Claims Business: Davies, Verisk, Insurity and CIRMA

Davies, an International professional services and technology business based in London, as acquired Boston-based TriPlus Service Inc.

TriPlus provides its long term care carrier clients with claims and policy administration management solutions as well as actuarial and claims consulting.

TriPlus will join Davies established Claims Solutions business in the United States, widening its claims and administration offering to include long-term care. Peter Lucas, chief of executive officer of TriPlus will continue to lead the business and report to US Claims Solutions CEO,Matt Button. All of TriPlus’ approximately 200 employees will continue in their roles as Davies employees, the company said.

TriPlus is Davies’ fifth acquisition in 2020. The company began an expansion into North America that began with the purchase of Frontier Adjusters, Inc, a multi-line independent claims adjuster, in September 2019. In October 2019, Davies purchased Alternative Service Concepts LLC, a workers’ compensation and property and casualty third party administrator that serves the United States and Canada.

Davies this year acquired Keoghs, an insurance-focused law firm; Codebase8 an automation and insurance software provider; Citadel & Cedar Consulting, a captive management and consulting businesses, and ContactPartners, which provides customer contact technologies.

Davies employs more than 4,000 people in operating centers in the United Kingdom, Ireland, Bermuda, the United States and Canada.

Verisk has acquired Franco Signor, a Medicare Secondary Payer Act compliance consultant based in Bradenton, Florida, for $160 million.

Verisk, an international data analytics provider to the insurance industry based in Jersey City, N.J., said Franco Signor will become part of its Claims Partners business.

While Claims Partners and Franco Signor have both delivered valued Medicare compliance services for decades, their approaches are very complementary Verisk said in a press release.

“The complexities of Medicare compliance obligations are extremely challenging,” stated Richard Della Rocca, president of claims at Verisk. “With the addition of Franco Signor to the Claims Partners team, we can offer the insight and experience of the country’s top MSP experts under one roof for the benefit of the entire industry and look forward to providing the very best experience and service for our customers.”

Verisk said its Medicare compliance suite includes Section 111 reporting, automated conditional payment processing, and professional administration of Medicare set-asides.

Insurity has formed a partnership with Official Disability Guidelines by MCG, a provider of evidence-based treatment guidelines for several state workers’ compensation systems.

Insurity, based in Hartford, Conn., said ODG’s treatment and return-to-work guidelines enhance the accuracy of the its machine-learning predictive models when forecasting claim severity. ODG data will be used in concert with the Valen Data Consortium, a collection of proprietary transactional and behavioral data specifically designed for analytics.

The consortium contains over $100 billion in premium, including $60 billion in workers’ compensation premium, with data such as risk profile, attributes, policy, submission, and claims history, plus data from over 20 third-party sources, Insurity said.

“This partnership represents the powerful combination of ODG’s industry-leading guidelines and our industry-leading data consortium for workers’ compensation, enabling Insurity to deliver the most robust predictive modeling solutions for insurers,” stated Lance Stewart, head of strategic partnerships at Insurity.

MCG, based in Austin, Texas, is part of the Hearst Health network. The company purchased ODG from the Work Loss Data Institute in 2017.

The Connecticut Interlocal Risk Management Agency, an insurance risk pool created by the Connecticut Conference of Municipalities, has launched a new claims platform that uses software provided by Guidewire.

The new platform, CIRMA ClaimCentral, will significantly enhance the way CIRMA engages with its members, the organization said in a press release. CIRMA ClaimCentral offers integrated workflows and embedded analytics that allow ClRMA claims adjusters to make claim decisions in real time, the organization said.

CIRMA operates two risk pools, the Workers’ Compensation, and Liability-Auto-Property pools. It also provides heart and hypertension claims services and risk management services to self-insured municipalities.