Michael Rowe is the founder of Claims Partners. He has over thirty years of Property & Casualty claim experience. He spent a number of years on the front lines handling multi-line claims and worked his way up step by step ultimately holding a number of senior executive roles with a Fortune 100 Property & Casualty company. He understands the claims process from the ground up and also has considerable experience applying predictive modeling and developing business rules.
As a thought leader, he balances innovation with science and mathematics. His passion is Decision Science, and he is a master of its application to complex systems. He sees major opportunities for data-driven improvements in claims and formed Claims Partners to channel his influence. He has had significant exposure to IT initiatives involving predictive modeling and rules based intelligence and he is a strong advocate for infusing the scientific method, including a clear business objective and quantifiable ROI, into every business activity.
A big decline in both auto accident and severe injury frequency has not produced a corresponding decline in loss costs. The slack has been taken up by inflated soft tissue injury claims fueled by hospital cost shift. Financially savvy hospital administrators and new software that “enhances” billing techniques have overcome claim deterrents so effectively that […]
Tied At The Hip The Property and Casualty (P&C) Insurance and Healthcare industries have a significant opportunity to reduce substantial friction costs and mend their necessary but tenuous relationship. The two are inexorably linked because the latter provides the medical treatment and the former pays the bills associated with Workers Compensation and Automobile Insurance medical […]
Introduction The Property & Casualty Insurance Industry claim automobile appraisal process is highly inefficient, resulting in hundreds of millions of dollars in annual leakage. This leakage is driven by both insufficient quantification of performance variation among appraisal resources and shortcomings in the assignment triage process. This article provides a path from today’s genre-centered, mean-based, macro […]
This is the third article in a three-part series on medical inflation. Previous articles in the series can be found here: Part 1 and Part 2. What Has Held Claims Back? In every domain where statistical rigor has been brought to bear, old paradigms steeped in years of certainty have crumbled overnight. Claims is one […]
This is the second article in a three-part series on medical inflation. Additional articles in the series can be found here: Part 1 and Part 3. Looking Beyond Standard Claim Measures The medical industry uses ICD-9, “diagnostic codes” to represent the nature and severity of injuries within their electronic medical records systems. The parameters for […]
This is the first article in a three-part series on medical inflation. Subsequent articles in the series can be found here: Part 2 and Part 3. The Insurance Research Council reports a huge unexplained increase in medical costs. Claim leaders are all confident that it is not happening in their shops, yet it is happening […]
The SIU Evolution The term Special Investigations Unit (SIU) is often used as a synonym for fraud, and that is a very unfortunate circumstance. Special Investigations Units have become largely detached from general claim departments while fraud has not. In their early days Special Investigations Units were often integrated with and working in close proximately […]
Insurance Research Council Findings A 2008 study by the Insurance Research Council (IRC) identified that auto accident frequency has fallen significantly since gasoline prices began rising in 2000 and at the same time, increasing vehicle safety lowered the incidence rate of serious injuries. In spite of such trends, loss costs were unyielding, sparking curiosity until […]