in pointing out that consumer affairs professionals need to hold on to their personal power to determine behavior because, by definition, consumer affairs professionals are interacting with those who are unhappy about some element of the insurance industry. He urged all attendees to remember the meaningful importance of the work done in consumer affairs and to remember that importance when shaping each day’s attitudes and behaviors.
And, a Well-stated Welcome
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Commissioner Jim Atterholt (Indiana DOI) welcomes attendees to ICAE’s Indianapolis Roundtable. |
Jim Atterholt, commissioner of the Indiana Department of Insurance, echoed Randy Brown’s them when he welcomed attendees to the Roundtable. Commissioner Atterholt discussed the vital role of consumer relations for all industries and added that consumer affairs plays a critical role within the insurance industry. He pointed out that neither government offices nor insurance companies enjoys a particularly robust reputation—mostly due to anecdotal, rather than statistical, information. As a result of the anecdotal commentary that surrounds the insurance industry, he feels the public has low expectations. Commissioner Atterholt’s view is that low expectations provide a tremendous opportunity to exceed and excel.
Commissioner Atterholt pointed out that Departments of Insurance (DOIs) working in partnership with industry is a win-win. He believes it’s possible and positive to have a pro-industry environment that is responsive to consumer needs. This is the goal of the Indiana DOI.
Atterholt acknowledged that insurance consumer affairs professionals have the difficult job of working with people who are usually in crisis or who have had a significant, life-altering event. He urged all attendees to continue to go the extra mile as he believes consumer affairs professionals have the ability to create a renewed faith in the industry.
Concluding his remarks, Commissioner Atterholt congratulated those attending for their dedication and professionalism. He pointed out that the insurance industry is an important economic engine that truly makes a difference in our society and that those in insurance consumer affairs are the conduit between the industry and the consumer, providing the link, the touch and the face of the organization—both an awesome responsibility and wonderful opportunity.
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ICAE President Liz Perry (WellPoint) reviews the goals and objectives of the Roundtable. |
Focus: The Work of the ICAE April 2008 Roundtable
Reaching beyond the role of conventional professional seminars, the ICAE Roundtable has traditionally selected topics of critical importance to the insurance industry (and consumer affairs specifically!), collecting input from attendees on the topic. ICAE is unique in the marketplace for its ability to gather a 360 degree range of input because attendees come from both regulatory and industry-oriented organizations. The result? ICAE can propose, examine and offer end-to-end solutions for issues troubling the regulators, industry and consumers.
The Topic and Goals
For the 2008 Roundtable, Complaint Data Analysis/Trending: How this Data is Used, was chosen as the topic and it proved to be popular for both regulators and industry professionals. This subject generated so much discussion and was deemed so significant that attendees were cautioned that a one-day session wouldn’t be enough time to:
- Benchmark the current environment,
- Review the impact of the current environment on all interested parties, or
- Propose and examine solutions and alternatives, to
- Make viable recommendations for ICAE-sanctioned positioning to DOIs, corporations and the National Association of Insurance Commissioners (NAIC).
Acknowledging the caution, it was agreed that even a partial “lifting of the veil” by regulators and insurers to know what complaint data was reviewed, by whom, and what triggers additional scrutiny would be extremely beneficial for all consumer affairs professionals. And, at the 30,000-foot-level, that’s just what occurred…
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Marty Fisher (Martha Fisher & Associates) explains that all attendees will have the opportunity to share their concerns throughout the event. |
The Process to Produce
An extensive topic, aggressive goals and numerous, eager professionals -- an ideal mix for a Roundtable session!
Recognizing that size could potentially be a barrier to robust interaction, the full group was divided into smaller groups, ensuring that each participant could offer substantial input. Groups were comprised of regulators and industry professionals, regardless of line of business.
The small groups were asked: What’s happening with complaint data today?
The groups separated and hunkered down to articulate the current environment, a picture that proved to be difficult to capture, largely due to the diversity in working with complaint data from state to state and across lines of business and carriers.
Painting the picture: The regulators’ environment
Although an overview was difficult to capture, regulators in attendance reported that complaint data is processed internally by:
- Using codes,
- Reviewing multiple levels, and
- Varying time frames for reporting to the NAIC (for those who do report).
Generally, regulators agreed that there is a danger that data can lose uniformity during translation and delays and that denials and lack of communication will trigger additional scrutiny and/or market conduct exams outside the regularly scheduled exams.
Regulator attendees noted that a tremendous amount of information is scrutinized and processed to spot trends or problem areas early, all to the ultimate benefit of consumers. Regulators agreed that they frequently rely on their staff members to discover trends via ad hoc queries.
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The record-attendance group of 60+ was initially divided into four small groups—ensuring that each participant could offer substantial input. |
Painting the picture: The insurers’ environment
Companies had myriad uses and processes for consumer complaint data. Virtually all send reports to business units and some send complaint data all the way up to the board of trustees. Most companies performed some root-cause analysis to make corrections in services, products or producers and/or to spot trends that might be corrected.
Regarding exactly what is tracked within an insurer entity, diversity is the key. Some companies track only information that the DOIs track; others track everything. Some will look at internal data while others rely on external analysis. Some require explanations for complaint increases, some for decreases and some for both increases and decreases.
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Carolyn Rubal (MetLife) summarizes one group’s suggestions to improve complaint data tracking issues. |
Most insurers agreed consistency can be an issue within the company and they work on collaboration to ensure internal data consistency. All companies have complaint data available for review and some are proactive in distributing that data to stakeholders.
Just like the regulators, companies want to use complaint data and complete competent, proactive analysis to identify trends and produce consumer-oriented solutions.
Although many attendees acknowledged that consistency is a challenge for both regulators and insurers, all were determined to become more consumer focused.
Impact of the current environment
Generally, regulators and insurers agreed the current environment has certain inherent weaknesses, including a lack of consistency which
- Provides the potential for incomplete or inaccurate trending and analysis.
- Provides the potential for propagating unfair, inaccurate or unsubstantiated information to DOIs, the NAIC or consumers.
Bringing the Group Together: Best Practices Recommended
Generally, insurers requested an opportunity for a consistent and approved feedback or reconciliation method that was available to all insurers. As a starting point, the state of Colorado was recognized as having a great model for on-line data reconciliation.
All attendees noted that spotting trends for the benefit of the consumer was the priority for all data collection, analysis and reporting. Proper and consistent use of data would helps all entities spot issues or problems and provides an opportunity for corrections to ensure consumers have a positive experience.
The Roundtable attendees proposed specific best practices for further discussion and the potential generation of a position paper. The best practices proposed were:
• Request all DOIs provide an opportunity for data reconciliation (currently, only 10 states provided this opportunity). Ideally, this process would be:
- Staggered, since an annual year-end reconciliation would be difficult due to volume;
- Consistent across states, particularly in terms of the:
- Use of an NAIC number to expedite reconciliation across all entities,
- Reconciliation process - who initiates, the company or DOI?,
- Expected response (i.e. necessary only if discrepancy is identified), and
- Process for responses (when made, how, to whom),
- The preferred process would be online; however, it was recognized that an electronic-only process is simply not viable for all states at this time and a paper-based mechanism would be necessary in the interim), and
- Established standard guidelines for posting of information (i.e. confirmed only vs. ALL complaints or complaint data posted only when specific thresholds are reached)
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Lisa Prisco (Progressive) offers some best practices regarding the tracking and use of complaint data. |
Additional best practices were suggested, but were “parked” for further review as specific recommendations were not agreed upon. Best practices noted for further discussion included requests:
- For a consistent standard across states on the practice of follow-up hard copies of correspondence, documents or information sent electronically.
- To standardize the acknowledgement of complaint(s)
Although additional best practices were proposed (information on complaints, use of actual due dates, etc.), review showed the recommendations to be duplicative of requested best practices already under review and/or proposed by ICAE. Further exploration at this time would be counterproductive.
The mandate for the Williamsburg Exchange
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The Williamsburg Lodge is the location for ICAE’s Fall Exchange, Building on the Foundations of Insurance. |
As the meeting was drawing to a close, the natural question became, “Where do we go from here?”. Because ICAE has firmly established itself as a collaborative association, the natural next step is to share the recommendations at the ICAE Exchange, slated for September 28-October 1, 2008 in Williamsburg, Virginia. There, the recommendations will be reviewed, discussed, added to and voted upon.
Perhaps even more important than the collaborative process, will be the group decision on how to get this set of recommendations to a greater audience. As a group, ICAE will be working to determine how their position papers—specifically this most current one on standardizing reconciliation methods for complaint data—can be best disseminated for broader awareness and ultimate acceptance.
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Looking back
Appropriately, ICAE is a forward-looking organization. By regularly posing questions and requesting input, the entire group is lifted to a new level of professionalism.
ICAE critically examines the consumer affairs world and poses questions to trigger an intellectual spark at all ICAE meetings. ICAE members and attending regulators have risen to each occasion. Equally important, however, is Whatever happened to…?
In this case, the question of whatever happened to the ICAE position paper on code standardization was answered by Bob Lisson, Deputy Commissioner, North Carolina Department of Insurance and Joy Hatchette, Associate Commissioner for Consumer Education and Advocacy, Maryland Insurance Administration. These individuals shared the current status of the NAIC’s work on code standardization and noted that the work on code standardization may be housed in a new committee. That committee will be brought up to speed before work can continue. Status information will be a topic at the ICAE Exchange in Williamsburg. |
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